What would you do if you could take a pill while pregnant and greatly reduce your child's chance of becoming obese as an adult?
It may sound fantastical, but that is the option being given to morbidly obese pregnant women in four British cities as a result of an NHS trial to try and counteract the "programming" that babies receive in the womb. In the case of pregnant women who are obese or have gestational diabetes, too much insulin is made, meaning babies get too much nutrition, and are born overly large themselves.
Being born very large as a result of this kind of atmosphere in the womb is correlated with becoming obese as an adult. And the last thing populations need, according to health authorities, is even more obese and/or type 2 diabetics. The treatment being proposed in this trial is to give the pregnant woman an everyday diabetes drug, Metformin, which lowers levels of insulin in the pregnant woman and may also help redistribute fat which might otherwise form problematically around the vital organs of the unborn child.
But the trial is not without its critics. For some, the issue is one of massive over-medication, of 'Big Pharma' finding a new, potentially lucrative consumer base (if the trial becomes successful). They point out that not all large pregnant women are either obese or diabetic - some give birth to small and average children who are the absolute pictures of health. Why should they be medicated?
For others, it's basically society giving up on the idea that we can somehow encourage and coerce people to follow a more healthy diet, and medicating the problem away without looking at the more fundamental causes of obesity (diet, exercise and so forth).
Certainly there are more and more large babies being born to larger and larger women, leading to a whole new suite of health problems and birthing risks. It costs money, in terms of the pregnancies themselves, but also down the track when seemingly an even bigger swathe of our population will be type 2 diabetics.
Like the current proposal from a diabetes specialist in South Auckland that obese people be 'treated' with gastric banding as the cheapest, quickest, and most successful option to weight loss, this issue of treating of obesity in the womb seeks to acknowledge the basic fact that humans are not going to drastically, in large numbers, modify their dietary habits - even when their own pregnancies and children may be at risk.
I'm sure the UK trial will be watched eagerly by all countries struggling to contain health costs, including New Zealand.