Thursday, September 27, 2012

A Northern Approach to Childhood Obesity?

Earlier this week I posted on the rather innovative and forward-thinking Position Statement on obesity prevention and management published by British Columbia’s Northern Health.

The following passage from this document, here referring to approaches of dealing with childhood obesity illustrates just how different the recommendations and conclusions are from the current line of thinking in most constituencies:

“…Weight seems to dominate current initiatives directed at children and youth and the long-term impacts of a weight-focused approach must be considered against a health-focused approach. In a weight-focussed approach, there is potential to do more harm than good (e.g. long-term risk for developing disordered eating, impacts on body image and self-esteem). Moreover, normal weight children may also have unhealthy behaviours while obese children may have healthy behaviours. The Canadian Measurements Survey does not support that obese children are any less active than their normal weight counterparts [note, a recent statement of mine to this effect can be found here].

The surveillance and screening of children and youth in schools and other community settings can be problematic. While information collected may be shared with parents to motivate them to take action on their child’s lifestyle and/or seek support from the health care system as appropriate and/or motivate educators and communities to support healthy lifestyles, the benefits of this practice are not clear. Schools and communities may not have the necessary resources to support children identified as being at risk; they may not be adequately resourced for data collection, information dissemination, ort to help interpret or apply the data ( e.g., appropriate tehcniques and equipment, ehtical and sensitive communication). It is also unclear if this practice is effective for determining abnormal or normal growth.

Harms are also documented in screening settings such as schools. Harms may include the adoption of a dieting mentality, increased stigmatization of obesity, lowered self-esteem, increased body dissatisfaction and disordered eating. Health messaging to children, youth and their parents must focus on supporting optimal growth, development and health, rather than a weight based approach for the purpose of avoiding obesity.”

Just compare these careful statements (referenced in the original document) to the recent shock, shame, and blame approach taken in Atlanta- quite the contrast!

It may be too early to know which approach will reduce harm but I’d be happy to place my bets with the Northern approach.

I’d certainly like to hear from my readers if they are aware of similar statements from other jurisdictions and if they agree with this ‘soft-ball’ approach to childhood obesity.

AMS
Edmonton, Alberta

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2 Responses to “A Northern Approach to Childhood Obesity?”

  1. Darliene Howell says:

    Shaming and stigmatizing fat people will do nothing to positively affect the health of the populace. Three 2011 studies confirm these facts.

    The study Obesity in the News: Do Photographic Images of Obese Persons Influence Antifat Attitudes? indicated that participants who viewed the negative photographs expressed more negative attitudes toward obese people than did those who viewed the positive photographs. Implications of these findings for the media are discussed, with emphasis on increasing awareness of weight bias in health communication and journalistic news reporting.

    The study Weight Stigma: Health Implications relates that weight stigma:
    • Compromises psychological well-being
    • Is NOT an effective motivator for lifestyle changes
    • Affects healthcare

    The study The Stigmas of Obesity: Does Perceived Weight Discrimination Affect Identity and Physical Health? reveals that perceived weight discrimination is found to be harmful, increasing the health risks of obesity associated with functional disability and, to a lesser degree, self-rated health.

    I would like to recommend the free NAAFA Child Advocacy ToolkitSM (CATK) and other written guidelines/resources. The NAAFA Child Advocacy Toolkit shows how Health At Every Size® takes the focus off weight and directs it to healthful eating and enjoyable movement. It addresses the bullying, building positive self-image and eliminating stigmatization of large children. Additionally, the CATK lists resources available to parents and educators or caregivers for educational materials, curriculum and programming that is beneficial for all children. It can be found at:
    http://issuu.com/naafa/docs/naafa_childadvocacy2011combined_v04?viewMode=magazine&mode=embed

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  2. Anonymous says:

    Tackle the alcohol problem first.
    I am the child of an alcoholic, I know what I’m talking about.

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