Although the Charter acknowledges the importance of recognising the rather close relationship between obesity and mental health both in adults and children, the focus of this Charter (and the conference leading up to it) was largely on adults.
Now, Shelley Russel-Mayhew (U of Calgary), who spoke a the Toronto Obesity and Mental Health Conference, and colleagues, publish a comprehensive overview of mental health, wellness and childhood overweight and obesity in the Journal of Obesity.
The researchers performed a systematic literature search of peer-reviewed, English-language studies published between January 2000 and January 2011 on this issue. They identified 759 unique records, of which 345 full-text articles were retrieved and 131 articles included in their analyses.
Based on these findings, they propose a theoretical model that reflects the current state of the literature and includes psychological factors (i.e., depression and anxiety, self-esteem, body dissatisfaction, eating disordered symptoms, and emotional problems); psychosocial mediating variables (i.e., weight-based teasing and concern about weight and shape), and wellness factors (i.e., quality of life and resiliency/protective factors).
Based on their findings, they recommend a number of possible solutions to addressing the rise in childhood obesity rates without (importantly!) further marginalize overweight and obese children and youth.
These include increasing mental resilience, stopping the focus on weight, recognising that many weight-related issues are socially constructed and maintained, promoting healthy body images (regardless of size or shape), and targeting positive adult role models.
Thus, the authors conclude that,
“…intervening for the psychosocial emotional health of overweight/obese children should be a focus in and of itself and not just an “add-on” measure to a primary outcome that is targeting weight reduction or the cessation of weight gain. Public health policy in the area of childhood obesity needs to encourage healthy body image, advocate that healthy behaviours come in every shape and size, and consider weight bias and weight and shape concerns as fundamental. In terms of mental health and wellness, this type of shift in paradigm could benefit all children and youth potentially for generations to come.”
Readers will find many of these thoughts reflected in the Toronto Charter and will certainly recognise many of these principles in many of the posts throughout these pages.
Russell-Mayhew S, McVey G, Bardick A, & Ireland A (2012). Mental Health, Wellness, and Childhood Overweight/Obesity. Journal of obesity, 2012 PMID: 22778915