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Living and Being Well in New Brunswick



New Brunswick, one of Canada’s three Maritime provinces, home to about 800,000 (with a large Francophone minority), certainly has an obesity problem of its own – 34% of its children and youth (ages 2-17) are overweight or obese, much higher than the Canadian average of 26%.

So, not surprisingly, obesity is high on the list of reasons why this province has an official wellness strategy – interestingly, however, it is a strategy that does not focus on nor, for that matter, even makes ‘losing weight’ or ‘reducing obesity rates’ part of its objective.

Rather, this strategy takes about as ‘holistic’ an approach as I have yet seen in a policy document.

Thus, the public document with the title “Live Well – Be Well“, which outlines the 2009-1013 wellness strategy for the province – is exactly that – a wellness strategy – for all New Brunswickers – irrespective of body weight or size!

In case any one is wondering, the document speaks to seven dimensions of wellness:

Emotional: The ability to understand ourselves and cope with the challenges life can bring.

Mental/Intellectual: The ability to open our minds to new ideas and experiences that can be applied to personal decisions, group interaction and community betterment.

Physical:The ability to maintain a healthy quality of life that allows us to get through our daily activities without undue fatigue or physical stress.

Social: The ability to relate to and connect with other people in our world.

Spiritual: The ability to establish peace and harmony in our lives.

Occupational: The ability to get personal fulfillment from our jobs or our chosen career fields while still maintaining balance in our lives.

Environmental: The ability to recognize our own responsibility for the quality of the air, the water and the land that surrounds us.

Central to the strategy are four pillars, the first of which (mental fitness and resilience) is seen as being fundamental to the other three pillars, namely improving healthy eating, physical activity and tobacco-free living.

In this context, the document explains the term ‘mental fitness’ Mental fitness as follows

…a state of psychosocial well being that goes beyond the absence of disease or sickness. It means having a positive sense of how we feel, think and act which improves our ability to enjoy life. It also implies the ability to efficiently respond to life’s challenges, and effectively restore and sustain a state of balance (e.g., through stress reduction practices, investing in friendships and healthy relationships, learning to become one’s own best friend, building new skills, seeking out support and information to take control over one’s health).

 

Having a higher level of mental fitness enables us to more fully enjoy and appreciate our environment and the people in it. When mental fitness needs are sufficiently met, people become more self-determined. They adopt behaviours that contribute to their own personal wellness and that of others, and they make healthier choices. Mental fitness is also reinforced by the messages we receive within our environments regarding the potential to make positive changes.

Resilience, on the other hand, means

“…the “ability to persevere and adapt when things go awry” (Reivich, K. & Shatté, A. 2002). It is a person’s style of thinking that determines resilience, more than genetics, intelligence, or any other single factor (Shatté, A. J. 2002). Resilience is influenced by the number of positive assets we have in our lives such as positive relationships, experiences, and inner strengths such as values, skills, commitments, etc. Thirty years of research tells us that resilient people are healthier, live longer, are more successful in school and jobs, are happier in relationships and are less prone to depression (Reivich, K. & Shatté, A. 2002).”

The plan seeks to promote this virtuous goal of improving mental fitness and resilience by addressing the needs of autonomy, relatedness and competency, which, according to the plan requires

“Addressing such need areas requires heightening a sense of belonging in the workplace, schools, communities and homes or setting (relatedness), building on existing strengths and capacity (competence) and involving individuals directly in determining the actions that will ultimately contribute to their own health and well-being (autonomy).”

(Faithful readers may recall my previous post on self-determination)

In case anyone is wondering about how NB plans to measure the success of these measures:

The key indicators are pro-social behaviours, oppositional behaviours, susceptibility to tobacco and connection to school – all of which will be measured through the NB Student Wellness Survey.

Readers may also be interested to note that even in the pillars healthy eating and physical activity, in fact nowhere in this document, are any of the indicators or measures related to reducing obesity or worrying about body weights.

This is probably as close a strategy aligned with the notion of ‘health at every size’ as I have ever seen in an official policy document (if there are others, I’d sure like to hear about them).

Will this plan also reduce obesity rates? This probably remains to be seen, but, no matter what happens to body weights, if this strategy works, New Brunswickers should turn out to be a rather healthy, happy, and resilient lot.

AMS
Edmonton, Alberta

Hat tip to Isabel Savoie for pointing me to this plan.

11 Comments

  1. Dr. Sharma, thank you so much for sharing this information. I am glad to see that we are moving toward the right direction. It is sometimes hard to see the light at the end of the tunnel but I strongly believe in the importance of having a holistic approach and the importance of wellness to help reduce the burden of illnesses and obesity on our province.

    I am more than open to speak with anyone who’s interested in the Wellness Strategy (isabel.savoie@gnb.ca) and I will be happy to share information about various initiatives that we have to support the Wellness Strategy, such as the NB Wellness Movement @ http://www.wellnessnb.ca

    In conclusion, feel free to like us on facebook @ New Brunswick Wellness / Mieux-être Nouveau-Brunswick where you can find resources such as webinars, links and information related to wellness!

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  2. Thanks for the heads up. Sounds like a great document. I couldn’t get over the irony of placing the tip in the context of your first paragraph, however, which makes it clear that you are not coming from a Health at Every Size (HAES) perspective. As you describe, it’s a wellness program and from what you wrote, that’s what it addresses: wellness, not weight. The problem for me came from your introduction, where you are framing it as a way to address an “obesity problem.” The Health at Every Size movement suggests that people stopping framing it as an “obesity problem” and instead get consistent with the HAES program strategy you are endorsing. That so many people are “overweight” or “obese” says more about the somewhat arbitrary definitions of these terms than it does about health. The problem, as per the HAES movement, is not the “obesity”; HAES is instead concerned about health, which is what a Wellness program should be – rather than invoking the weight stigmatization implied in citing an “obesity problem,” which in and of itself negatively impacts on health.
    Thanks again for the alert – sounds like a great program.

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  3. @Linda – I am definitely not coming at this from a HAES perspective – I still believe that when excess body fat becomes a health problem it should be treated (read: ‘reduced’) to the best of our ability under full consideration of medical risk/benefit ratios. On the other hand, I am the first to agree that ‘health’ cannot be measured by simply stepping on a scale, BMI has no role in individual counselling, that anyone at any size can get a lot healthier by feeling better about themselves, finding work-life balance, and lead as healthy a life style as they can enjoy – rather than worrying about their weight (yes, you can be perfectly healthy over a wide range of body sizes). I am also the first to agree that the pursuit of ‘weight loss’ simply for the sake of losing weight is destructive, misguided, and potentially more harmful (physically, mentally, economically, and perhaps even spiritually and environmentally) than simply being the healthiest you can at your current weight. Obesity treatments (different from simply losing weight – but that’s another nuanced discussion) should be reserved for those individuals, whose health and well-being is either directly or (in some cases) indirectly affected by their excess body fat. Unfortunately, because for many people (both within the ‘normal’ weight and ‘obese’ range, ‘excess’ or simply ‘ectopic’ body fat actually does affect their health and well-being, it does become a health problem. This is then (by definition) a medical problem that requires medical diagnostics and medical management. This is not ‘medicalising’ obesity – this is ‘medicalising’ a very real health problem that exists for that individual – the individual decision to treat or not to treat becomes a medical decision between that patient and their doctor (who hopefully knows what she/he is doing).

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