Talking about change

Over a decade ago, we used to have a campaign in schools which aimed to help children with unhealthy BMIs reach a more desirable body mass index. It was of course a bad idea. For obvious reasons.

That was eventually replaced with a programme which promotes a healthy lifestyle to all children, not just those with undesirable BMIs. Although children who are overweight are still a target for bullies, at least schools aren’t their bit to add to the stigma of being overweight.

These were lessons not learnt, apparently. Because there was a Childhood Obesity campaign in another part of the world a few years ago, which had children talking about their experiences of being discriminated against for their weight. Yes, more airtime to the stigma of being fat.

And if it’s not obvious why these campaigns are counter-productive, there’s research to suggest that it is so. A 2013 study, which asked 1085 respondents to evaluate a number of existing health campaigns, found that the motivation to adopt healthy lifestyle changes and their confidence about doing so was not greater after viewing a stigmatizing campaign compared to a less stigmatizing campaign.

It also doesn’t help that the American Medical Association now considers obesity to be a disease. A recent study found that for people with a BMI higher than 30, this information made them less concerned about healthy eating and more likely to choose a higher-calorie snack, compared to others who were told that obesity is not a disease or given some other unrelated public health information. Giving obesity the disease label, appears to send home the message, “Don’t bother trying to manage your weight through healthy eating or physical activity”.

Given the fact that younger children have difficulties distinguishing children’s TV programming and advertisements, it’s a good thing that fast food advertising is now a thing of the past here. It will not be possible for ads with foods containing too much salt, sugar, and/or saturated fat to reach children aged 12 years and below (read about those guidelines here). Happy meals might have to turn into healthier meals in order to reach their target audience.

There are however other ways to tackle childhood obesity. Here’s advice from the experts for talking to children and adults:

1. Don’t talk about healthy eating
It seems like a good idea to help by talking about healthy eating than body size or weight. But research suggests the opposite. A 2013 study found that overweight teenagers whose parent(s) talked about healthy eating, were more likely to use unhealthy weight-control methods (e.g., throwing up) and to binge eat, than if their parent(s) had talked about their size or weight. In contrast, those whose parent talked about body size or weight, were likely to “diet”. Instead, it might be good to talk about what foods to eat, not healthy eating.

2. Affirm their feelings and provide emotional support
Having a one-time “You can eat more fruits and vegetables. And why don’t you exercise more?” conversation with someone you care about could instill in them a negative attitude about food and exercise. It could make them conscious about their body shape, size and/or weight. It’s crucial that your children know you love them regardless of their shape, size, and weight. Here’s a list of what to say and what not to say for parents.

And telling them that they’re fat (shock tactics) are likely to backfire. Results from a recent study demonstrate the self-fulfilling prophecy: Girls who were told they were fat when they were 10 years old, were at a much higher risk of having a BMI above 30 nine years later. So don’t threaten, judge, and nag. Ask your teenagers and close friends how you can help.

3. Start with small lifestyle changes
Rather than talk to children and teenagers about healthy eating habits, it’s easier to help them be healthy by walking the talk. Parents can feed their families more fruits and vegetables, and store fewer sugared drinks at home (more tips here). Fruits and veggies don’t need to be eaten plain or raw. There are many food ideas to make fun meals with fruits and veggies: try this website for more ideas. Preparing meals together is a great way to introduce healthy ingredients to loved ones. Getting your kids to try everything (at least once) isn’t easy. But it’s worth the effort.

4. Do it together with them
It’s easier to help children and loved ones adopt healthy eating habits and incorporate physical activity into their regular routine if it’s a collaborative decision. This guide for parents advocates making changes as a family. It’s easier to persuade someone to eat healthy and be active if you’re also doing it together with them. Try shopping together for healthy food options. Make the visit to the Bird Park or River Safari a family day outing (it’s more effective than if you sell it to them as fun rather than a chance to exercise).

5. Assess their readiness for change
Making healthy lifestyle changes isn’t as easy as it sounds. Being ready for change can make things easier. But not everyone is equipped for conversations about the motivation for change and how to make those changes. But there are tools to equip health professionals for such conversations. One such tool is motivational interviewing — a “collaborative conversation for strengthening a person’s own motivation and commitment to change“. And in fact, there’s a free app for practicing such conversations. It’s called Change Talk.

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