Jennifer A.O Dea. Dealing with child & adolescent weight issues body image concerns, eating disorders & child obesity. MPH, PhD

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1 Jennifer A.O Dea MPH, PhD Dealing with child & adolescent weight issues body image concerns, eating disorders & child obesity 10th Conference of the Association For the Welfare of Child Health Parramatta, April 28-29, 2005

4 Trends in Overweight Over past 20 years Child Obesity has tripled and continues to rise 1.6% in 1989 to 5% in 1995 (Magarey et al, 2001, Medical Journal of Australia) 6% primary school & 7% high school (O Dea, 2003, Medical Journal of Australia) Overweight 10% in 1989 to 15% in 1995(Magarey, 2001) Overweight 19% primary school & 17% high school (O Dea, 2003)

5 Disordered eating appears to have increased Anorexia Nervosa fairly stable at 1-4% but disordered eating has increased vomiting, laxatives, strict/fad dieting, pills, smoking 50% of year 9 girls use at least one method in past 12 months 35% of year 9 boys Croll et al, Jour Adol Health, 2002.

10 Body Image Improvement, Eating Disorder Prevention & Child Obesity Prevention? The same kettle of fish? They are Interrelated Issues They Predict Each Other

11 Prevention of Child Obesity - First, Do No Harm (O Dea, Health Education Research, 2004)

12 Prevention Vs. Treatment Clarifying the role of education and health professionals The absence of obesity does not guarantee a healthy child physical, mental, social health Child obesity prevention should not dominate the overall picture of child health

13 Inadvertent suggestion of dieting and other weight loss techniques

15 Avoid further Stigmatization, Prejudice and Discrimination * Big children are aware of their weight status and the associated stigma and bias * Bias among health professionals * Inadvertent discrimination * Effects on self esteem

aware of potential damaging effects of unintentional verbal and

16 Transference and Misinformation Health professionals need to examine their own attitudes towards overweight individuals Be aware of potential damaging effects of unintentional verbal and non-verbal prejudice Recent study of teachers (Yager & O Dea, In Press)

17 Undesirable outcomes of unplanned approaches All preventive initiatives must be properly designed, pre-tested and evaluated

18 Avoidance of health services Overweight adults are less likely to visit health professionals Preventive efforts that focus on weight are likely to produce a similar response You can t help people if they don t come back!

19 Avoidance of Physical Activity Perceived lack of athletic ability Barriers to participation Forced involvement

20 Blaming the victim Current media panic Also a Moral Panic - judgemental guilt, blame, shame Racist & Classist

21 Further marginalizing low SES Association between lower SES and obesity is well documented O Dea, MJA, 2003 and O Dea et al, In Press Avoid taking judgmental, moralistic approach

22 Obesity as a sick role Fat people are not necessarily sick Good nutrition and physical activity are not just for obese children Weight Loss Drugs for children are not recommended

24 Using Sound Health Education Theory & A Positive Approach Motivating healthy eating and exercise Ecological, environmental and holistic approaches Health includes physical, social, psychological, emotional, spiritual Promoting a healthy school environment in many different ways

25 Some Issues for Schools and Curriculum Teasing & Bullying Training for teachers, coaches, health professionals Early detection & referral of eating disorders Choice of healthy food, drinks & fun PE Modest sports uniforms and swimwear Privacy in change rooms and showers Communities

26 Some Specific examples of the positive, self acceptance, self esteem approach

27 Understanding growth,development & puberty Male/Female differences Concept of weight for height Concept of health at any size Many broad benefits of healthy eating and physical activity O Dea, JADA, April 2003.

29 Changing nature of fashion How marketing works and why fashions need to change each season How pictures are perfected using computers How fashion runs in cycles Self acceptance amid pressure to conform

34 Positive rather than negative nutrition education Avoid good foods/bad foods Focus on nutrient density Not just calories Avoid guilt, blame, shame Encourage food skills

37 Media Literacy that ends with self acceptance Analysis of how the media operates Analysis of media stereotypes Discussion of how the pursuit of perfection is a futile quest when human! Values about Everybody s Different and self acceptance,tolerance of others, valuing uniqueness

48 Everybody s Different Intervention O Dea & Abraham, 2000, International Journal of Eating Disorders, 28,

52 Self Esteem Activities Build sense of self worth; self esteem; respect of self and others; reduce perfectionism; tolerance of others.

54 Examination of gender and media stereotypes Reject stereotypes; reinforce value of individual differences and acceptance of self and others.

55 Research Results

Keeping a Healthy Weight & Nutrition Guidelines. Mrs. Anthony

Keeping a Healthy Weight & Nutrition Guidelines Mrs. Anthony The Ideal Body Weight Myth Average female model: 5 10, 120 lbs Typical American Adult Female: 5 4, 160 lbs Average male model: 6, 155 lbs Typical