4th June, 2018
This subject comes up a great deal. I have spoken with various radio programme presenters over the years and from time to time it is an aspect of individual cases with whom I have been involved. In 2011 I was the educational psychologist representative member of a cross- divisional working group involving clinical, health, counselling and academic psychologists chaired by Dr Julia Walmesley, Director of Psychology and Counselling at the University of Northampton. I wrote the chapter on obesity in children for the Paper that was produced by the group ‘Obesity in the UK: a psychological perspective’ with the help of my clinical psychologist daughter, Dr Ella Cullen. The paper, which is packed with references, can be found on the BPS website: https://www1.bps.org.uk/system/files/Public%20files/Policy/obesity_in_the_uk_-_a_psychological_perspective.pdf
In summary, the chapter drew on a National Children’s Bureau information sheet on obesity in children and young people (NCB Highlight No. 250,by Reilly, 2009) and other literature and covered the extent of the problem and also possible interventions. Here is an extract from the conclusion:
“Many psychological reasons lie behind the choices that are made in relation to diet and activity. These include individuals’ personal habits and behavioural choices and the wider societal influences as well as some individuals’ experience of serious trauma, such as child abuse. A large number of factors contribute to the development of obesity and its maintenance. These factors interact in a complex way and so interventions need to be tailor-made for the individual. The psychosocial effects of obesity are again not clear-cut, but mental health, achievement, social status and self-esteem may potentially be affected and therefore, awareness of this possibility is important.
The most important goal for managing obesity in children and young people is that of weight maintenance and this is a long-term venture. A holistic approach needs to be taken to intervention as simplistic interventions that target one form of sedentary behaviour” (e.g. excessive television watching) “have not been shown to be effective. It is preferable to provide appealing opportunities to be physically active and to eat more healthily and thereby encourage intrinsic motivation to make lifestyle changes as there is greater likelihood of these behaviours being maintained. Care needs to be taken so that an unhealthy preoccupation with weight is not encouraged and so that the possibility of stigmatisation is not increased. Firm rules and occasional treats are the ideal diet strategy, along with an unwavering emphasis on the positive rather than any form of criticism or communication of failure. In relation to this, psychologically based interventions should fully utilise positive psychology approaches.”
The conclusion goes on to highlight the need for more input by professional psychologists, both academic and applied, and in so doing to create:
“long-term behavioural change and the promotion of children’s positive self-esteem and increased confidence. They should also offer support to address possible bullying, to improve family communication and to provide parental support and empowerment.”
It also makes the point that children and young people need to be consulted and for parents to be fully involved.
If I had to select one priority for addressing the psychosocial issue that childhood obesity undoubtedly represents it would be this last point. Children’s main teachers and role models for how to make healthy food and lifestyle choices are their parents and carers. If parents can be supported in being better informed about nutrition and dietary choices, participation in exercise and activity and generally living lives that support their own physical and mental wellbeing they will bring their children along with them. This way is not a top-down, add-on, prescriptive strategy and is therefore most likely to embed itself into individuals’ and the nation’s mind-sets and daily lives but it will take time. Most complex social/psychological problems have developed over time and therefore the solutions are always going to take time as well. Government, particularly the Department for Health and the Department for Education, has an enormous capacity to recognise and support this complex change as long as it resists short-term, simplistic and quick-fix solutions, however well-intentioned.