As public health researchers who’ve worked with government, non-governmental organisations, schools, childcare organisations, families and children to understand the complexity of obesity and effective healthy public policy, we find the article “F for fat” in today’s Fairfax papers both deeply disappointing and disturbing.
The article quotes former University of Melbourne vice chancellor David Penington suggesting that putting children’s weight on school report cards and linking them to physical education teachers would make an impact on childhood obesity rates.
Penington, a high-profile academic who is very experienced in chairing public health initiatives and leading strong research foundations, is floating an initiative that runs counter to the evidence accumulated from over 15 years of careful, dedicated research that spans child health, obesity prevention, and community partnerships. The notion that including a measure of fatness would make a significant impact on childhood obesity, and that conversations with a physical education teacher might be a solution is not a new idea – but it is a bad one.
Connecting a stigma-related concept to reported indicators of learning and development – while it may appear simple and likely to shock parents into action – would be flawed, harmful, and unethical. In research conducted by ourselves or colleagues, parents have pulled out of studies, torn up parental feedback, and contributed to significantly reduced participation rates at the mere mention of individual reports.
There is a role for monitoring and measurement as a support for managing weight, provided it’s done in a way that promotes positive body image with an emphasis on taking care of your general health. And, for children, this also needs to be done in the context of their environments. That has to promote healthy food choices in schools that aren’t dependent on McDonald’s or Coles for their physical activity equipment, and where there are transparent fund-raising policies and no more chocolate drives.
Today’s Fairfax article quoted Obesity Australia chairman John Funder as saying Penington’s report card idea would need to be implemented “sensitively”.
Obesity Australia is a new initiative established to provide an advocacy platform and has the potential to step obesity prevention up, but it’s extremely difficult to find out anything about it. It doesn’t yet have a website, its advisory committee membership is unclear, and its charter or experience in obesity is even more opaque.
A meeting this week held by Obesity Australia featured a range of speakers, so their report of what else was said and discussed would help assess whether it could make a meaningful difference to national anti-obesity efforts.
What we do know is that it includes experienced medical leaders who confer a perception of expertise, and that makes it even more important that it forms plans and strategies to advocate in ways that not only maximise health outcomes, but that these strategies are ethically sound and do no harm.
More than 15 years after the obesity epidemic was first reported, and when significant investment in research into how to stop it began, Australia is in the extremely fortunate position to have a strong repertoire of relevant evidence on what will work. Sadly, the initiatives that we know to be effective are usually not the ones that are sufficiently funded.
We have great evidence clearly showing that:
prevention works, especially in settings where children and families can avoid sugar-dense processed foods with high levels of sugar and fat;
a third of children are affected by obesity in areas more likely to be disadvantaged – with lower employment, lower school completion rates, lower average income and where schools are less likely to have resources for promoting physical activity;
sweetened drinks contribute to obesity levels ;
overweight and obese children are more likely to be stigmatised, and already have lower quality of life; and
the food and beverage industries are using strategies that appear to be socially responsible in order to ensure sales of their most profitable items.
And while levels of physical activity have clearly fallen over time and this is one of many factors involved in obesity prevention, physical education alone is not sufficient to address the complex determinants of obesity.
Raising the fear in parents' minds that their children will be measured, without highlighting the need for industry to stop misguiding them with a focus on physical activity, is unethical, dishonest and not in the best interests of children. If anything, it has the potential to increase obesity by side-stepping the discussion of the role of soft drinks, energy-dense foods, and advertising in the obesity epidemic.
Perhaps what would be a more effective thing to have on children’s report cards is what they are exposed to in their environment, such as easy access to sugar-sweetened drinks in their learning environment, Coles vouchers as rewards, and fast food companies linked to physical activity programs.
Measures that will make a difference are engaging children and young people in solutions, normalising healthy environments and understanding the needs of parents and families, making links between industry and the learning environment transparent, and leadership and advocacy that pays attention to evidence.
Anything else is a waste of time, money and public attention.
John Zigar
Researcher
I find it unbelievable that authorities stick their noses more and more into people’s private business. It’s absurd that children be scrutinised for fat and this be noted on a report card. Old, and I mean old, John Funder has made it a habit to front government bodies. Go away John! It’s about time he retired. Rather than create serious self-esteem issues for young children, ban junk food at the tuck shop and ban advertising at school. I already had several arguments with my child’s school as they…
Read moreLorraine Brown
retired
John I agreed with you up to the point when you said "sack fat teachers". When will people realise that being fat has nothing to do with how inltelligent you are or no one would be fat.
There is quite enough discrimination now without not being allowed to teach because someone presumes you are too fat.
John Zigar
Researcher
Lorraine, I stand corrected, I actually meant that if 'fat' teachers were to write reports on 'fat' kids then perhaps the 'fat' teachers should get sacked. You can't have it both ways. There are more important things to focus on in society, such as smoking and drinking.
Colin MacGillivray
Retired architect
Good article, you said-
"We have great evidence clearly showing that:.... avoid sugar-dense processed foods with high levels of sugar and .....sweetened drinks contribute to obesity levels...the food and beverage industries are using strategies that appear to be socially responsible in order to ensure sales of their most profitable items."
So what to do about the main culprit?
Higher gst, plain bottles, with gruesome pictures of diabetic feet?
Only the government can act, so why not?
Jo Salmon
NHMRC Principal Research Fellow
Well written Liz et al. Another obvious and previously debated flaw with this report card approach (agree this is NOT a new idea) is that we provide the report card to parents...and then what? Parents and children require educational support for healthy lifestyle choices as well as supportive environments promoting physical activity and healthy eating. Reducing time children spend sedentary throughout the day is also critical.
The notion of referring parents to PE teachers (assuming they have the time & skills for counseling families) is absurd given so few primary schools have the luxury of a specialist PE teacher. A government serious about tackling childhood obesity in Australia would ensure that ALL schools were funded to employ full-time PE teachers.
Judith Olney
Ms
I would also like to see government fund extracurricular physical activities for children as well as PE teachers. That way all children regardless of the SES would be able to participate in sport after school hours.
Perhaps, rather than spending money on school kids bonuses, and baby bonuses, the money would be better spent on giving families access to free sporting equipment, and allowing them to utilise school equipment and grounds after school hours.
I live in a low income area, but the…
Read moreRosemary Stanton
Nutritionist & Visiting Fellow at University of New South Wales
Thank you for this article.
I absolutely agree that we need to avoid blaming the victim here. Let's put the blame where it belongs.
Read more1. On schools that consider the profits from selling junk food (either at the canteen or through fund-raising drives using donuts or chocolates) more important than their educational role.
2. On education departments that under-fund schools, forcing them to raise funds in this way.
3. On companies that target schools through offering junk food for fund-raising…
Judith Olney
Ms
Rosemary, I totally agree with the points you raise, it sickens me to see blanket advertising for KFC, Hungry Jacks etc etc, whenever there is a national sporting event taking place, knowing that children are watching these sporting events as much as adults, not to mention the alcohol advertising, (big problems with this that are rarely acknowledged).
I also think the cost of sport for children is a deterrent for parents on low incomes, and children learn to become watchers instead of participators…
Read moreElizabeth Waters
Jack Brockhoff Chair of Child Public Health at University of Melbourne
My understanding from their meeting this week is that Obesity Australia has partnerships with Coles, Allergan and BUPA because of the significant co-branding on the documentation, but I haven't been able to confirm this.
Meg Thornton
Dilletante
I was always a plump kid growing up - I had a brief skinny period when I was about eight (the result of a sudden growth spurt). Basically, in me it was most likely the result of both genetic (two out of four grandparents were short and stocky; my maternal grandmother had a body type almost identical to mine) and psychological factors (both of my parents were depressed, and I learned how to comfort eat very early on in life).
I was shamed for my weight in my home environment. I was shamed for…
Read moreComment removed by moderator.
Chris Gillham
Journalist
A measure that would profoundly impact child obesity and health would be to stop threatening them with punishment for having fun enjoying exercise the way they want to ... i.e. repeal mandatory bicycle helmet laws.
Australia and New Zealand have suffered similar disastrous results from helmet laws. Read the New Zealand data at http://www.cycle-helmets.com/new-zealand-helmet-disaster.pdf
Re teachers being fat - it's almost guaranteed they're fat because Australia has become one of the fattest nations on earth since regular recreational cycling exercise was made uncomfortable, inconvenient, more dangerous and a punishable offence.
Before launching a standard tirade against this comment, claiming you and/or somebody you know would be dead without a helmet (a claim that simply reinforces the points made by helmet law critics), read the New Zealand results and pay attention to the evidence.
Jeff Anderson
Health instructor
Child obesity is now being one of the most complex terms in the society, so childcare organizations as well as other health organization are worried to get the proper remedies of childhood obesity. Although hit doesn't have any perfect cure only awareness is the best medicine to cure childhood obesity we should understand the diet and physical workout importance to control the facts to obesity.
http://www.medifasthealth.org/weight-loss-tips/healthy-weight-loss-just-one-change/