The moral pieces of the child obesity puzzle

If child obesity were simple it would not generate the flurry of articles and discussions it does. Victoria University of Wellington's Snita Ahir-Knight examines two pieces of the puzzle. 

Child obesity has been getting media coverage again. The flurry of articles has been prompted by an international UNICEF report. It is reported New Zealand has the second-highest rate of child obesity in the OECD.

Factors that may contribute to child obesity have been reported to include poverty, a lack of knowing what nutrition children need, food advertising and sedentary lifestyles.

Various solutions have been raised to prevent obesity and help to lose weight, such as practical steps for parents, taxing junk food and sugary drinks, banning food on public transport, and surgery.

Child obesity has also been recognised in the government’s plan to improve child wellbeing and help children out of poverty. The plan, announced earlier this year, includes development of a programme to promote healthy eating and physical activity in schools.

Some pieces of the puzzle

Child obesity is a medical matter. It is a matter for health because being obese may be a risk factor, now and later in life, for health conditions such as diabetes, heart disease and joint problems.

Child obesity is a political matter. It is a matter for policy and politics because wider social and economic factors, such as inequalities, may impact on children being obese.

Child obesity is also a mental and moral matter.

First, the mental

Child obesity is a mental matter because distress may be a link to becoming obese. Erik Hemmingsson is a researcher in obesity who has proposed a new model. His model says emotional distress is a fundamental link between a disadvantaged environment and putting on weight.

It goes something like this – socioeconomic disadvantages cause distress to a child. A child at particular risk is exposed to such things as a lack of support and has unmet emotional needs. The experiences the child faces increase their distress, which may include low self-esteem, negative self-belief and powerlessness. They do not have adequate resilience to cope, so this leads to emotional overload. They cope by eating high calorific foods. Stress negatively impacts on biological weight gaining effects too, such as impacting their metabolic signals. This leads to weight gain. The weight gain causes negative consequences, which makes the distress worse for them. They cope by eating more high calorific foods. Stress negatively impacts further on biological weight gaining effects in their body. This results in their gaining more weight. 

More research is needed to fully test Hemmingsson’s model. But it does not seem far-fetched.

Socioeconomic disadvantages cause distress – the Child Poverty Action Group and the New Zealand Psychological Society examined the negative impact poverty has on children’s mental health. And there is research to show a link between stress and unhealthy eating in children.    

Any initiative to reduce child obesity must not risk ignoring this potential piece of the puzzle.

Disadvantaged environments need to be tackled. And providing the conditions for children to build resilience and coping skills also needs to be considered.   

Second, the moral

Child obesity is a moral matter because being fat is viewed by some as a moral failing by the individual. Once some societies viewed fat people as happy, wealthy and powerful. Those who are fat may now be viewed as unattractive, lazy and sinful - gluttonous. They may be viewed as not conforming to the social norm of being thin and physically fit - they are deviant.

Being fat is stigmatised by many because those who are fat are viewed as individually responsible for their predicament. If they ate healthier and were more active, they would not be fat. Or with children, their parents are responsible for the child’s predicament. If the parents gave their children healthier foods and did not drive them to school, the child would not be fat.

Many may say that sometimes simple solutions are all that are needed. But most often than not, child obesity is much more complex. There is more to the story than individual choices and parenting. It is then not only unkind, but a mistake to stigmatise children who are obese and their parents.

Any initiative to reduce child obesity must not risk - even inadvertently - perpetuating this stigmatising view. Stigma needs to be tackled. And when analysing any initiative, the risk of perpetuating stigma needs to be considered and addressed too.

Complex solutions

If child obesity were simple it would not generate the flurry of articles and discussions it does. I have pointed out two pieces of the puzzle but I am sure there are more. And complex matters require complex solutions.     

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