© 2006 The Author(s).
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Childhood Obesity Prevention—Issues and Controversies
In this special issue of HER, we have attempted to combine several facets of health education theory, research and practice to guide researchers and practitioners in the prevention of childhood obesity and the promotion of child and adolescent health and well-being. The issues raised in this edition are varied and some are very controversial, but all are important to consider before any action is taken to implement preventive initiatives.Important issues include whether or not schools should become involved in the measurement of students' weight for height; how researchers can properly measure and interpret such data while taking into account its many limitations; what to do (or not to do) with any data collected; whether to combine childhood obesity prevention within a broader framework and spectrum of prevention of ‘weight and eating issues’ such as eating disorders, dieting and disordered eating; how to involve parents, teachers, school staff and community members in preventive initiatives and how best to encourage (rather than discourage) healthy eating and physical activity in children and adolescents, particularly among girls. These, of course, are enormous questions to ask, but the contributors to this special edition certainly have the experience, expertize and success to address such vital questions about program design and intervention.
We begin this issue with a detailed explanation of the different childhood overweight and obesity definitions and the prevalence and measurement constraints written by world expert(s), Katherine Flegal (and her colleagues) from the Centers for Disease Control and Prevention and the US Centre for Disease Statistics. Flegal clearly outlines the uses and limitations of various methods of measuring weight for height in children and adolescents. This paper is particularly helpful in clarifying the difference between measurement of weight for height for public health surveillance, screening and monitoring purposes versus measurement by health professionals for the purpose of health risk assessment and diagnosis. As health educators and health promoters, we need to clearly understand the uses and limitations of such methodologies.
The second paper in this special issue deals with a very important issue in school health education and school-based health promotion and it is probably the most controversial issue at this stage in the childhood obesity prevention debate worldwide. The paper by Joanne Ikeda and her colleagues, examines the practice of school-based assessment of height and weight and the issuing of ‘BMI report cards’ to parents. The potential benefits and risks of such practices are outlined in this paper and the experiences of some schools from the United States are presented.
The theoretical and practical reasoning for an integrated approach in the prevention of obesity, eating disorders and disordered eating is convincingly argued by Haines and Neumark-Sztainer. With many years of extensive research and program implementation experience in all these three research areas, these authors are suitably positioned to make such proposals for a preventive approach that incorporates the prevention of a spectrum of eating and weight issues in a health-promoting environment.
These are all controversial, yet vital issues for anyone planning a childhood obesity prevention program and we are fortunate to have such world-class leaders in the field to share their perceptions with us.
Also in this issue, thorough reviews of the literature on the methodological issues in childhood obesity prevention programs (see review paper by Thomas) and physical activity (Rees, Allender, Gillison) are presented and the role of parental feeding style (Arrendondo), schools and the views of lay people are discussed (Worsley). Some successful and highly relevant interventions are presented and discussed, including the importance of providing breakfast programs (O'Dea and Wilson), reducing weight- and shape-related teasing and finding ways to motivate inactive adolescents (Brooks, Ward).
Finally, the successful outcomes of school-based interventions among Belgian schoolchildren (Haerens) are presented. These results are very promising and illustrate how the whole school community can collaborate to promote health among young people. I hope you enjoy this special issue of the journal as much as I have enjoyed serving as the Guest Editor.
Guest Editor/Associate Editor, Faculty of Education and Social Work, University of Sydney, Australia
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