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Psychological considerations in childhood obesity Physical Education and Childhood Obesity Seminar A

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Centile curves are spaced two thirds of z score apart. (Cole et al. 2000) 0 ... Run the class through a series of fitness tests to show them where they are poor ... – PowerPoint PPT presentation

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Title: Psychological considerations in childhood obesity Physical Education and Childhood Obesity Seminar A


1
Psychological considerations in childhood
obesityPhysical Education and Childhood Obesity
SeminarAssociation for Physical Education2nd
May 2007Daventry
Professor Ken Fox Exercise, Nutrition and Health
Sciences University of Bristol
2
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3
Diversity among young people
4
Childhood obesityPrevention, treatment or both?
  • Prevention requires either
  • a targeting strategy to identify those at risk of
    becoming obese
  • or a broad sweep strategy that has potential
    benefits for all
  • Treatment assumes an identified population and
    special provision

5
Centiles for body mass index for British males.
Centile curves are spaced two thirds of z score
apart. (Cole et al. 2000)
6
PhilosophyWhere do you stand?
Some All Children Children
A
B
Performance Health
D
C
7
What are the overall aims for either obesity
prevention or treatment?
  • Facilitate energy balance through physical
    activity and healthy eating
  • Facilitate healthy attitudes towards physical
    activity

8
Energy balance
Energy intake
Energy expenditure
9
Facilitating increased activity
  • Organised sport and play at school
  • Active informal play inside school
  • Organised sport and play outside school
  • Active travel
  • Active informal play outside school
  • Reduced sedentary time

10
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11
  • UK
  • Sweden
  • Germany
  • Switzerland
  • Denmark

12
Mean CSA counts per minute for non-overweight Vs
overweight boys during the week
13
Mean CSA counts per minute for non-overweight Vs
overweight boys during the weekend
14
Not all obese children are low in activity
15
Are children who walk to school more active the
rest of the time?
Cooper et al., American Journal of Preventivc
Medicine, (2003)
16
What we need
  • More young people involved in sports and active
    past-times
  • More walking and cycling
  • More active play at school and out of school
  • Reduced time spent sedentary (watching TV etc)
    for some children

17
The active school will have
  • A healthy/active school committee and policy
  • A comprehensive activity provision
  • A working active transport scheme
  • Safe routes to and from home
  • Facilities for active play at break and lunch
  • Wide range of extra-curricular sports and
    exercise opportunities
  • Extensive intramural programme of activities
  • Strong links with community sport and exercise

18
2. Facilitating healthy attitudes to physical
activity
19
Of obese 9-10 year olds.
  • Acutely aware of being fat
  • For most, overfatness has not yet become central
    or had a deeply detrimental effect on their
    mental well-being
  • They are beginning to use coping strategies to
    deal with the negative aspects of being overfat
  • They feel they are making changes in their eating
    and activity to put things right
  • These may be intentions only and not translated
    into consistent behaviours
  • They are receiving little assistance from parents
    and teachers about how to deal with their
    overfatness problem
  • They see friends as an important element of
    support.
  • Fox K.R Edmunds, L.E., . (2000) Understanding
    the world of the fat kid Can schools help
    provide a better experience? Reclaiming
    Childhood and Youth, 9, 177-181

20
LIFELONG PHYSICAL ACTIVITY
Long term objective
ACTIVE IDENTITY Can
I do it? Is it worth it?
Perceptions of Attitudes,
beliefs, competence/control
rewards, values
Psychological objectives
Primary objectives
Physical Physical
Health Skills Fitness
Skills
Fox Biddle, BJPE, 1987
21
Self-esteem needs
  • Competence
  • Autonomy and control
  • Significance and importance
  • Love and regard
  • Affiliation
  • Multiple meaningful resources
  • (Baumeister, 1993 Cloninger, 1999 Deci Ryan,
    1995, Epstein, 1973, Rogers, 1951)

22
How do children see themselves?Can I do it?
  • Young children
  • Older children
  • Adolescents

23
Identity development in 6-9 year olds The
behaviourist stage
  • Start to develop perceptions of ability in
    different areas
  • Self-judgements based on what can be seen and
    easily assessed
  • Simple self-perception profiles
  • Rely on parents and teachers for information
    about self and performance

24
Identity development in 6-9 year olds The
behaviourist stage
  • Success results from trying hard if I won it
    was because I tried hard
  • Optimistic view of ability
  • No real sense of general worth or integrated
    identity
  • Highly motivated by the here and now and to
    impress important others such as teachers.

25
Identity development in 9-12year olds The
social psychologist stage
  • Increasing ability to judge self in many areas of
    life multidimensional self
  • Use social comparison with peers to assess
    personal abilities and performance not very
    accurate
  • Development of a differentiated view of success
    effort does not always work so there must be
    something else ability
  • Measurable sense of worth and depression is
    possible
  • Generally well motivated but signs of withdrawal
    where they believe that their ability does not
    work

26
The bucket theory
High ability
Limited ability
70 of effort
Full of effort
27
Learned helplessnessNo matter how hard I try it
does not seem to make a difference!
  • Example Wayne is an overweight 13 year old in
    the shuttle run
  • Scores low even though he tries hard
  • Highly public exposure of his poor performance
  • Makes him feel that he could never be like the
    others
  • Convinces him that exercise is to be avoided at
    all costs
  • Starts to use defensive strategies
  • Absence
  • Disruption
  • Never show effort
  • Attach low importance whats the point in it?

28
Am I bovvered?Look at my face!
  • Desperation?
  • Defensive strategy?
  • Maladaptive strategy?
  • Outcomes?

29
Identity development -13 onwards The
psycho-analysts
  • Complex self-perception profiles based on
    increasingly accurate self-assessment
  • More individual constructs develop
  • Still use peer comparison throughout teen years
  • A well-developed differentiated view of success
    a result of ability as a capacity and effort
    combined
  • A measurable sense of worth and vulnerability to
    mood swings and depression

30
Competence style
  • Be mastery and task orientated
  • Focus on your own improvement and dont worry
    about how good others are
  • Develop self-determination
  • Take responsibility for your achievements. Its
    the only way to feel good about yourself.
  • (Lloyd Fox, 1992 Goudas, Biddle, Underwood
    Fox, 1995)

31
Helping youngsters stay motivated
  • Mastery and task orientation
  • Focus children on their own improvement rather
    than worrying about how good others are doing
  • (Lloyd Fox, 1992 Goudas, Biddle, Underwood
    Fox, 1995)

32
Helping youngsters stay motivated
  • Creating an ego environment
  • Post scores publicly
  • Pointing out who is the best in class
  • Using overt competition to motivate
  • Encourage kids to compare and look around
  • Creating a mastery environment
  • Concentrate on effort and trying best
  • Focus on completion of tasks
  • Discourage comparison with others and look for
    personal improvement
  • Self-determination
  • Encourage youngsters to take responsibility for
    their achievements. Its the most profound way
    to increase true self-esteem (Deci Ryan, 1993)
  • Safe passage through puberty
  • Help them understand the nature of changing
    bodies, changing skill levels and that nothing is
    fixed
  • (Lloyd Fox, 1992 Goudas, Biddle, Underwood
    Fox, 1995)

33
Helping youngsters stay motivated
  • Self-determination
  • Encourage youngsters to take responsibility for
    their achievements. Its the most profound way
    to increase true self-esteem (Deci Ryan, 1993)
  • (Lloyd Fox, 1992 Goudas, Biddle, Underwood
    Fox, 1995)

34
Helping youngsters stay motivated
  • Self-determination
  • Avoid the white coat image
  • Encourage youngsters to design their own
    activities
  • Encourage youngsters to make their own decisions
  • Show children that their efforts have made the
    difference
  • (Lloyd Fox, 1992 Goudas, Biddle, Underwood
    Fox, 1995)

35
Helping youngsters stay motivated
  • Celebrate being special
  • Help them to learn to understand and deal with
    their individuality, strengths and weaknesses and
    be proud of what they have
  • Learn to like your body
  • Help them understand that the body is not the
    enemy, that it is part of the whole person and
    responds to friendly treatment
  • Safe passage through puberty
  • Help them understand the nature of changing
    bodies, changing skill levels and that nothing is
    fixed

36
Sport and exercise identity
Physical self-perceptions discriminate 75 of
late adolescents into active or inactive and
are closely associated with type of activity in
those who are active
37
ACTIVE LIFESTYLES
Long term objective
ACTIVE IDENTITY Can
I do it? Is it worth it?
Perceptions of Attitudes,
beliefs, competence/control
rewards, values
Psychological objectives
AGE /STAGE APPROPRIATE POLICIES
Primary objectives
Physical Physical
Health Skills Fitness
Skills
Fox Biddle, BJPE, 1987
38
Attitude development
  • Young children
  • Can conceptualise immediate see-able constructs
    such as food, running, jumping but not
    abstractions such as health or diet
  • Attitudes and beliefs drawn from significant
    adults parents and teachers
  • Modelling of adult attitudes and behaviours

39
  • Children
  • Is eating apples fun?
  • Is running around the gym fun?
  • Does eating well please my parents?
  • Does scoring a goal make me feel good?
  • Will sport help me get on with my friends?

40
Attitude development
  • Older children
  • Conceptualise longer term outcomes such as
    getting fitter, losing weight and can start to
    direct behaviour but not very successful
  • Attitudes and beliefs drawn increasingly from
    peers and generally norms for age set by the
    media through magazines and television

41
Attitude development
  • Adolescents
  • Can conceptualise longer term outcomes and alter
    their behaviour to receive deferred
    gratification such as working for exams,
    practicing musical instruments
  • Attitudes and beliefs are drawn increasingly from
    groups to which they wish to belong.
  • Will select friends who have similar attitudes to
    confirm their own so similar friendship groups
    grow.

42
I dont exercise or play sport because.
  • it is too exhausting and painful
  • I am useless
  • it will make me look muscly
  • it will make me want to eat more
  • I do not have the time
  • I am not the sporty type
  • I always get left behind
  • I am too embarrassed
  • whats the point?

43
I exercise/play sport because.
  • my mates play
  • I want to be a great player
  • other kids tell me I am a good player
  • my body feels better
  • its a great crowd to be with
  • its a lot of fun
  • the coach is great
  • It puts me in a better mood

44
LIFELONG PHYSICAL ACTIVITY
Long term objective
ACTIVE IDENTITY Can
I do it? Is it worth it?
Perceptions of Attitudes,
beliefs, competence/control
rewards, values
Psychological objectives
Primary objectives
Physical Physical
Health Skills Fitness
Skills
Fox Biddle, BJPE, 1987
45
An active school will have
  • A sport and PE programme that
  • Promotes confidence and perceived competence in
    all kids
  • Encourages personal mastery and improvement
  • Offers a wide range of sport and exercise
    opportunities that are enjoyable
  • Physically educates youngsters about their bodies
    and the expertise to maintain lifetime activity
  • Identifies youngsters with poor activity and
    health profiles and provides remedial action

46
Thanks for listening ACKNOWLEDGEMENTS Research
colleagues Ashley Cooper Angie Page Mark
Davis Russ Jago
Contact Professor Ken Fox Department of Exercise
Nutrition and Health Sciences University of
Bristol www.bris.ac.uk/ehs K.R.Fox_at_bristol.ac.uk
47
Multichoice Quiz
  • Which would you choose?
  • When a child makes fun of a fat youngster in gym,
    the teacher should
  • Make the youngster apologise in front of the
    class and say why it is wrong.
  • Take the offending youngster to one side after
    class and explain the effect the comment had
  • Ignore the event and explain to the fat youngster
    after class why you let it go.
  • Your suggestion?
  • __________________________________________________
    ___________
  • You want to get across the importance of avoiding
    obesity in a health class
  • Provide lots of information about the diseases
    associated with obesity
  • Use skinfold calipers to measure each youngsters
    fatness during a class session
  • Talk about what constitutes healthy eating and
    activity in avoiding weight gain.
  • Your suggestion?
  • __________________________________________________
    _________
  • You are trying to motivate children to be more
    active outside class
  • Run the class through a series of fitness tests
    to show them where they are poor
  • Suggest in the class that all the fatter children
    should come to special after school sessions

48
  • You want to encourage healthy eating habits
  • You take away all high calorie foods in the
    tuckshop and canteen
  • You offer healthier options alongside the usual
    high calories foods and drinks
  • You provide eating advice in class to help
    youngsters diet.
  • Your suggestion? ________________________________
    _____________________________
  • You want to seriously help fat children at school
    to lose weight
  • You offer a special programme each morning just
    for fat children that includes activity and
    eating advice
  • You adopt a whole school policy which is passed
    to teachers and children about how to treat
    children who are fat.
  • You bring parents into school and teach them how
    to deal with the causes of obesity in the home.
  • Your suggestion? ________________________________
    _____________________________
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