Childhood Obesity: It’s not as simple as “eat less and move more”

Childhood obesity affects 4.3 million children in the UK, with 1 in 3 children either overweight or obese.  

Perhaps you have family of your own or work directly with families affected by obesity. This blog aims to provide context around the issue of childhood obesity from our real-life experience of working with families, as well as some ideas for action.  

Over the past 15 years we have supported thousands of families across the UK to make sustainable changes towards a healthier way of life. What we’ve learned from these interactions, is that the typical simplistic narrative of “eat less and exercise more” is unmotivating and unhelpful for families living with obesity.  

This is not to suggest that families (and adults) don’t already think this. Most do. They have accepted the narrative of personal responsibility. Alternatively, some people have abdicated all responsibility, usually citing genetics or something congenital as the cause.  

The truth is that obesity and human behaviour are complex matters. There are a vast number of other factors that influence childhood obesity that significantly influence diet and exercise that need to be explored and addressed to enable these families to make long-lasting change. 

People have usually bought into one side or the other of this debate about personal responsibility. The reality is much more nuanced and interrelated – which is why it is less likely that people will naturally gravitate towards this position.   

Simple extremes are a) simpler to understand, and b) a narrative that is pushed by companies looking to divorce themselves of responsibility. An example is fast food companies who push the true (but misleading!) statement that ‘can be consumed as part of a healthy diet’ and push physical activity to add ‘balance’…and shift responsibility! 

Your physical environment includes everything that surrounds you; from your home to the street outside your house, to the park around the corner, to the way you travel to and from your daily activities to the shops you visit, to the billboards you see, to the school or office buildings you spend time in.   

So, as you can imagine, our environment affects our decision making around lifestyle choices…What food is available to us in any given situation? How prominent is it on the shelf? How many billboards do I see it on? Did I really need those chicken nuggets?!  Check out this Video created by Biteback 2030 about marketing in the physical environment and how it affects personal choice (marketing really is a separate issue, but this includes physical marketing!). 

Here is a thought experiment to dig a little deeper into the influences of supermarkets and marketing on our irrational decision making… 

Imagine you were to send two shoppers round the supermarket and introduce a couple of factors:  

1. One is completely blind and one is not.
2. Each is hungry when they shop 
3. The blind person can only ask for what they can think of, the sighted person is able to use their vision to help guide decision making 

What do their shopping trolleys look like?  

Now introduce a ‘helper’ to the visually impaired person, who is describing what is around them. They are subject to what the sighted person wants to, or thinks they should, tell them. They are much more likely to notice and find the notice worthy deals (and therefore, mention worthy), as we are wired towards the ‘power of free’. Where are the highest fat and sugar foods places on shelves? Where are deals located?  

So, whilst we all agree supermarkets should discount healthy foods, we do not exercise our true power (not buying unhealthy deals), because we are not wired to do that. We don’t always do what we suggest we might when asked.  

Physical environment also impacts the decisions you make around how you travel; deciding to use the car or public transport vs walking or cycling, can be impacted by the distance to your destination but also the infrastructure e.g. paths, pavements or cycle lanes.  

It impacts the decisions you make about how you spend your leisure time. Do you have access to a local park or green space? Or are your activity options indoors or sedentary?  

Physical environment is huge factor, but taking notice of your physical environment and even beginning to make adjustments can help regain some choice over the lifestyle decisions you’re making. 

This is one that many families fall into – the “crap cupboard”, or the “treat drawer”.  

Adding friction to a behaviour, e.g. making eating unhealthy snacks more difficult to access, is a great mini intervention. A start point could be to remove the stuff that makes you feel guilty when you eat it and replace it with a healthier version. This small change means that when you are in the house your choice of snacks is now a healthier one, by default.  

Our family nutritionists have put together some additional guidance around healthy snacking in this Parent’s Guide to Snacks. 

These are the relationships that are directly around you. For children that’s likely to be their parents and siblings, neighbours, friends, teachers and any healthcare or support workers they regularly interact with.  

These relationships are hugely important and influential with children, often they are the people dictating the choices and the decisions of the children directly e.g. around how to get to and from places, or what they buy from the shops.  

Children also copy “modelled” behaviour, so whatever lifestyle choices the people they have the most contact with are making, are most likely to be copied by the child.  

But it goes beyond simply ‘copying’. As we grow up, we are looking to our immediate surroundings for what is aspirational and what we should avoid. We are forming our tastes and preferences, but also our expectations for life. These can change over time, but they are harder to change the older we get.  

It is only by punctuating these tastes, preferences, and expectations that we can see and choose something different. And that has to happen in line with our social relationships. To bring this back to the example above, in physical environment. What if everyone you knew and respected, all of a sudden began walking to school rather than getting a lift. If they live near you, walk similar distances etc,. would it change your behaviour? Maybe, maybe not. But these are the relational factors that influence our behaviour, alongside the many other factors. 

So who you spend time with WILL massively impact your own choices and the choices of your children. Choose wisely! 

Community is hugely important and influential for children. This could be family and friends, their school, clubs, social or support groups. Community provides emotional and practical support for families, as well as allowing children to foster relationships with a wide range of people who will each provide new inputs and influences. Of course, ‘community’ is made up of physical environments as well as personal relationships, but we have identified it here as it is an important concept that is being talked about more and more, which means it is being misunderstood more and more! 

At BeeZee Bodies we take a community-centred approach, helping our participants to explore how their communities can support their healthy lifestyle changes, and helping our teams to reach and work with more people.  

We’re passionate about Asset Based Community Development (ABCD), which is where we go into communities and identify and harness “assets” – individual people or organisations – who have skills, knowledge, experience, or enthusiasm to create healthy places to live. These also include physical assets, which means different things to different people – e.g. for some people a skate park is a great local asset and for others it is a scary place. (Again, we are back to physical places and relationships – it’s all inter-related). 

Our future lies in working alongside communities. This can mean very different things to different people, but we believe that learning from communities; what matters to local people, what has happened before, where people spend their time, what are local relationships like, how do they interact and what skills and talents exist locally, and how do people want to apply them for the good of their community.  

Services like BeeZee Families are much more effective when they are delivered in places people are already comfortable, supported by local people who are trusted in the local area and delivered by people who are already part of the community in which we are delivering the services.   

We passionately believe that communities have the power to have a significant positive impact on childhood obesity; in fact, communities will be the differentiator between a healthier, happier population and the trajectory we are currently on – one unique community at a time! 

Put simply, you are twice as likely to live with obesity as a child if you are from the least versus the most affluent area. Statistics cannot be ignored. 

There are many reasons why this is that case, including the fact that healthy foods are harder to come by. Cheaper processed foods are more readily available, and fast-food options are more heavily concentrated in areas of high deprivation.  

The Broken Plate Report recently suggested that the most deprived fifth of the population would need to spend 50% of their disposable income on food to meet the cost of the government’s recommended healthy diet. This compares to just 11% for the least deprived. 

Families with lower income are also more likely to have additional strain that makes convenient, cheap options the most likely. Parents may be working multiple jobs, and ultimately, they just have more to worry about which makes being overweight or obese, less of a priority concern.  

At the micro-level, families with less money have less money to waste – literally. Trying new foods and persevering with healthier foods (no mean feat!) gets expensive if it goes to waste, so it is more likely that people stick with defaults and options they know their kids will eat. We see more and more fussy eaters at BeeZee Families, which is difficult to challenge when financial pressures prevent trying new foods that could go to waste. 

If you are interested to explore our programmes and how we take a holistic approach to supporting childhood obesity, then get in touch!