How To Prevent Obesity
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- Godwin Andrews
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1 Healthier children: A better world Preventing obesity through mental health promotion. Gail L. McVey, Ph.D., C.Psych Health Systems Scientist, Community Health Systems Resource Group Director, Ontario Community Outreach Program for Eating Disorders Associate Professor, Dalla Lana School of Public Health, U of Toronto Core Steering Committee Member, Ontario Healthy Schools Coalition contact: gail.mcvey@sickkids.ca
2 Bernier et al (2010) Study in Winnipeg Manitoba 25% children years reported receiving frequent weight related advice (girls and boys) 7/3/2012 McVey
3 R E S E A R C H ~ Body Satisfaction Eating Problems Sport Weight Related Disorders P O l I C y ~ P R A C T I C E Preschool Extra Curricular School After School Care University Fitness Centers Health Care
4 Things to consider in our discourses about sensitive topics Our work combines our own biases shaped by our personal experiences, our professional discipline or training, our working alongside, beneath or above others who have differing values Gail McVey PhD SickKids Hospital 2012
5 Weight Bias as a silent player Chronic Disease Weight Related Disorders Gail McVey PhD SickKids Hospital 2012
6 Psychological Consequences of Weight Bias Weight Bias Vulnerability for Depression Anxiety Low Self Esteem Poor Body-image Suicidal acts and thoughts Gail McVey PhD SickKids Hospital 2012 Rudd Report, 2008
7 Weight Stigma Individual Health Consequences Unhealthy eating and lower physical activity Psychological disorders Stress induced pathophysiology Substandard health care and decreased health care utilization Public Health Consequences Disregard of societal and environmental contributions to obesity Impaired obesity prevention efforts Increased health disparities Social inequalities Gail McVey PhD SickKids Hospital 2012
8 How do we promote health in a meaningful enough way? (that acknowledges the complexity of the determinants of health and minimizes the risk of harm) Learning from the prevention of weightrelated disorders e.g. mental health promotion and ecological models of prevention Gail McVey PhD SickKids Hospital 2012
9 Health Promotion Process to enable people to increase control over, and to improve, their health. Gail McVey PhD SickKids Hospital 2012
10 Broad themes in prevention 1. Individual change approach has some benefits On its own, likely to be canceled out by strong pressures from peers, family, media 2. Social ecological model shows promise Addresses multiple layers Taps into the real life experiences of children & youth.
11 Take home message Shared Opportunities for Prevention
12 Shared risk factors: ED/OB (Haines; Neumark Sztainer; Austin Flamant, Buchholz, Henderson ) Dieting Media use Body Image dissatisfaction Weight related teasing Weight loss strategies trigger both
13 Goals of current research 1. Identify how best to prepare health professionals to implement evidence informed decision making (and practices) that respond to the complex and diverse needs of the community all the while sensitizing them to multiple factors that can hinder or support the uptake of health promoting behaviours. 2. Identify what are the active ingredients that foster inter disciplinary collaborations and intersectoral action to make such complex public health interventions work and become sustainable over time?
14 Professional Development Centered around personal reflection about role as an adult influencer and one s own attitudes and beliefs as it impacts practice utilizing: Didactic Research Sharing Multimedia Components Personal Reflection Activities Collaborative group conceptualization activities
15 LENS Professional Development System Leveraging equitable, non stigmatizing health promotion delivery Interdisciplinary Research Project Team Investigators: SickKids, CHSRG: G. McVey (Principal Applicant ); Katie Walker and Heather Harrison (Research team) University of Calgary: Shelly Russell Mayhew (Co Principal Applicant) Sudbury and District Health Unit: Joanne Beyers (Co Applicant) Knowledge Users: Sudbury and District Health Unit: Lesley Andrade Toronto Public Health, Ella Manowiec Ottawa Public Health: Elaine Murkin, Robin Ray, Lorette Dupuis Collaborators and study sites: Health Promotion Specialist, Toronto Sari Simkins OPHEA: Jennifer Cowie Bonne/Chris Markham OPHA: Nutrition Resource Centre: Cindy Scythes Peel Public Health: Lora Stratton HKPR District Health Unit: Rachel Moon Kelly SickKids, Department of Adolescent Medicine: John Westland Cancer Care Ontario, Prevention and Screening: Rebecca Trustcott OPHA: Heart Health Resource Centre: Andrea Bodkin University de Montreal: Lyne Mongeau
16 Awareness raising about personal values/attitudes about weight Understanding negative consequences of weight bias on both mental health and health promoting behaviours Social Determinants of Health Awareness raising about the role of the context and the negative influence of social/economic barriers Minimize attitude of individual control over weight and/or health promoting behaviours Weight Bias Weight Preoccupation triggered by extreme messaging about healthy eating, active living and healthy weights Mental health /coping problems Balanced messaging Awareness raising about personal values and attitudes about food, weight and exercise Gail McVey PhD SickKids Hospital 2012 Understand that without mental health there is no health (mediating role of mental health) Awareness raising about the importance of integrating mental health promotion into chronic disease prevention efforts to foster resilience/sense of belonging and connection
17 First step: Focus on adult influencers Look within first Reflect on how within influences our practices As role models and as agents of change Foster skills in delivering best practices
18 Health Centered Paradigm Good health at every size Eating in normal, healthy ways & being active; shifting away from preoccupation with thinness and ideal weight Self acceptance, self respect Appreciating diversity in size in others Avoiding the disruption of internally regulated eating patterns No weight related goals or promise of weight loss Acceptance that some clients will gain, others might lose and others might stay the same weight Gail McVey PhD SickKids Hospital 2012
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