Everybody’s different : a positive approach to teaching about health, puberty, body image, nutrition, self-esteem and obesity prevention

338 Pages·2007·2.381 MB·English

by  O’Dea, Jenny

EVERYBODY’S
EVERYBODY’S
E
V
DIFFERENT
E
R
Y
DIFFERENT
B
O
A positive approach to teaching about health, D
puberty, body image, nutrition, self-esteem Y
and obesity prevention ’
S

D
Body dissatisfaction in young males and females has I
increased dramatically in the last few decades, with F
an increased prevalence of dieting, eating disorders, F
E
obsessive exercise, excessive weight-lifting and steroid
abuse. Recent research found that the successful R
implementation of a self-esteem program can ward off E
the development of body image concerns and eating N
problems in young people. T

Everybody’s Different details how to apply the self-esteem
D
approach in schools, community settings and clinical
r
situations to improve body image conceptions, prevent J
e
eating disorders and obesity, and foster health, nutrition
n
and physical activity in young people.
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The book takes a whole-school approach to promoting O
overall health among students. It contains information, ’
D
case studies and research outcomes, as well as classroom
e
activities and work sheets about health, self-esteem
a
development, growth, puberty, nutrition and media literacy
for body image improvement.
Everybody’s Different explains how to implement school-
based obesity prevention programs that are certain to
benefi t and ‘do no harm’ to otherwise weight-sensitive
young people. It also covers how to combine body image A positive approach to teaching about health,
improvement programs and obesity prevention initiatives
in school curriculum, school policies and activities, puberty, body image, nutrition, self-esteem
community links and teacher training.
and obesity prevention
Dr Jenny O’Dea
Dr Jenny O’Dea is a dietitian, health
and nutrition education researcher
and Associate Professor in the Faculty
of Education and Social Work at
the University of Sydney. She is an
Associate Editor for Health Education
Research, has written three books
on child nutrition and health, and is
conducting two Australian Research
Council studies about food habits,
physical activity, sport, growth, pubertal development,
body image and weight issues among children
and adolescents. Dr Jenny O’Dea
Cover image: MedioImages/Getty Images
EVERYBODY’S
DIFFERENT
A positive approach to teaching about health,
puberty, body image, nutrition, self-esteem
and obesity prevention
Dr Jenny O’Dea
ACER Press
First published 2007
by ACER Press
Australian Council for Educational Research Ltd
19 Prospect Hill Road, Camberwell, Victoria 3124
Copyright © Jenny O’Dea 2007
All rights reserved. Except under the conditions described in the Copyright Act 1968 of Australia and
subsequent amendments, no part of this publication may be reproduced, stored in a retrieval system or
transmitted in any form or by any means, electronic, mechanical, photocopying, recording or otherwise,
without the written permission of the publishers.
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For those pages not marked as blackline master pages the normal copying limits in the Act, as described
above, apply.
Edited by Susannah Burgess
Cover design by FOUNDRY Typography, Design & Visual Dialogue
Text design by Sarn Potter
Typeset in 10/14pt Stone Serif by SPG
Printed by BPA Print Group
National Library of Australia Cataloguing-in-Publication data:
O’Dea, Jenny.
Everybody’s different : a positive approach to teaching about health, puberty, body image, nutrition, self-
esteem and obesity prevention.
Bibliography.
ISBN 9780864317735.
1. Children – Nutrition – Study and teaching. 2. Teenagers – Nutrition – Study and teaching.
3. Body image in children – Study and teaching. 4. Body image in adolescence – Study and teaching.
5. Eating disorders in children – Study and teaching. 6. Eating disorders in adolescence – Study and
teaching. 7. Self esteem in children – Study and teaching. 8. Self esteem in adolescence – Study and
teaching. 9. Puberty – Study and teaching. 10. Obesity in children – Study and teaching. 11. Obesity
in adolescence – Study and teaching. I. Title.
613.2083
Visit our website: www.acerpress.com.au
Contents
List of Figures vii
List of Tables vii
Preface ix
1 Body image and health in children and adolescents 1
Introduction 1
The meaning of ‘child health’ 1
Body image and health 2
Social infl uences on body image in Western society 5
Body image among adolescents 6
Age and pubertal differences in body image 8
Self-concept, perceived body weight and body image 9
Theoretical frameworks that address body image 11
Summary 14
References 14
2 Body image and eating problems among boys and girls 17
Introduction 17
Description of body image issues and eating problems 17
Health consequences of eating disorders 20
Causes of eating disorders 22
Body image concerns and eating disorders in athletes 24
Weight loss issues for girls and boys 25
Weight gain methods in boys 27
Case studies of students with eating disorders 30
Summary 31
Recommended websites 32
References 33
3 Positive body image programs in schools 35
Introduction 35
The need for positive body image programs 35
Childhood overweight, body image and eating disturbances 36
First, do no harm 36
Risks associated with eating disorder prevention 37
Interventions to prevent eating disorders and improve body image 38
Media literacy interventions 38
Self-esteem development to improve body image 44
A school-based self-esteem program—‘Everybody’s Different’ 45
Conclusions from programs to date 47
School policy, curriculum and environmental considerations 47
Summary 48
References 48
iv Contents
4 Developing self-esteem 51
Introduction 51
Self-concept and self-esteem among children and adolescents 51
Self-esteem for the prevention of body image and eating problems 55
A self-esteem program—‘Everybody’s Different’ 57
Major research study results from Everybody’s Different 58
Other research studies that utilise a self-esteem approach 59
Everybody’s Different program activities 60
Everybody’s Different self-esteem activities 61
Ways to raise self-esteem among children and adolescents 62
Summary 63
Activities 65
References 94
5 Media literacy for a positive body image 98
Introduction 98
The benefi ts of positive body image in boys and girls 98
What is media literacy? 98
Media literacy and body image 99
Media infl uences on body image and eating problems 100
Media literacy lessons from the ‘Everybody’s Different’ program 101
Other studies that utilise the media literacy approach 101
Media literacy and body image messages 102
Media literacy activities 102
Summary 103
Activities 104
References 122
6 Growth, development and puberty 124
Introduction 124
Child and adolescent growth 125
Pubertal Tanner Stages 1–5 in girls 127
Pubertal Tanner Stages 1–5 in boys 129
Factors that infl uence height 130
Teaching about puberty in a positive way 131
Activities for teaching about growth and development 131
Summary 131
Recommended websites 131
References 132
Activities 133
Contents v
7 A positive approach to food and nutrition 149
Introduction 149
The eating habits and attitudes of children and adolescents 149
The function and benefi ts of child and adolescent nutrition 153
Nutrition needs of children and adolescents 157
The healthy eating pyramid 159
Nutrient requirements of babies, toddlers, children and adolescents 160
Nutritional problems in children and adolescents 166
How to read food labels 169
Vegetarian diets 171
Fad weight loss diets 174
Sports nutrition 176
Teaching nutrition in a positive way 182
Food and nutrition lessons and activities 185
Summary 185
Recommended websites 186
References 186
Activities 187
8 Weight issues and child obesity prevention 227
Introduction 227
Concurrent prevention of eating problems, body image improvement and obesity 227
Measurement of ‘overweight’ and ‘obesity’ in children and adolescents 228
Limitations of using the BMI 230
Assessment of weight status among Australian school children 231
Prevalence of overweight and obesity over the past three decades 232
Prevalence of overweight and obesity in international studies 233
BMI and risk of Type 2 diabetes 233
Issues for teachers to consider before initiating obesity prevention 233
Undesirable outcomes of unplanned approaches 236
The need for a positive approach 238
Case studies 240
Positive case studies from schools 241
Factors affecting child growth and overweight 243
Emotional eating 244
Ways of fostering a healthy weight among children and adolescents 245
Self-esteem and weight 245
Promoting physical activity in a positive way 247
Unhelpful and undesirable approaches to obesity prevention in schools 251
Activities for prevention of overweight and obesity in schools 252
Activities for teaching about health and weight in a holistic and positive way 252
Summary 254
Activities 255
References 276
vi Contents
9 The role of teachers in body image development and prevention of obesity 279
Introduction 279
Schools as appropriate sites for prevention of body image problems and obesity 279
Prevention versus treatment 280
Issues of professional training and preparedness 281
Prepared for prevention or treatment? 282
Issues of referral 282
Attitudes towards obesity and eating disorders 283
Eating and exercise behaviours of school professionals 283
Issues of our own susceptibility to eating problems as teachers 284
First, do no harm 286
Modelling and transference of attitudes and behaviours 286
Implications for teacher training and retraining 287
Teacher training to enable prevention of eating disorders and obesity 289
Case study activities for use in tutorials 289
Case studies 291
Case study activity—discussion guide and answers for lecturer or tutor 293
Discussion activities for tutorials 293
Course assignment and assessment guide 294
Summary 294
References 295
10 A whole-school approach to body image and obesity 298
Introduction 298
A health promoting schools framework 299
Ecological and environmental considerations 301
Case studies—applying the health promoting schools framework 302
Summary 315
References 315
11 Summary and conclusions 317
The benefi ts of positive body image in boys and girls 317
Summary of chapter content 318
Controversial issues in this book 324
Using this book in a coordinated and integrated approach 325
List of Figures
FIGURE 1.1 Pictures of the changing shape of female fashion mannequins 4
FIGURE 1.2 Body shape preferences used in research studies of young men and women 5
FIGURE 6.1 Tanner Stages of pubertal breast development in girls 128
FIGURE 6.2 Tanner Stages of pubic hair development in girls 129
FIGURE 6.3 Tanner Stages of testicular, penis and pubic hair development in boys 129
FIGURE 7.1 The healthy eating pyramid 159
FIGURE 7.2 The healthy eating pyramid for vegetarians 172
List of Tables
TABLE 2.1 Methods of weight loss used by young adolescents 26
TABLE 2.2 The weight gain practices, body image, beliefs and weight-related advice
received from others among male adolescents aged 13–18 years 28
TABLE 3.1 A summary of large, controlled, school-based intervention studies of eating
disorders prevention and/or body image improvement programs among
children and adolescents 39
TABLE 3.2 An outline of the objectives, methods and approaches in the
Everybody’s Different program 46
TABLE 4.1 An outline of the content in the Everybody’s Different program 61
TABLE 6.1 Summary of average pubertal development stages in girls 127
TABLE 6.2 Summary of average pubertal development stages in boys 130
TABLE 7.1 Major themes related to the perceived benefi ts of healthy eating identifi ed
by children and adolescents 151
TABLE 7.2 Percentage of children and adolescents in the National Nutrition and
Physical Activity Study who reported consuming none of the foods listed
in the three days prior to the study 152
TABLE 7.3 Type of breakfast consumed on the day of the study 153
TABLE 7.4 Daily food servings from the fi ve food groups for children and adolescents
aged 7–18 years 158
TABLE 7.5 Major recommended dietary intakes for young people 160
TABLE 7.6 Good food sources of dietary protein 162
TABLE 7.7 Good food sources of dietary calcium 163
TABLE 7.8 Good food sources of dietary haem and non-haem iron 164
TABLE 7.9 Good food sources of dietary fi bre 165
TABLE 7.10 Caffeine content of some common foods and drinks 168
TABLE 7.11 Types of vegetarian diets 171
TABLE 7.12 Example of a healthy eating plan for lacto-ovo vegetarian adolescents
aged 13–18 years 175
TABLE 7.13 Levels of energy expenditure and carbohydrate requirements 177
TABLE 7.14 Major sources of carbohydrates in foods 178
TABLE 7.15 Outline of some low, moderate and high GI foods 179
viii List of tables
TABLE 8.1 Overweight and obesity in 4441 Australian school children 231
TABLE 8.2 A summary of potentially undesirable and unhelpful outcomes of obesity
prevention programs in schools 239
TABLE 8.3 Major themes related to the perceived benefi ts of physical activity
among children and adolescents 248
TABLE 8.4 Major barriers to physical activities as given by students in Years 4–12 250
TABLE 8.5 Positive approaches for activities that foster health, physical activity and
wellbeing in schools 253
TABLE 9.1 Course content of a teacher training program that addresses body image,
self-esteem development and psychosocial health issues 289
TABLE 9.2 Outline of weekly course content of a teacher training program that addresses
body image, self-esteem development and psychosocial health issues 290
TABLE 9.3 Course assignments and assessment for a teacher training program that
addresses body image, self-esteem development and psychosocial health issues 294
TABLE 10.1 Guiding principles for the development of health promoting schools 300
Preface
Body dissatisfaction in young males and females has increased dramatically in the last
few decades. There is an increased prevalence of dieting, disordered eating, smoking and
drug taking for weight control, eating disorders, obsessive exercise, excessive weight-
lifting and steroid abuse. Children and adolescents have become more susceptible to
overweight and obesity over the past three decades, and healthy ways of preventing the
interrelated issues of weight problems and body image concerns are now required in
order to promote the healthy development of young people.
Self-esteem development is known to be protective for the mental health of young
people and a positive sense of self-worth, self-respect and tolerance for differences among
others also promotes aspects of social, cultural, spiritual and environmental health.
Positive self-esteem can act as a protective, health promoting factor for children and
adolescents as it contributes to positive social behaviours. It acts as a buffer against the
impact of negative infl uences and promotes physical activity. Poor self-esteem can play
a critical role in the development of depression, anorexia nervosa, bulimia nervosa,
other eating disorders, anxiety, violence, smoking, drug and alcohol abuse, high-risk
behaviours, social isolation and suicide.
Conversely, positive self-esteem is protective against these problems and contributes
to their prevention, as well as the promotion of positive outcomes such as academic
achievement, competence in several different arenas, self-satisfaction, life satisfaction,
effective communication and relationships, resilience and coping ability.
My recent research study among 470 adolescents found that the successful
implementation of a self-esteem program alone can ward off the development of body
image concerns and eating problems in young people, as well as provide a general
protective mental health effect.
The body image improvement program was titled ‘Everybody’s Different’ and it
forms the basis for this book, which contains the self-esteem theory, research fi ndings
and program activities from the original research intervention.
This book sets out in detail how to apply the self-esteem approach in schools,
community settings and clinical situations to:
• improve body image
• prevent eating problems and childhood obesity
• foster health, nutrition and physical activity in children and adolescents.
There is information, research outcomes and classroom activities and work sheets
about self-esteem development, media literacy for body image improvement, positive
ways to teach about health, growth, puberty, food and nutrition, and how to implement
school-based obesity prevention programs that are certain to benefi t children and ‘Do
no harm’ to otherwise weight-sensitive young people. The program is suitable for use
in primary schools, secondary schools and university courses, especially in teacher
training and health education.
There is a chapter about childhood overweight and obesity and how they are
defi ned using the body mass index. Limitations in the measurement and defi nitions
of childhood overweight and obesity are explained, common pitfalls experienced by
schools are illustrated, and positive ways of motivating healthy eating and physical
activity are presented in several case studies from schools.