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Childhood obesity prevention must begin with parental models

Rachel Soon
Medical Writer
03 Jul 2018
Associate Professor Dr Alvin Ng

Parents must be educated on how to model positive eating habits for children to help combat childhood obesity, says an expert.

Speaking at the recent national conference of the Malaysian Dietitian’s Association, Dr Alvin Ng, associate professor of clinical psychology at Sunway University, said that it was important to assist adults to change their own practices before the basics could be taught to their children, as children were highly likely to emulate the dietary habits of their parents.

“We need to look at the bigger picture of not just dieting and exercise, but a lifestyle change, a psychosocial one,” said Ng. “To maximize their chances, they should be learning skills for continued change; there’s no magic involved.”

Ng cited a multitude of common problems encountered when trying to effect change in dietary behaviours, including but not limited to unrealistic expectations, emotional eating, difficulty differentiating between desire for food and true hunger, social influences, and a lack of monitoring.

“One of the single most important things to do is regular self-monitoring,” said Ng. “Because weight fluctuates on a daily basis, and you never know when (a measurement) might be on an up or down.”

According to Ng, a useful psychological tool to work through with parents is the Health Belief model, which focuses on identifying a patient’s perceptions about their current state of health. These perceptions can be classified into four groups; susceptibility, severity, barriers and benefits.

“Every one of us has a certain perception of whether we are susceptible to a certain kind of disorder—such as obesity—and whether we have a severe level of it,” said Ng. “Often, a perceived susceptibility and perceived severity are enough to get people to change their behaviour.”

When counselling both adults and children, Ng advised the use of motivational interviewing when counselling; the method emphasizes asking questions for the patient to answer for themselves, rather than giving direct advice on their behaviour.

“They should try to answer the questions: what’s good about changing, or not changing (my behaviour)? And what’s not good about changing or not changing?” said Ng. “We should try to encourage them to ask themselves what they want, what they consider a better quality of life and what they can do for it, and who they think can help.”

Ng cautioned that it was important to focus on breaking down desired behaviours into individual skill components, rather than jump straight into trying to change an entire behaviour all at once. Such skills might include setting reminders for daily motivation, making time and energy for health activities, practicing responses to sabotaging thoughts, and coping skills in the face of triggers.

“Every behaviour serves a function,” said Ng. “Whether it’s a reflex, to get something, to keep or maintain it, escape or avoid it, or to communicate. Each behaviour consists of a trigger, a response, and a consequence. By manipulating the triggers and the consequences, we can get behavioural change.”

Ng noted that these strategies were primarily focused on the nonclinical population susceptible to obesity, not those with psychological disorders, who may require different psychological or pharmacological approaches.

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