Saturday, November 12, 2011

Child Obesity - Unconditional Parenting and SDT self determined theory

In an article on childhood obesity Dr Arya Sharma quotes Whitaker RC (2011). The childhood obesity epidemic: lessons for preventing socially determined health conditions. Archives of pediatrics & adolescent medicine.

 He says that childhood obesity is a reflection on societal norms and values. The current way of living, consumerism-advertising, fast food and sweets diet ,  lack of community, and multiple stresses  contribute to obesity. Instead of following the conventional wisdom and target 'prevention' measures at kids when they are young, we need to change societal norms and values.

There is a lot of stress in the lives of kids. It is well known the connection between  stress and weight gain. The hormone cortisol converts muscle into fat to help us deal with stress, so strict dieting and exercise alone won't help if we do not change our  life styles  and reduce stress.

We also need to examine certain structures in society that contribute to consumerism and obesity.  The unlimited expose to advertising and unhealthy foods , especially sweets makes it very difficult for kids to make better and healthier choices .  Naomi Aldort says it is not about teaching kids to make better choices but rather creating an environment where kids can make choices.

'Choosing sugar is shaped by the addictive nature of sugar; it is not a free choice. When free to choose, the child knows what he needs. However, a child who “needs” candy or a movie is not free; the experience of candy or TV has created the illusion of a need. That which chooses is manipulated by the choice. The industry does a great job of manufacturing a sense of need.'

 In order to address the problem of obesity Dr Sharma quoting the  article  says ' both children and adults need to find purpose and meaning in life , which requires lifelong growth and development … autonomy , competence, mastery, self-acceptance, positive relations with others and transcending self through commitment or connection to something or someone.'

These words resonate with me , but I am afraid that one would need to read Alfie Kohn's Unconditional Parenting in order to put into practice  his suggestions.

AK in his UP book quotes Deci  and Ryan. Kids have the ability to make decisions in a way that meets their needs , they are equipped with a gyroscope of natural self regulation. When we control kids excessively – by using rewards and praise to get compliance- they start to become dependent on external sources of control. The gyroscope begins to wobble and they lose their ability to regulate themselves. Food consumption is a very literal example of this.

A parenting style that does not support ' autonomy ' will promote obesity in their kids, even if we provide   kids with restricted food choices and teach them about healthy eating. 

If we observe the eating patterns of kids over time, we notice how some days they hardly eat and then suddenly put away huge portions. If they eat something fattening, they will tend to eat less, or something   less caloric, afterward.  In terms of how much they eat then, children seem to have a remarkable capacity for self-regulation. Unless, that is , we try to run their bodies for them. 

In an experiment observing 77 kids between the ages of 2 and 4 and their parents, it was discovered that those parents who insisted their kids eat only during meal times rather than when they were hungry or who encouraged them to clean their plates, even when they obviously were not hungry, or who used food – especially deserts as a reward wound up with kids who lost their ability to regulate their caloric intake. Kids who had few opportunities to learn to control their own food intake came to stop trusting their bodies ' cues about when they were hungry . One result – many of them were already starting to get fat.    – Alfie Kohn  Unconditional Parenting

This claim – that people have lost the ability to self regulate -  to eat when they are hungry and stop when they are full – is the basis against traditional dieting. One does not learn to self regulate – eat when hungry and stop when full.

Another problem is that parents will bribe or 'incentivize '  kids in order to eat healthy food. In the Kefir drink experiment  ' good jobs '  and promises of reward  got kids to drink many glasses of this health drink .Some time later the kids were offered the drink without an incentive or praise  attached. Those kids who were previously praised for every time they downed a glass , now  did not touch the drink , those who received a reward had a limited interest , whereas those who did not receive any reward or praise gladly showed  interest in the drink and enjoyed themselves having the drink. The kids who did not receive any reward or verbal praise developed some intrinsic satisfaction and  motivation or a taste for the drink. Those kids who received rewards or praise initially drank a lot, but then lost interest in the drink.  – Alfie Kohn – Punished by Rewards

 In order to promote intrinsic motivation for healthy eating we should avoid any forms of reward, and  let kids participate not only in choosing food items but also help to prepare meals.

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