Overweight, obesity, eating attitudes and behaviors, physical activity, and body image are all interrelated and will need to be addressed in comprehensive ways that do no harm. Thus, safe and effective overweight and obesity prevention programs will include measures to prevent related problems, such as eating disorders, hazardous weight loss, nutrient deficiencies, size discrimination, and body hatred. Harm can result if obesity prevention efforts move ahead without appropriate attention to these related problems
A. Set goals for health, not weight, as appropriate for growing children. Expecting all children to be at an ideal weight range is unrealistic and can lead to problems.5 It is more realistic to expect that children maintain a healthy weight. Healthy weight can be defined as the natural weight the body adopts, given a healthy diet and meaningful level of physical activity.6
B. Set goals for a nurturing environment. A nurturing environment promotes all aspects of growth and development for children — physically, mentally, and socially. This environment fosters self-esteem, body satisfaction, and a positive body image, qualities that facilitate health-promoting behaviors. It’s what’s inside that counts is a guide for dealing with children, such that character, aspirations, talents, and gifts of all are recognized and cultivated. Youth today need tools to empower them to combat our culture’s current extreme focus on appearance. This can be addressed through media literacy training, including analysis of marketing techniques and how the media and advertising affect culture and body image.
Policies for creating a nurturing environment will also include recognition of weight- and size acceptance. Within each school’s policy on acceptance of diversity, weight and size discrimination, name calling, and shaming about weight and size can be addressed. Such a policy promotes self-confidence and respect, as well as safety for schools and communities.
C. Set goals for healthy eating. We urge attention to both what and how children eat. Good nutrition focuses on following the Dietary Guidelines,7 understanding portion size and energy density, and regularly eating recommended servings from all five groups of the Food Guide Pyramid.7 Healthy eating patterns include eating a variety of foods, having regular meals and snacks, responding to body signals of hunger and fullness, creating a positive environment for meals, and eating family meals together when possible. Healthy eating also means taking time to relax, enjoy the food, and feel satiety.8
D. Set goals for physical activity. Aim for all children to achieve the following: be active at least one hour a day9; reduce sedentary activities (limiting television to less than 2 hours a day and replacing excessive television and screen time with more involving activities)9; increase strength, endurance, and fitness; enjoy movement as natural and pleasurable; and learn skills for sports and activities they will continue and enjoy through life. Children need access to a variety of activities so each can succeed in some activities. These goals are achievable by children of all sizes and weights. Having a large body size need not be a barrier if the activity program is thoughtfully and sensitively planned and executed. Opportunities for physical activity need to be available within the school day, in after-school activities, and at home with family and friends.
Among young children the appropriate focus of physical activity is to provide ample opportunity for active free play and movement. As children mature, they need to master movement skills, so they can participate confidently in many different forms of activity, and come to understand that fitness is intimately related to long-term health and well being.
Communities are encouraged to support fitness and physical activity by providing parks, playgrounds, and other facilities that are safe, convenient, appealing, and affordable places for children and parents to spend time.
