Can teenage obesity be prevented?

Teenage obesity is an ever growing problem throughout both western and developing countries, including South Africa. Factors such as dietary energy density, increased portion sizes, fast food consumption and a sedentary lifestyle have been found to be among the most important drivers of the teenage obesity epidemic.

Can we stop our young people from gaining weight? Can we halt this seemingly inexorable progression?

These were the questions international nutrition expert, Prof Barbara Livingstone, from the University of Ulster in Northern Ireland, recently addressed in a lecture she gave in Johannesburg. DietDoc reports back.


Epode is an international obesity prevention network that aims to reduce childhood obesity through community-based initiatives. The acronym Epode is derived from the French statement of intent: "Ensemble, prevenons l’obesite des enfants...", which means "Together, let’s prevent obesity in children".

According to Prof Livingstone, this programme which was started 10 years ago, is "a large-scale, coordinated, capacity building approach for communities to implement effective and sustainable strategies to prevent childhood obesity".

The initiative targets children from birth to the age of 12 years, as well as their families.

The Epode initiative is characterised by:
  • Use of positive messages ("Do", not "Don't" messages!)
  • A ban on stigmatisation of overweight and obesity (such stigmatisation is common among the general public and tragically also amongst healthcare workers in all disciplines from medical specialists to clinic assistants)
  • Step-by step-learning (slow and steady acquisition of knowledge)
  • Accommodation of all socio-economic groups so that the principles of the Epode initiative become embedded in the daily life of the family.

Global expansion

Epode is already being used in eight countries and three continents (Europe, Australia and Central America), with more than 20 million people in 500 towns participating.
After starting out in France, the initiative subsequently evolved into the Epode European Network (EEN) which was founded in 2008 to facilitate the implementation of Epode methods in other countries, regions and towns.

By 2011, the EEN had developed further into the Epode International Network (EIN), which is determined to make Epode available in all parts of the world and involve 400 million people worldwide (Livingstone, 2013).

Important lessons

According to Prof Livingstone, the following important lessons that have already been learned, need to be taken to heart by anyone or any organisation or government planning to tackle childhood and adolescent obesity:
  • That there are no quick fixes - this applies to weight loss diets and to attempting to change the behaviour of populations
  • "One size does not fit all" - modern people are so used to quick fixes and uniform solutions that the idea of individual dietary changes may be difficult to grasp and to implement. Making changes to the diet of a nation and to individual lifestyles cannot be approached like a vaccination campaign!
  • To prevent failure and the waste of effort and money that usually accompanies such initiatives, these projects must be coordinated and they should never underestimate how complex the issues of dietary and lifestyle changes really are. 
  • These coordinated interventions require inputs at every level - the individual, local and national levels. Without the support of the central government and the provincial authorities for example, no campaign to change food intake or increase physical activity stands a chance to succeed.  
  • The coordinated interventions must also be continuous throughout the lives of the targeted children from the toddler stage until the end of their teens. Nothing can be achieved by suddenly targeting high school children, if they have not been exposed to messages about balanced diets and exercise in each year of their primary school careers.
  • Everyone must come to the party - the central government and all its branches at every level, health professionals in all disciplines that impact on obesity, NGOs, research institutions, educational organisations, and parent-teacher groups. Unless everyone is involved, too many children will fall through the cracks.
  • Evaluation at regular intervals is vital. These coordinated interventions must be held up to careful scrutiny to determine if all the effort, money and time that are being expended on changing diets, eating habits and physical activity, make any difference or not. Failures must be used to learn how to improve and successes must be emulated.
The problem of adolescent obesity is serious and we need remedies right now. "Can we do it?" Hopefully the nations of the world will answer as President Obama did: "Yes, we can!"

(References: Dietary & Lifestyle Risk Factors for Adolescent Obesity: Is Prevention Possible? Paper presented at Nutritional Solutions CNE, Johannesburg 11 April 2013)

(Photo of fat boy from Shutterstock)
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