Obesity Prevention Interventions in US Public Schools: Are Schools Using Programs That Promote Weight Stigma?

Abstract

IntroductionDespite substantial research on school-based obesity prevention programs, it is unclear how widely they are disseminated. It is also unknown whether schools use obesity programs that inadvertently promote weight stigma or disordered weight-control behaviors.MethodsIn spring 2016, we distributed an online survey about school wellness programming to a simple random sample of US public school administrators (N = 247 respondents; 10.3% response rate). We analyzed survey responses and conducted immersion/crystallization analysis of written open-ended responses.ResultsSlightly less than half (n = 117, 47.4%) of schools offered any obesity prevention program. Only 17 (6.9%) reported using a predeveloped program, and 7 (2.8%) reported using a program with evidence for effectiveness. Thirty-seven schools (15.0%) reported developing intervention programs that focused primarily on individual students’ or staff members’ weight rather than nutrition or physical activity; 28 schools (11.3% of overall) used staff weight-loss competitions. School administrators who reported implementing a program were more likely to describe having a program champion and adequate buy-in from staff, families, and students. Lack of funding, training, and time were widely reported as barriers to implementation. Few administrators used educational (n = 12, 10.3%) or scientific (n = 6, 5.1%) literature for wellness program decision making.ConclusionEvidence-based obesity prevention programs appear to be rarely implemented in US schools. Schools may be implementing programs lacking evidence and programs that may unintentionally exacerbate student weight stigma by focusing on student weight rather than healthy habits. Public health practitioners and researchers should focus on improving support for schools to implement evidence-based programs.

Weight Stigma in the School Setting: The Role of Inclusive Weight Climate—A Commentary

“…Finally, schools should carefully evaluate the weight‐related messages relayed in health curricula. Most health programs in US public schools focus on “obesity prevention” in ways that exacerbate weight stigma . In particular, curricula that emphasize the importance of personal responsibility in weight maintenance indirectly can blame youth with overweight and obesity for their high weight .…”

“…Most health programs in US public schools focus on “obesity prevention” in ways that exacerbate weight stigma . In particular, curricula that emphasize the importance of personal responsibility in weight maintenance indirectly can blame youth with overweight and obesity for their high weight . Unlike obesity prevention programs, those that focus on healthy eating and physical activity for all students are likely to be more effective in promoting health and well‐being .…”

Treatment of children and adolescents who are overweight or obese

“…It required annual body mass index (BMI) screenings for all public school students, elimination of elementary school students’ access to vending machines, and creation of physical education and nutrition standards via district physical activity and nutrition committees along with input from a Child Health Advisory committee. 91 , 92 A study published in 2018 assessing the effectiveness of this policy concluded that it was very unlikely that the Arkansas Act was having an impact on preventing adolescent overweight and obesity. 93 …”

Does A Multiple-Sport Intervention Based on the TGfU Pedagogical Model for Physical Education Increase Physical Fitness in Primary School Children?

“…Despite its recognized value and advantages, not all school programs targeting health have shown to be effective. For instance, previous literature highlights how programs not founded on strong evidence may have a negative impact on students’ cognitive and physical assets [ 6 ]. A review of physical education interventions showed that only half of the studies obtained significantly positive results [ 7 ].…”