Page 213 - MHF-FeedingMinds-final.indd
P. 213
204 7.2 Childhood Obesity
NICE (2006) guidelines noted that for a or less goals are ideal. They should not lead to
programme to be considered a behavioural conflict between family members and should be
intervention for children it must incorporate the SMART (Table 7.2.3).
following aspects:
When these changes have been made and
●● stimulus control sustained, the family can be encouraged to consider
another set of lifestyle changes.
●● self-monitoring
Self-monitoring
●● goal setting By keeping records of the goals and the
achievements the family can review them. When
●● rewards for reaching goals goals are not achieved, it can be an opportunity to
re-evaluate motivation and the complexity or effort
●● problem solving. required to achieve that goal.
Although not strictly defined as behavioural Reward systems
techniques, giving praise and encouraging parents to Children are more willing to repeat behaviours
role-model desired behaviours are also recommended. that are rewarded. The degree of the reward should
match the magnitude of the effort required by the
Stimulus control child to achieve that goal. A star chart can be used
This involves removing inconsistencies in the to work towards a larger reward in several stages. If
family environment. Parents can limit the a goal is not achieved then the reward agreed for it
availability of foods and triggers that lead to should not be given; however, earned rewards
overeating, for example: should not be withdrawn to punish poor behaviour.
Rewards should not be food or drinks. More
●● ideally, not bringing high-calorie, low-nutrient suitable non-food rewards include playing games
foods into the house at all with children, reading books to them, taking them
on a swimming trip or other outing.
●● buying an individual packet rather than multi-
packs of snack foods or biscuits that must be Problem solving
stored somewhere in the house Through reviewing how difficult lifestyle changes
are to make, problems can be identified and
●● not going to ‘all you can eat for £x’ style possible solutions explored.
restaurants
Other solutions
●● having set mealtimes, preferably with all the Drug therapy and bariatric surgery are sometimes
family eating together considered for older adolescents who are morbidly
obese but not for those who:
●● having readily available healthy snacks to use in
between meals.
Goal setting
Families can agree simple goals for behaviour
change and what benefits they will achieve. Three
Table 7.2.3 Making goals SMART
Aspect of goal Good examples Poor examples
Specific Choose healthy drinks
Have sugar-free squash in place of
Measurable ordinary squash Eat fewer crisps
Achievable Walk to school every day from now on
Relevant Have one packet of crisps each week No candyfloss at the funfair
Time-limited Play more football in the park with Dad
Walk to school twice next week this year
Reduce the number of sweets I eat
Play football with Dad in the park
once this weekend
