Trim and Fit

Last updated

The Trim and Fit (TAF) programme was a weight loss programme that targeted child obesity in Singapore schools between 1992 and 2007. Introduced by the Ministry of Education, schoolchildren under the programme were educated on nutrition, calorie control, and participated in intense physical exercise and activities.

Contents

Overview

Overall, the programme was successful in reducing the obesity rate amongst schoolchildren from 14% to 9.8% by 2002. However, it came at a psychological cost of participants being stigmatised and in some cases, reportedly diagnosed with eating disorders. [1] [2] The TAF programme has since been replaced by the Holistic Health Framework (HHF) which includes all schoolchildren.

The programme

The TAF programme was introduced into schools in 1992 as part of the National Healthy Lifestyle Campaign. It was a result of a 1991 review of the nation's health plan by a national committee. Students aged 9 to pre-tertiary education were required to undergo annual BMI measurements and National Physical Fitness Award test (a precursor fitness test similar to Individual Physical Proficiency Test for National Servicemen). The country's population at that time was showing an increase in obesity that became associated with health problems and loss of manpower for male conscripts in National Service, which caused many conscripts to be deemed unfit for deployment into combat service. [3]

The programme was deemed by observers as an interventionist measure, requiring students who were deemed overweight to be subject to additional intense exercises or physical activities for at least one and a half hours per week. These activities were organised during recess or at times set aside before or after lessons at schools' discretion. They were also issued with "calorie cash" – food ration coupons from which no more than a certain number of calories may be purchased and consumed in a recess break. The amount of calorie cash was inversely proportional to the child's obesity rate. [2] [4] Children which exceeded the 160% of the ideal BMI were referred to the Health Promotion Board for follow-up action.

A direct impact of the TAF programme was a reduction of the obesity rate of schoolchildren from 14% to 9.8% by 2002. [5] Worldwide public health experts have evaluated the TAF model for possible replication around the world.

A carrot-and-stick approach was adopted in putting pressure on schools to meet the targets of fitness and obesity set by the ministry. Cash incentives were awarded by the ministry to schools that exceeded fitness targets and created new strategies to maintain students' obesity levels. Schools that failed had to face "consultation" sessions with ministry officials. Schools were also ranked annually based on how well targets were met at national level. [4] Schools were given a wide discretion in determining how TAF was to be implemented, which resulted in some schools going so far as to implement apartheid-like segregation – for instance, where children were grouped to sit at normal and overweight tables during recess. [2]

Psychological factors

Psychological motivation and peer pressure was emphasised in implementation of the programme, which formed the bulk of criticism of the programme as being insensitive and heavy-handed. Several TAF participants reported experiences of stigmatization, teasing, physiological stress and lower self-esteem as they found themselves being singled out for being obese. [4] [6] [7] It was also quickly pointed out that the name of the programme contained a negative connotation, as its anadrome was 'FAT'. [1] [7] Despite such criticism, education officials continually insisted that the programme was not out to stigmatise overweight children. [4]

In 2005, a National University of Singapore study of 4,400 schoolgirls linked TAF to an increase in eating disorders. It found that girls were more likely to have poorer relationship with their parents and their female friends. The findings correlated to a Singapore General Hospital study released a week earlier which found that instances of anorexia nervosa and bulimia increased six-fold from 1994 to 2002. [1] [8] The Ministry of Education quickly rejected these findings; claiming TAF was not a factor in the increase in anorexia. [9]

Two years later, in 2007, the Ministry of Education decided to replace TAF with the Holistic Health Framework (HHF). The HHF intended to ensure the fitness and health of all school children. [6] [7] [10]

Related Research Articles

Dieting is the practice of eating food in a regulated way to decrease, maintain, or increase body weight, or to prevent and treat diseases such as diabetes and obesity. As weight loss depends on calorie intake, different kinds of calorie-reduced diets, such as those emphasising particular macronutrients, have been shown to be no more effective than one another. As weight regain is common, diet success is best predicted by long-term adherence. Regardless, the outcome of a diet can vary widely depending on the individual.

<span class="mw-page-title-main">Obesity</span> Medical condition of excess body fat

Obesity is a medical condition, sometimes considered a disease, in which excess body fat has accumulated to such an extent that it can potentially have negative effects on health. People are classified as obese when their body mass index (BMI)—a person's mass divided by the square of the person's height—is over 30 kg/m2; the range 25–30 kg/m2 is defined as overweight. Some East Asian countries use lower values to calculate obesity. Obesity is a major cause of disability and is correlated with various diseases and conditions, particularly cardiovascular diseases, type 2 diabetes, obstructive sleep apnea, certain types of cancer, and osteoarthritis.

The National Physical Fitness Award (NAPFA) is a standard physical fitness test for Singaporeans as part of Singapore's Sports For Life programme. NAPFA was launched in January 1982 as a standardised assessment of overall fitness for the general population.

<span class="mw-page-title-main">Sociology of the body</span> Branch of sociology studying the human body

Sociology of the body is a branch of sociology studying the representations and social uses of the human body in modern societies.

Wellspring Academies was a pair of therapeutic boarding schools for overweight and obese children, teens, and young adults, both operated by Wellspring, a division of Aspen Education Group. It is said to be the first weight loss boarding school in the United States.

<span class="mw-page-title-main">Childhood obesity</span> Obesity in children

Childhood obesity is a condition where excess body fat negatively affects a child's health or well-being. As methods to determine body fat directly are difficult, the diagnosis of obesity is often based on BMI. Due to the rising prevalence of obesity in children and its many adverse health effects it is being recognized as a serious public health concern. The term overweight rather than obese is often used when discussing childhood obesity, as it is less stigmatizing, although the term overweight can also refer to a different BMI category. The prevalence of childhood obesity is known to differ by sex and gender.

<span class="mw-page-title-main">Sociology of food</span> Study of food as it relates to society

The sociology of food is the study of food as it relates to the history, progression, and future development of society, encompassing its production, preparation, consumption, and distribution, its medical, ritual, spiritual, ethical and cultural applications, and related environmental and labor issues.

<span class="mw-page-title-main">Obesity in the United States</span>

Obesity is common in the United States and is a major health issue associated with numerous diseases, specifically an increased risk of certain types of cancer, coronary artery disease, type 2 diabetes, stroke, and cardiovascular disease, as well as significant increases in early mortality and economic costs.

<span class="mw-page-title-main">Overweight</span> Above a weight considered healthy

Being overweight is having more body fat than is optimally healthy. Being overweight is especially common where food supplies are plentiful and lifestyles are sedentary.

<span class="mw-page-title-main">Obesity in the United Kingdom</span> Overview of obesity in the United Kingdom

Obesity in the United Kingdom is a significant contemporary health concern, with authorities stating that it is one of the leading preventable causes of death. In February 2016, former Health Secretary Jeremy Hunt described rising rates of childhood obesity as a "national emergency". The National Childhood Measurement Programme, which measures obesity prevalence among school-age pupils in reception class and year 6, found obesity levels rocketed in both years groups by more than 4 percentage points between 2019–20 and 2020–21, the highest rise since the programme began. Among reception-aged children, those aged four and five, the rates of obesity rose from 9.9% in 2019–20 to 14.4% in 2020–21. By the time they are aged 10 or 11, more than a quarter are obese. In just 12 months, the rate is up from 21% in 2019–20 to 25.5% in 2020–21.

<span class="mw-page-title-main">Obesity in China</span> Overview of obesity in the Peoples Republic of China

Obesity in China is a major health concern according to the WHO, with overall rates of obesity between 5% and 6% for the country, but greater than 20% in some cities where fast food is popular.

<span class="mw-page-title-main">Weight management</span> Techniques for maintaining body weight

Weight management comprises behaviors, techniques, and physiological processes that contribute to a person's ability to attain and maintain a healthy weight. Most weight management techniques encompass long-term lifestyle strategies that promote healthy eating and daily physical activity. Weight management generally includes tracking weight over time and identifying an individual's ideal body weight.

<span class="mw-page-title-main">Let's Move!</span> Public health campaign in the United States

Let's Move! was a public health campaign in the United States led by former First Lady Michelle Obama. The campaign aimed to reduce childhood obesity and encourage a healthy lifestyle in children.

<span class="mw-page-title-main">Obesity in the Middle East and North Africa</span>

Obesity in the Middle East and North Africa is a notable health issue. Out of the 15 fattest nations in the world as of 2014, according to the World Health Organization (WHO), five were located in the Middle East and North Africa region.

Social stigma of obesity is bias or discriminatory behaviors targeted at overweight and obese individuals because of their weight and high body fat percentage. Such social stigmas can span one's entire life as long as excess weight is present, starting from a young age and lasting into adulthood. Studies also indicate overweight and obese individuals experience higher levels of stigma compared to other people. Stigmatization of obesity is usually associated with increased health risks (morbidity) of being overweight or obese and the possibility of a shorter lifespan (mortality).

<span class="mw-page-title-main">Criticism of fast food</span>

Criticism of fast food includes claims of negative health effects, animal cruelty, cases of worker exploitation, children-targeted marketing and claims of cultural degradation via shifts in people's eating patterns away from traditional foods. Fast food chains have come under fire from consumer groups, such as the Center for Science in the Public Interest, a longtime fast food critic over issues such as caloric content, trans fats and portion sizes. Social scientists have highlighted how the prominence of fast food narratives in popular urban legends suggests that modern consumers have an ambivalent relationship with fast food, particularly in relation to children.

<span class="mw-page-title-main">Obesity and the environment</span> Overview of environmental factors affecting the incidence of obesity

Obesity and the environment aims to look at the different environmental factors that researchers worldwide have determined cause and perpetuate obesity. Obesity is a condition in which a person's weight is higher than what is considered healthy for their height, and is the leading cause of preventable death worldwide. Obesity can result from several factors such as poor nutritional choices, overeating, genetics, culture, and metabolism. Many diseases and health complications are associated with obesity. Worldwide, the rates of obesity have nearly tripled since 1975, leading health professionals to label the condition as a modern epidemic in most parts of the world. Current worldwide population estimates of obese adults are near 13%; overweight adults total approximately 39%.

<span class="mw-page-title-main">Childhood obesity in Australia</span> Overview of childhood obesity in Australia

Obesity is defined as the excessive accumulation of fat and is predominantly caused when there is an energy imbalance between calorie consumption and calorie expenditure. Childhood obesity is becoming an increasing concern worldwide, and Australia alone recognizes that 1 in 4 children are either overweight or obese.

<span class="mw-page-title-main">Obesity in Thailand</span> Overview of the causes for and prevalence of obesity in Thailand

Obesity in Thailand has been flagged as a major source of health concern, with 32% of the population identifying as overweight and 9% obese. With reference to 2016 data from the World Health Organization (WHO), Thailand has one of the highest incidence of overweight citizens in the South East Asian region, second to only Malaysia. The Thai National Health Examination Surveys (NHES) found that obesity in Thailand more than doubled during the period 1991-2014. This spike in obesity levels has been largely attributed to increased access to junk food, and unhealthy switches from active to sedentary lifestyles. These factors are closely linked to economic growth in the country.

Diet culture refers to a common set of trends and norms that may specifically affect those undertaking dieting or monitoring their caloric or nutritional intake. It often describes a set of societal beliefs pertaining to food and body image, primarily focused on losing weight, an endorsement of thinness as a high moral standard, and the alteration of food consumption. Scholars and activists believe that diet culture is often intertwined with racism and other forms of prejudice, and rely on an intersectional approach to discuss the interactions of prejudice based on gender, race, and weight. As a term, "diet culture" is used as a framework for social analysis and as a critique of contemporary social standards and their impact on body images and health as it pertains to those classified as overweight and engaged in a diet regimen.

References

  1. 1 2 3 Singapore schools' weight-loss programme linked to eating disorders: study, Agence France-Presse, 24 May 2005
  2. 1 2 3 Obesity series part III: Singapore Archived 25 July 2011 at the Wayback Machine , The World (radio program), 14 November 2007
  3. ↑ Singapore Shapes Up, Bryan Walsh, Time Asia, 1 November 2004
  4. 1 2 3 4 Schools making fat students thin, but emotional burden is heavy, Agence France Presse, 22 February 2005
  5. ↑ Fighting fat: with TAF in Singapore Archived 24 January 2013 at the Wayback Machine , Warren Lee, Diabetes Voice (International Diabetes Federation), May 2003
  6. 1 2 Singapore to Scrap Anti-Obesity Program, The Associated Press, 20 March 2007
  7. 1 2 3 "HuHF, it's not TAF to get fit". www.asiaone.com. Retrieved 12 October 2021.
  8. ↑ Hell-bent on looking thin Archived 21 May 2011 at the Wayback Machine , Ng Cheng Yee, The Star (Malaysia), 24 July 2007
  9. ↑ TAF students not at higher risk of anorexia Archived 18 February 2008 at the Wayback Machine , Ho Peng, Ministry of Education, Singapore, 20 May 2005
  10. ↑ Childhood obesity's about good choices, Melinda Tankard Reist, The Sydney Morning Herald, 12 April 2007
This page is based on this Wikipedia article
Text is available under the CC BY-SA 4.0 license; additional terms may apply.
Images, videos and audio are available under their respective licenses.