childhood obesity dissertation examples

Childhood Obesity: Causes/Solutions Research Paper

Thesis statement, introduction, statistics about the problem, causes of childhood obesity, steps the government should take to eliminate the problem, works cited, note card i, note card ii.

Childhood obesity is one of the biggest developing health problems associated with the things such as types of foods that children consume, genetic factors, addiction to highly pleasurable foods, and diminished physical activities.

Therefore, failure of the government to take precautionary measures such as controlling the foods served to children, introduction of BMI checking to schoolchildren, and planning of anti-obesity campaigns amongst others will automatically threaten the health of children and that of the population of the nation at large.

Obesity is the development of more weight than the body of an individual is supposed to carry. Ideally, the body of a person should carry weight within a certain range according to the height of the given individual. Much weight for a specific height is deemed overweight and consequently underweight for a much less weight for a specific height.

Therefore, childhood obesity is the development of more weight, which is mostly fats, more than the height can accommodate. It is usually 20% more body fat weight in a child. Childhood obesity is a serious health problem to society due to the frequency of obesity cases that are being reported of late.

The greatest concern brought about by childhood obesity is that it has been identified as a precursor to certain adulthood ailments if not controlled. Thus, controlling it is a way of eliminating some adulthood ailments. As Riley reveals, childhood obesity leads to such ailments as; “hypertension, respiratory ailments, orthopedic problems, depression, type two diabetes, and high cholesterol among others” (395).

According to Green and Riley, childhood obesity has increased threefold since the year 1981. Sixteen per cent percentage of the population of children between the ages of 6 and 19 years suffer from obesity (917).

In the United States, 23% of children coming from poor families are likely to suffer from obesity compared to 14% of those who come from families that are doing well socially and economically (Riley 395). Obesity has led to a rise in the cost of healthcare for the national government with obesity cases consuming up to 71million dollars in terms of treatment between the years 2008-2009.

According to statistics, there has been a 50% increase in obese cases among children of 7-12 years during the years 1991-1998. Eyler finds that the United States of America government has had to come up with policies and legislation that would reverse the trend by the year 2015 (2294). This effort is an indicator to the seriousness of the problem and the concern that the government has towards it. What causes childhood obesity?

The Foods in the Market

One of the biggest causes of childhood obesity is the type of food a child eats. Following the increase in populations and the decrease in the land for agricultural production, scientists have come up with ways of producing high yields of crops on remarkably small pieces of land for feeding the populations. Most of these foods are produced using biotechnology and bioengineering, which lead to high crop yields. Most crops produced using the methods have been cited as sources of obesity upon producing food from them.

High yield crop production involves altering of the genetic makeup of the crops. When consumed by children and or other people, the effects are directly transferred to them. Animals that used as food to human beings are usually fed on foods with high hormones to spur quick growth of the animals. When children feed on products from these animals, the hormones are directly transferred to them thus triggering a faster development of their cells and body tissues hence leading to obesity.

Genetic Factors

Genetic factors can also be attributed to be a cause of childhood obesity that happens when a child grows bigger than the actual size, and then it is cited as a family trend. Some people are naturally grown. This condition sometimes inherited and passes from one generation to the other.

The study further revealed that there is a 75% chance of children being obese if their parents were obese and a 75% chance of children being thin or slim if their parents were thin. This fact is a sure indicator that obesity is a genetic factor that is passed on from parents to their children. The situation can be controlled if the children engage in activities that can enable them burn the extra calories and fats.

Addiction to highly pleasurable foods

According to Pretlow, addiction to highly pleasurable foods can be one of the biggest causes of obesity in children between the age of 5years to 19years (297). Most of these highly pleasurable foods are extraordinarily high in calories thus leading to extremely fast weight gain in children and young adults.

The advent of fast food outlets has exacerbated the problem because most of the foods sold in fast food outlets are highly pleasurable besides containing excess calories. Addiction to these kinds of foods can be equated to some extent to the addiction found in substances like drugs. Addiction to highly pleasurable foods thus leads the child eating more and more of the food. Because they are not in a position to burn the loads of calories gained by their bodies, they tend to begin piling more and more fats in their bodies.

Diminished physical activities

Childhood obesity can be attributed to diminished physical activities among children. Most children nowadays do not engage in physical activities as compared to the past. In the past, most parents would engage their children in physical activities like doing household chores while going out to play at the same time as a way of engaging in fun. That trend has changed dramatically in the recent past with most children engaging in activities that are not energy sapping.

The trend has changed with the introduction of computer games in society. Most children have ended up becoming couch potatoes because they spend almost all of their playing time playing computer games, which are addictive in nature. The increase in television programs has also led to children getting addicted to watching television. Reilly finds that television companies have come up with tailor-made programs for children thus leading to television addiction (395).

Controlling the food served in schools

The government should come up with a policy guideline on what types of food can be served in school kitchens. Nutritionists should recommend the foods because they have the right calorie contents for children at specific ages.

This campaign will see the government prepare a school feeding diet program that is based on healthy eating habits, which are aimed at reducing obesity and hence eliminating it in the end. An observation by Wojcicki and Heyman contends that an awareness program starting from schools is a sure way of controlling obesity (1630).

Introduction of BMI check in schools

The government should introduce a regular body mass index check to all children in schools as a way of checking and regulating the problem. A regular body mass index check will make the children aware of their weight status and the need to keep healthy bodies and lifestyles.

Such checks can also be used for recommending specific physical activity programs to the children as a way of enabling them burn the excess fats that have accumulated in their bodies. Children growing up with the awareness of the right body mass index will be able to control overweight problems when they occur in the future thus ensuring a healthy nation.

Develop a nationwide anti obesity campaign

The government should develop a nationwide campaign that will see the awareness levels of the population increased to such an extent that everyone in society is aware of the problem. Huang observes that a nationwide campaign to eliminate obesity will enable parents bring up their children with awareness of the obesity problem (148).

Most parents are usually unaware of the obesity problem in their children thus ending up not taking the right steps to stop it. The society today is made up of parents who spend a lot of their time chasing their careers than taking care of their children and hence the need to remind them of their responsibility.

Childhood obesity is a complex problem that cannot be easily wished away due to the many different elements that cause to it. It needs a multipronged approach that will control it. The problem with obesity is that it cannot be eliminated. Thus, there is a need for the government to put measures as discussed above to minimize it as much as possible.

Eyler, Army et al. “Patterns and predictions of state childhood obesity legislation in United States: 2006-2009.” American Journal of Public health 102.12 (2012): 2294- 2302. Print.

Green, Gregory, and Riley Clarence. “Physical activity and childhood obesity: Strategies and solutions for schools and parents.” Education 132.4 (2012): 915-920. Print.

Huang, Terry. “Prevention and treatment: Solutions beyond the individual.” Journal of Law, Medicine & Ethics 35 (2007): 148-149. Print.

Pretlow, Robert. Addiction to highly pleasurable food as a cause of the childhood obesity epidemic: A qualitative internet study . Washington D.C: Routledge, 2008. Print.

Riley, John. “Childhood obesity: An overview.” Children & Society 21.5 (2007): 390-396. Print.

Wojcicki, Janet, and Melvin Heyman. “Reducing childhood obesity by eliminating 100% fruit juice.” American Journal of Public Health 102.9 (2012): 1630-1633. Print.

Summary Note Card:

Following the rising impacts that obesity has had on the US citizens, leave alone the children, there has been a call to the government to pass bills that emphasize the need to reduce the danger caused by this fatal disease. Patterns and Predictors of Enactment of State Childhood Obesity Legislation in the United States: 2006-2009 points out the efforts that the US is making to curb the rising trend by 2015. The article reveals how the US has made it a priority to pass bills that address needs of the obese people as a way of ensuring that they are not left to die of the disease when measures can actually be implemented to rescue them and the US at large.

Quotation Note Card:

Eyler et al state, “…the number of bills introduced from 2006 to 2009 with obesity prevention content is encouraging, as is the enactment rate of these bills.”

Eyler, Army et al. “Patterns and predictions of state childhood obesity legislation in United States: 2006-2009.” American Journal of Public health 102.12 (2012): 2298. Print.

Paraphrase Note Card:

According to Eyler et al, the period 2006-2008 has been characterized by tremendous efforts by the US government to publish many bills that specifically touch on the issue of obesity. The findings indicate that the earlier on observed obesity trend in the US will be changing with time with fewer reports of obesity cases.

Despite the many efforts put in place to fight obesity, it is alarming to find out how obesity prevalence is rising in the UK and the US specifically among children and adolescents.

This revelation indicates that the current strategies used to fight the disease do not have a well-crafted message to persuade the children and adolescents to change their eating habits and or engage in strenuous activities to help rid themselves of the many useless calories whose accumulation has led to their obese nature. Hence, there is room for more studies on the best strategies to use to reach the affected children and adolescent if at all eliminating obesity is the goal of both the UK and the US.

“Successful prevention of obesity in future will require good examples or models of interventions which have achieved objectively measured and sustained behavior change”

Riley, John. “Childhood obesity: An overview.” Children & Society 21.5 (2007): 395. Print.

Due to the observed failure of the current strategies to help the obese children and adolescents, there has been a call for future research to incorporate interventions that will have the capacity to alter the observed high rates of obesity among the US and the UK children and adolescents.

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Dissertations / Theses on the topic 'Childhood obesity'

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Motlagh, Ahmad Reza Dorosty. "Epidemiology of childhood obesity." Thesis, University of Glasgow, 2001. http://theses.gla.ac.uk/1932/.

Schwartz, Heidi C. "Patterns in childhood obesity." The Ohio State University, 1995. http://rave.ohiolink.edu/etdc/view?acc_num=osu1392714183.

Horton, Leslie Nicole. "Childhood obesity and depression." [Huntington, WV : Marshall University Libraries], 2008. http://www.marshall.edu/etd/descript.asp?ref=863.

Garcia, Jessica. "Obesity Surveillance in Childhood." ScholarWorks, 2015. https://scholarworks.waldenu.edu/dissertations/887.

Thomson, Alison. "Helping Families Change Childhood Obesity." The University of Waikato, 2008. http://hdl.handle.net/10289/2480.

Farooqi, Ismaa Sadaf. "Genetics of severe childhood obesity." Thesis, University of Cambridge, 2001. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.621345.

Haroun, Dalia. "Body composition in childhood obesity." Thesis, University College London (University of London), 2008. http://discovery.ucl.ac.uk/1444191/.

Staaf, Johan. "Childhood Obesity and Islet Function." Doctoral thesis, Uppsala universitet, Institutionen för medicinsk cellbiologi, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-313310.

Koch, Felix-Sebastian. "Stress and Obesity in Childhood." Doctoral thesis, Linköping : Department of Clinical and Experimental Medicine, Linköping University, 2009. http://www.bibl.liu.se/liupubl/disp/disp2009/med1100s.pdf.

Bawaked, Rowaedh Ahmed 1985. "Childhood obesity : interrelation amoong diet quality, lifestyle factors, and obesity." Doctoral thesis, Universitat Pompeu Fabra, 2018. http://hdl.handle.net/10803/665009.

Pratt, Keeley Lamson Angela. "Medical Family Therapy Meets Childhood Obesity." [Greenville, N.C.] : East Carolina University, 2010. http://hdl.handle.net/10342/2793.

Bell, Lana Michelle. "The medical complications of childhood obesity." University of Western Australia. School of Population Health, 2008. http://theses.library.uwa.edu.au/adt-WU2008.0139.

Carnell, Susan. "Parental feeding style and childhood obesity." Thesis, University College London (University of London), 2005. http://discovery.ucl.ac.uk/1444564/.

Santos, Diogo Filipe Oliveira dos. "Gene-diet interactions on childhood obesity." Bachelor's thesis, [s.n.], 2019. http://hdl.handle.net/10284/8517.

Robert, Courtney Adele. "Childhood Obesity and the Home Environment." Diss., Virginia Tech, 2010. http://hdl.handle.net/10919/28698.

Xu, Jinyu Xu. "Snacking, Childhood Obesity, and Colon Carcinogenesis." The Ohio State University, 2016. http://rave.ohiolink.edu/etdc/view?acc_num=osu1461245235.

Stone, William L., Karen E. Schetzina, and Charles Stuart. "Childhood Obesity: A Systems Medicine Approach." Digital Commons @ East Tennessee State University, 2016. https://dc.etsu.edu/etsu-works/5120.

Fernández, Barrés Sílvia. "Early life factors and childhood obesity development." Doctoral thesis, Universitat Rovira i Virgili, 2016. http://hdl.handle.net/10803/399640.

Jingxiong, Jiang. "Intervention for Childhood Obesity in Beijing, China." Doctoral thesis, Uppsala : Acta Universitatis Upsaliensis : Univ.-bibl. [distributör], 2006. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-7159.

Alcazar, Maria. "Childhood/teen obesity in the Hispanic community." Thesis, California State University, Long Beach, 2015. http://pqdtopen.proquest.com/#viewpdf?dispub=1587255.

Obesity in the United States should be of great concern to all Americans. The rates of obesity among children and adolescents have been on the rise, demonstrating the need for action now. Obesity at a young age can lead to obesity into adulthood, thereby also increasing the risk of health issues such as the development of high blood pressure and diabetes. Many factors go into play when dealing with obesity, yet the factors that will be considered in this study are the effects of decrease activity and the impact of BMI of a child or teen. Another factor that will be consideed in this study is the consumption of sugar sweetened beverages and how this also affects a child or teens BMI.

He, Qing, and 何淸. "Childhood obesity: definition, risk factors and consequences." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2000. http://hub.hku.hk/bib/B31240252.

Eddy, Luke E. "The relationship between childhood obesity and depression." Honors in the Major Thesis, University of Central Florida, 2010. http://digital.library.ucf.edu/cdm/ref/collection/ETH/id/1399.

Trigwell, Joanne. "Addressing childhood obesity in ethnic minority populations." Thesis, Liverpool John Moores University, 2011. http://researchonline.ljmu.ac.uk/6156/.

Holt, Jim. "Addressing Childhood Obesity in Primary Care Practice." Digital Commons @ East Tennessee State University, 2002. https://dc.etsu.edu/etsu-works/6508.

Wright, Erinn J. "A MULTI-DISCIPLINARY APPROACH TO CHILDHOOD OBESITY." Wright State University Professional Psychology Program / OhioLINK, 2013. http://rave.ohiolink.edu/etdc/view?acc_num=wsupsych1341941334.

He, Qing. "Childhood obesity : definition, risk factors and consequences /." Hong Kong : University of Hong Kong, 2000. http://sunzi.lib.hku.hk/hkuto/record.jsp?B21904145.

Procter, Kimberley Lonsdale. "Measuring the obesogenic environment of childhood obesity." Thesis, University of Leeds, 2007. http://etheses.whiterose.ac.uk/358/.

Kestel, Lauryn. "Getting to the Heart of Childhood Obesity." Thesis, The University of Arizona, 2014. http://hdl.handle.net/10150/320207.

Goins-Jones, April Dawn. "Understanding a School's Response to Childhood Obesity." ScholarWorks, 2016. https://scholarworks.waldenu.edu/dissertations/3097.

McGrath, Sandra McGrath. "Childhood Obesity Comorbitities Awareness Hospital-based Education." ScholarWorks, 2017. https://scholarworks.waldenu.edu/dissertations/3458.

Paxton, Heather L. "The effects of childhood obesity on self-esteem." Huntington, WV : [Marshall University Libraries], 2005. http://www.marshall.edu/etd/descript.asp?ref=518.

Bagully, Michael. "The impact of childhood obesity on academic performance." CONNECT TO ELECTRONIC THESIS, 2006. http://hdl.handle.net/1961/3590.

Känsäkoski, H. (Helena). "Value creation in childhood obesity care and prevention." Doctoral thesis, Oulun yliopisto, 2014. http://urn.fi/urn:isbn:9789526204130.

Hejazi, Samar. "Temperament, parenting, and the development of childhood obesity." Thesis, University of British Columbia, 2007. http://hdl.handle.net/2429/203.

Lakshman, Rajalakshmi. "Development of complex interventions to prevent childhood obesity." Thesis, University of Cambridge, 2011. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.609780.

Teixeira, Vânia Fernandes. "Socioeconomic factors in childhood and obesity in adulthood." Master's thesis, Faculdade de Medicina da Universidade do Porto, 2009. http://hdl.handle.net/10216/53775.

McClure, Erika Iolanthe. "Childhood obesity in Bangladeshi immigrants : a biocultural investigation." Thesis, Durham University, 2017. http://etheses.dur.ac.uk/11952/.

Nakimuli, Brenda. "Socioeconomic inequalities of childhood obesity in South Africa." Master's thesis, University of Cape Town, 2016. http://hdl.handle.net/11427/23395.

Metcalf, Bradley Scott. "Physical activity and obesity-related health in childhood." Thesis, Exeter and Plymouth Peninsula Medical School, 2015. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.699434.

Laurson, Kelly Rian. "Designing and evaluating clinical cutpoints for childhood obesity." [Ames, Iowa : Iowa State University], 2008.

Hayden, Wade Helen A. "A proposed psychosocial consequences model of childhood obesity /." Diss., Connect to a 24 p. preview or request complete full text in PDF format. Access restricted to UC campuses, 2002. http://wwwlib.umi.com/cr/ucsd/fullcit?p3044785.

Klopotowski, Georges Montaldo. "Exploring Childhood Overweight and Obesity through Social Networks." Thesis, The University of Sydney, 2013. http://hdl.handle.net/2123/10263.

Teixeira, Vânia Fernandes. "Socioeconomic factors in childhood and obesity in adulthood." Dissertação, Faculdade de Medicina da Universidade do Porto, 2009. http://hdl.handle.net/10216/53775.

Toten, Deborah Ann. "Childhood overweight and childhood obesity in fifth graders at Granite Hill Elementary School." CSUSB ScholarWorks, 2003. https://scholarworks.lib.csusb.edu/etd-project/2181.

Au, W. M. "Childhood obesity in Hong Kong medical and psychological sequelae /." Click to view the E-thesis via HKUTO, 2003. http://sunzi.lib.hku.hk/hkuto/record/B31971416.

De, Bont Jeroen 1989. "Urban environment, air pollution and childhood growth and obesity." Doctoral thesis, Universitat Pompeu Fabra, 2020. http://hdl.handle.net/10803/670315.

Raphael, Alissa. "School Beverage Contracts & Childhood Obesity: A Case Study." Thesis, University of Waterloo, 2006. http://hdl.handle.net/10012/2795.

Wilsman, Kristi. "Development of the Posttraumatic Stress Symptoms -- Childhood Obesity Model." TopSCHOLAR®, 2012. http://digitalcommons.wku.edu/theses/1185.

Harper, Christopher R. "Developmental Psychopathology and Childhood Obesity: A Developmental Cascade Model." Digital Archive @ GSU, 2013. http://digitalarchive.gsu.edu/psych_diss/117.

Au, W. M., and 區慧敏. "Childhood obesity in Hong Kong: medical and psychological sequelae." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2003. http://hub.hku.hk/bib/B31971416.

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Evaluating the Impact of Childhood Obesity, Dissertation – Methodology Example

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Introduction

Research strategy 

The research held concerning this dissertation is an applied one, not new research focusing on the international samples, not a specific region. The research uses an ecological model in recognition of multiple levels of influence on health behaviors. The behaviors include individual factors, institutional and organizational factors, community factors, and public policy factors. For the evaluation of the impact of childhood obesity reducing interventions in primary schools, there were adjustments of the demographic, behavioral, and economic variables for every selected sample population (Mackey & Gass, 2015).   The ecological model researchers encourage the collaboration within the interested external researchers to assemble a group of researcher-initiated grant applications for innovative research involving new data collection from research participants. The selection of the participants of the study was from 10 primary schools located in various states of America. The sampling of the population was to represent Physical activity, nutrition, and health education interventions of different students between the ages of 9 yrs to 11yrs. The research was based on the healthy school framework with adopted and integrated approach entailing eating policies and eating environment. The framework of healthy schools promotes physical activities and healthy eating in America, reducing the problem of obesity.

Research Question  

How effective are school-based interventions (physical activity, nutrition, health education) to prevent or reduce the risk factors of obesity?

Methodology 

The best research methodology for this project is the secondary research method. The process will effectively use the existing data already existing through the summary of the existing data for effective research (Kumar, 2019). It is cost-effective and provides a complete description and analysis of the research subject without the limitation of the research scope and the nature of participants’ responses. The purpose of the section of the research will explain the research methods and the methodology implemented for the study (Guerra, Silveira & Salvador, 2016). The research technique is useful when the goal of the research is for explaining a phenomenon depending on the perception of individual experience within a given state (Hayes, Tan, Lung, Brown Moodie& Baur, 2019). Secondary such as survey methods would be suitable when the researcher needs to understand the relationship between the existing variables. Since the reason for this study is evaluating the impact of childhood obesity, reducing interventions in primary schools, qualitative research is appropriate for the entire study.

The grids and research themes

The themes emerge from the content and the nature of the research study, such as the topic—statement, facts, and piece of data.

• The themes of the study include how to work patients who do not care for their health.
• The challenges and the stressors within the study.
• Impacts of the burden of evaluating the impact of childhood obesity on society.

Research approach 

The study’s research approaches were inductive since the research began with particular observation for the application of universal theories and conclusions from the research study. The primary reason for the occupation of the inductive approach was taking into account the context from which the research study’s efforts are active and appropriate for smaller samples producing qualitative data. In evaluating the impact of childhood obesity and reducing interventions in primary schools, the inductive approach was appropriate for the study because of the existence of small samples. However, the major weaknesses of the inductive approach are the production of the universal conclusions and theories related to small observations, putting the study’s reliability under questionable risks.

Data collection tools and analysis techniques 

In the research study, intensive interviews were used structured questionnaires to the students. The questionnaire data collection tool responsible for identifying the participant’s emotions, feelings, and opinions related to evaluating the impact of childhood obesity in reducing interventions in primary schools. The significant benefit of questionnaires within the study involved personal and direct data contact between researchers and the participants, including the elimination of non-response rates. All the questions were read by the trained staff while explaining all the concepts such as food models, portion size and photos to increase the accuracy of investigations

Data analysis

The analysis of the data collected for the correspondents by questionnaires setting questions and answering. (Mackey & Gass, 2015). Ten literary sources were used for the scrutiny and in-depth analysis of the impact of childhood obesity, reducing interventions in primary schools   (Physical activity, nutrition, and health education interventions). Data collected a categorization into theme easy comparability purposes within the research study.

Database keywords

KW: Ecological model in evaluating the impact of childhood obesity. In searching the journals from the databases, various keywords were used, including ‘school obesity’ and ‘evaluating,’ ‘childhood obesity’ and ‘health,’ ‘nutrition,’ ‘physical activity,’ intervention.

Prisma Chart

There was an application of the PRISMA chart to filter the research study and get relevant in answering the research question, as reflected below. The peer-reviewed journals’ relevance to the problem in question was ascertained using the data extraction table shown in appendix one. There was a summary of the study results and findings within the data extraction table and the examination of about ten literary peer-reviewed resources to ascertain their eligibility for the problem in the research question.

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Guerra, P. H., Silveira, J. A. C. D. & Salvador, E. P. (2016). Physical activity and nutrition education at the school environment aimed at preventing childhood obesity: evidence from systematic reviews. Journal de pediatria, 92(1), 15-23.

Hayes, A., Tan, E. J., Lung, T., Brown, V., Moodie, M., & Baur, L. (2019). A new model for the evaluation of interventions to prevent obesity in early childhood. Frontiers in endocrinology, 10, 132.

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Mackey, A., & Gass, S. M. (2015). Second language research: Methodology and design. Routledge.

Peffers, K., Tuunanen, T., Rothenberger, M. A., & Chatterjee, S. (2007). A design science research methodology for information systems research. Journal of management information systems, 24(3), 45-77.

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• Int J Qual Stud Health Well-being
• v.6(3); 2011

Children's understandings’ of obesity, a thematic analysis

Childhood obesity is a major concern in today's society. Research suggests the inclusion of the views and understandings of a target group facilitates strategies that have better efficacy. The objective of this study was to explore the concepts and themes that make up children's understandings of the causes and consequences of obesity. Participants were selected from Reception (4–5 years old) and Year 6 (10–11 years old), and attended a school in an area of Sunderland, in North East England. Participants were separated according to age and gender, resulting in four focus groups, run across two sessions. A thematic analysis (Braun & Clarke, 2006) identified overarching themes evident across all groups, suggesting the key concepts that contribute to children's understandings of obesity are “Knowledge through Education,” “Role Models,” “Fat is Bad,” and “Mixed Messages.” The implications of these findings and considerations of the methodology are discussed in full.

The Health Survey for England 2009 illustrated that 65.9% of men and 56.9% of women have a body mass index (BMI) higher than 25 kg/m 2 , classing them as overweight, obese (>30 kg/m 2 ), or morbidly obese (>40 kg/m 2 ). Obesity is linked to many chronic illnesses, including type II diabetes, heart disease, and some cancers—specifically bowel and others within the digestive system (Renehan, Tyson, Egger, Heller, & Zwahlen, 2008 ). As a result, the direct cost to the National Health Service (NHS) of treating obesity was estimated to be between £991 and £1,124 million, for the 2001/2002 financial year (McCormick & Stone, 2007 ).

Childhood obesity is of particular concern because obese children are far more likely than children of a normal weight to become obese adults (Alexander & Sherman, 1991 ). The Health Survey for England 2009 showed that between 1995 and 2008, the percentage of overweight and obese girls rose from 25.5 to 29.2% and from 24.5 to 31.4% for boys. This is despite the fact that during the same period reported total energy intake in the United Kingdom (UK) fell by around 20% (Statistics on Obesity, Physical Activity and Diet England, 2006 ). These contradictory figures highlight the complexity of factors contributing to obesity, pointing to issues such as levels of physical activity, which have significantly fallen over the past two decades (Prentice & Jebb, 1995 ).

Many other factors influence incidences of obesity. The negative impact of childhood obesity causes the greatest concern and needs to be further understood. Obese children are more likely to become obese adults and experience increased health problems. Knowler, Pettitt, and Saad ( 1991 ), highlighted the links between childhood obesity and a poor immune system, risk of raised blood pressure, and cardiovascular problems. Studies have also identified that overweight and obese children are more likely to suffer psychological problems associated with low self-esteem, bullying, and social exclusion (Breat, Mervielde, & Vandereycken, 1997 ).

On an international scale, obesity can be seen as a problem of the developed world, a result of economic wealth, high food availability, and low levels of manual labour leading to lower levels of physical activity. This is in conjunction with high levels of car ownership and wide ranging public transport systems adding to the problem. In short, at the heart of obesity lies a homeostatic biological system that works constantly to maintain energy balance to keep the body at a constant weight. This system has not yet adapted to the world in which we currently live because the pace of technological progress has surpassed evolution resulting in a more sedentary lifestyle (Department of Innovation Universities and Skills, 2007). One surprising feature of the geographical distribution of obesity is its increased prevalence in economically and socially deprived areas in the western world, including the focus of this current piece of research, the United Kingdom. This phenomenon is very much a recent development, because historically deprived areas tended to see higher levels of under-nutrition. Brunt, Lester, Davies, and Williams ( 2008 ) illustrate how this situation has now reversed. They found between 1995 and 2005 the gap between obesity levels in the most deprived areas compared to the least (the latter typically having the higher levels) was steadily closing, and that by 2005 obesity levels in the most deprived areas had overtaken those in the least deprived areas, a phenomena that persists today.

The Childhood Measurement Programme (Department of Health and Department for Children, Schools and Families, 2008 ) demonstrated Sunderland in the north-east of England has some of the highest levels of overweight and obese children in the United Kingdom. This same publication also points out the strong positive correlation between areas considered as deprived and levels of obesity in children in Reception (4–5 year olds) and Year 6 (10–11 year olds). Areas of Sunderland are considered to be economically and socially deprived meaning the children who live there can be considered high risk. The statistics relating to Sunderland, where this study took place, demonstrate that 27.8% of Reception-aged children are either overweight or obese and for Year 6 pupils this rises to 38.4%.

The Foresight Report (Department of Innovation Universities and Skills, 2007), tackling obesity, points out that current policies are failing because they do not provide the depth and range of interventions needed. This might lead to positive interventions being ineffective if they are undermined by other areas in society such as social factors and the power of media advertising. The government launched its Healthy Schools Initiative in 2005; however, there has been no substantial reduction in obesity levels since 2005 (Department of Health and Department for Children, Schools and Families, 2008). With this in mind it would seem timely to approach the problem from a different perspective. Effective policies to tackle obesity need to consider all parties involved. However, current policies have been formed using a top down approach i.e., from government, health and education professionals, and even celebrity chefs! Even though these groups are likely to have a broad understanding of the problem from its roots to the long-term consequences, there has been a notable failure to take into consideration the understandings of the individuals at highest risk of obesity, the children themselves. There is growing evidence that interventions incorporating the views of the target population have a greater level of success (Hesketh, Water, Green, Salmon, & Williams, 2005). In the United Kingdom there has been a strong movement to ensure the inclusion of children in decision making particularly in relation to issues that directly affect them such as education, social care, and health (Department of Health, 2002 ; Department of Health and Department for Education and Skills, 2004 ). The collection and dissemination of the understandings of children relating to obesity could provide an insight into why so many strategies are failing. This in turn could lead to the development of policies that can be delivered to provide more successful outcomes.

There is a clear shortage of research examining children's understandings’ of obesity, the studies that have attempted to explore this domain have focused on exploring parent and care giver perceptions (Young-Hyman, Herman, Scott, & Schlundt, 1999), and the understandings of health professionals (Chamberlin, Sherman, Jain, Powers, & Whitaker, 2002 ). More recently studies have considered the understandings of care givers, health professionals, and teachers alongside those of the children themselves (Borra, Kelly, Shirreffs, Neville, & Geiger, 2003; Hesketh et al., 2005). Studies that have examined children's understanding have been focused on body image, overweight versus underweight (Hill & Silver, 1995 ), and peer perceptions of overweight and eating behaviour (Bell & Morgan, 2000 ; Oliver & Thelen, 1996 ), but not on the understandings’ of the children themselves with regards to the causes and consequences of obesity.

Focus groups have proved to be a particularly useful method for collecting data from children, they are most effective with groups of three children and in situations where the children know and like each other. Groups must be carefully selected to ensure the children are comfortable with each other. Talking together in small groups is familiar territory for children because it simulates class work. This method allows the researcher to structure the discussion around themes or topics rather than direct questions. This in turn enables the children to take control of the discussion (Mauthner, 1997 ) with the researcher present to keep things on track. Conducting group discussions in single sex groups can also prove to be more successful because boys are often louder and more willing to talk and this can mean they direct the topic of conversation. It has also been noted the use of some sort of structured activity such as drawing, reading, or sorting cards, can help focus discussion in particular with young children. When discussing diet with children, nutritionists and dieticians regularly use replica food items to help visualise the topic under discussion and photos depicting scenes of physical activity have proved effective in qualitative studies (Hesketh et al., 2005 ).

In summary the objective of this research is to investigate the understandings of a high risk group of children (high risk because of their socio-economic status so determined by their locality), of some of the causes and consequences of obesity, and its links to diet and physical activity. The concepts and themes generated by this research should be used to provide an insight that may inform local policies and interventions that need to be developed to provide a broader and deeper range of options to address this multi-faceted issue.

In order to address the gaps in current literature it was decided this research should focus on identifying themes within the participants understanding. This would provide the researcher with scope for further investigation of the subject in question. It was therefore decided that the most appropriate method of analysis would be a thematic analysis. However, there have been criticisms of this approach in the past due to the lack of clear guidelines for researchers employing such methods. This has subsequently contributed to some researchers omitting “how” they actually analysed their results (Attride-Stirling, 2001 ). It was of upmost importance to the authors in this current study to employ a clear, replicable, and transparent methodology.

Braun and Clarke ( 2006 ) outline a series of phases through which researchers must pass in order to produce a thematic analysis. This procedure allows a clear demarcation of thematic analysis, providing researchers with a well-defined explanation of what it is and how it is carried out whilst maintaining the “flexibility” tied to its epistemological position. The authors in this paper take a position that acknowledges our desire to incorporate the individual experiences of the participants and the meanings they attach to them. However, we also wish to consider the impact of the wider social context on these meanings. Braun and Clarke describe such a position as “contextualist,” sitting firmly between essentialism or realism and constuctionism. Not all theorists describe these two poles of epistemological outlook in the same way; Madill et al. ( 2000 ) refers to them as “naive realist” and “radical relativist.” Methodologies that go hand in hand with this mid-ground position are typically phenomenological in nature, but the flexibility of thematic analysis means that it can also be underpinned by an “in-between” epistemological position. Willig ( 2008 , p. 13) summarises this by explaining a position that argues “while experience is always the product of interpretation and, therefore, constructed (and flexible) … it is nevertheless ‘real’ to the person who is having the experience.” We wish to consider the reality of obesity to the participants, through an exploration of their experiences and the meanings they attach to them, whilst incorporating the broader role society plays in contributing to and shaping the participants meaning making and subsequent understandings.

Participants

Twelve participants were selected through liaising with the school and class teachers, this was particularly important considering the sensitive nature of the research topic and the fact that the participants taking part in this study were children—a vulnerable group. Measures were taken to prevent any of the participants feeling stigmatised. Therefore, under the guidance of the class teachers, the participants approached to take part in the study were carefully selected to ensure no children who may have been made to feel uncomfortable by the discussion were included, and to make sure that the children selected to be in the same focus groups were comfortable with each other. Six (three boys and three girls) were selected from two school years; Reception, aged between 4 and 5 years and Year 6 aged between 10 and 11. The motivation for selecting these age groups was that government statistics relating to childhood obesity are published for these two age brackets. These age groups are viewed as critical points in measuring children's BMI and in monitoring their changing health status. Through looking at these age groups, it may help us to gain an insight into what understandings children arrive at school with (primarily shaped by their experiences set within a home environment) and those that they have later on in their school life when further social influence (school and peers) may play a role in shaping their understandings. Efforts were made to make the sample representative of ethnicities attending the school so a proportionate number of children of Bangladeshi and Afro-Caribbean heritage took part. Participants were not recruited on account of their BMI or weight status. The parents of the children were provided with a study information letter and, in addition, received a phone call from the school's community liaison officer to ensure that parents fully understood the nature of the study because the researcher was aware that for some parents English was not their first language. The phone calls were made in their mother tongue thus allowing the parents to sign the parental assent form with all their queries being answered. Participants were also asked for their verbal consent on the day prior to the study taking place.

The study had received ethical approval from Northumbria University's School of Psychology and Sports Science Ethics Board prior to commencing. The researcher had also been approved by means of an enhanced criminal records background check clearing her to work with children; this approval was required by both the school and the university.

The focus groups all took place in the same quiet room at the school and were conducted by the principal investigator (referred to herein as the researcher). On arrival, the researcher introduced herself and provided name badges for the participants. The researcher briefly explained to the participants that she was there to talk to them about food and exercise. The researcher also explained to the participants that she wanted them to assume that she knew nothing, they were not being tested, and she was only interested in hearing what they had to say—not whether they were right or wrong. Verbal instructions were provided to the participants and they provided verbal assent prior to the recording commencing. A series of questions were developed by the research team, these were designed to keep the focus group sessions on track whilst exploring issues relevant to the research question. The sessions started initially with a discussion centred on the replica food items laid out on the table. Participants were asked to use the replica food and pick out healthy foods and make what they thought would be a healthy lunch. They were asked to explain why it was healthy and what made it healthy. Participants were then asked about foods they liked and why they liked them. In addition, they were asked about the sorts of things they normally ate at home and in school and things they liked to eat. Once conversation had dwindled concerning the replica food the researcher introduced the laminated picture cards, and the discussion moved to physical activity with the researcher encouraging the participants to explore the relationship between diet and exercise. Questions focussed on what activities they thought were healthy (as the images depicted activities that were both physical and sedentary; that is, one image of somebody running another of somebody playing computer games). The participants were asked about what sorts of activities they liked doing and what made those activities good for them. They were asked what activities they regularly engaged with, the sorts of sports their parents and siblings took part in, and the activities they did as families. The themes of discussion were encouraged around the two elements pertinent to any strategy looking to reduce obesity: healthy eating and physical activity. Furthermore, questions also probed at what the participants thought the benefits were of following a healthy lifestyle and what the consequences were of not following one. They were also asked what advice they would give somebody who wanted to be healthier and how important it was to them to be healthy. The focus group guide was intended to provide a structure but not rigidly dictate the line of questioning. The researcher included prompts and encouraged participants to expand on their initial responses and followed up on notions that the participants raised themselves. The sessions on the first day lasted between 20 and 30 min, ending when the participants input was insufficient to continue. At the end of each session the researcher read out the participant debrief and provided each participant with a parental debrief information sheet to take home.

In order to strengthen the analysis process and gather the most appropriate data, the researchers reviewed the recording made on the first day and reflected on the procedures employed in the focus groups. Similar approaches of reviewing data to informing further data collection are used in methods such as grounded theory and it was felt that doing so would strengthen the current study. The decision was made not to use the props (replica food and cards) used on the first day in the second round of focus groups, as at times they had proved to be a distraction to the participants. As an alternative, Reception children were given colouring pens and paper to focus their attention. Year 6 focus groups were run again allowing for free discussion, following on from issues and understandings they had raised in the initial session. The second round of focus groups, other than the changes already detailed above, followed the same sequence as they had on day one and lasted around 30 min. The recordings were transcribed combining the recordings from both days creating four transcripts, one for each group.

Data analysis

The data collected from all the focus groups was transcribed by the principal investigator, during this process the initial thoughts and ideas were noted down as this is considered an essential stage in analysis (Riessman, 1993 ). The transcribed data was then read and re-read several times and, in addition, the recordings were listened to several times to ensure the accuracy of the transcription. This process of “repeated reading” (Braun & Clarke, 2006 ) and the use of the recordings to listen to the data, results in data immersion and refers to the researcher's closeness with the data. Following on from this initial stage and building on the notes and ideas generated through transcription and data immersion is the coding phase. These codes identified features of the data that the researcher considered pertinent to the research question. Furthermore, as is intrinsic to the method, the whole data set was given equal attention so that full consideration could be given to repeated patterns within the data. The third stage involved searching for themes; these explained larger sections of the data by combining different codes that may have been very similar or may have been considered the same aspect within the data. All initial codes relevant to the research question were incorporated into a theme. Braun and Clarke (2006) also suggest the development of thematic maps to aid the generation of themes. These helped the researchers to visualise and consider the links and relationships between themes. At this point any themes that did not have enough data to support them or were too diverse were discarded. This refinement of the themes took place on two levels, primarily with the coded data ensuring they formed a coherent pattern, secondly once a coherent pattern was formed the themes were considered in relation to the data set as a whole. This ensured the themes accurately reflected what was evident in the data set as a whole (Braun & Clarke, 2006 ). Further coding also took place at this stage to ensure no codes had been missed in the earlier stages. Once a clear idea of the various themes and how they fitted together emerged, analysis moved to phase five. This involves defining and naming the themes, each theme needs to be clearly defined and accompanied by a detailed analysis. Considerations were made not only of the story told within individual themes but how these related to the overall story that was evident within the data. In addition, it was highly important to develop short but punchy names that conveyed an immediate indication of the essence of the theme. The final stage or the report production involved choosing examples of transcript to illustrate elements of the themes. These extracts clearly identified issues within the theme and presented a lucid example of the point being made.

The thematic analysis process that was applied to the transcripts elicited key concepts that were evident in the data. These themes are viewed as essential in determining the understandings of all the participants. These categories have been labelled as “Knowledge through Education,” “Role Models,” “Fat is Bad,” and “Mixed Messages.” There are of course aspects of the participants’ understandings that overlap across these categories. This, however, should be viewed as a good interpretation of understandings and attitudes in general, which are never made up of isolated concepts but are all relative to each other.

Knowledge through education

This theme is defined by the ability of all the participants to understand the roles of diet and physical activity. This is, in part, likely to be defined by different levels of education that the two age groups represented have, but nothing conclusive can be drawn given the relatively small sample size. The impact of their education on their knowledge will be demonstrated through evidence from the transcript.

All participants in the reception age group expressed the ability to name and identify different food items from the replica food. When they were asked to prepare a healthy lunch from the food items, they were able to point out food that would typically be classified as healthy.

I: No none of it is real! So what have you put in your healthy lunches girls? You tell me what you have got. *: Apple, I've got pasta, egg, cracker, grapes, bun and cheese. Girls reception Open in a separate window

However, despite displaying that they “know” what healthy means there is evidence of confusion, and it would seem the concept of something being “good” for them is interpreted to be things they like to eat. This suggests that they don't yet fully understand the concept of “healthy” food.

I: And why's rice healthy? *: Because it's nice. I: What healthy food do you eat? *: Chips Boys reception Open in a separate window

Their definition of healthy is centred on food they believe will make them grow for which fruit is highlighted as being particularly important. However, they also attribute this property to the food that makes up their personal diets. This understanding might result from being told to eat so they grow up to be big and strong. It is important to consider younger children's understandings are likely to be primarily shaped by their home environment, where the emphasis is often on how much children are eating as opposed to what they are eating.

I: Why is a banana important? *: Because it makes you strong so you can grow you have to have fruit so you can grow. I: Can you tell me then girls, we have found all these things that are good, as an example can you tell me, sausage, why is sausage good? *: Because it makes you feel strong. Girls reception Open in a separate window

This understanding of the reception-aged girls represented in this study of eating so they can grow up to be strong is also evident with the boys in the same age group. However, the reception boys also place great importance on the necessity of exercise to develop strength, this demonstrates another aspect in their knowledge.

I: What about this one here, swimming, who likes swimming? *: Me *: Me *: Me I: And why is swimming good for you? *: Cos it makes you strong. Boys reception Open in a separate window

It is fair to say Year 6 groups relished the opportunity to express their knowledge. They were able to identify and name different food groups and discuss different types of physical activity; what's more they understand the link between the two in relation to obesity. It seems other influences have impacted on the children's understandings’ such as school and extracurricular groups.

*: This is a banana. I: Ok why's a banana healthy? *: Because it's got seeds inside, because it's a fruit. Girls year 6 Open in a separate window

The ability to identify a particular fruit by one of its universal characteristics shows a deeper level of understanding and suggests that a higher degree of learning. In fact it is explicitly stated that this nutritional knowledge has been gained at school.

I: So do you know the different groups of food like carbohydrates, I heard you say protein and dairy before? *: Done it in science. Girls year 6 Open in a separate window

Moreover, it isn't just a nutritional knowledge they have developed through education. They appear well versed in the concept of a balanced diet and also understand the importance of a balanced lifestyle in relation to physical activity. They are able to articulate the notion of a balanced, healthy lifestyle through a consideration of the consequences of over eating and not exercising.

I: So what happens to you if all you do is you do watch TV and play the computer, eat the food that you told me was the bad food, what would happen to you? *: You would have a miserable life. *: Get fat, teeth will fall out. Girls year 6 Open in a separate window

In the case of the Year 6 boys who took part in this study, it is apparent that although a great deal of their knowledge has come through education at school, other avenues have helped them develop different aspects of their understandings. In this case it seems to be through taking part in activities, typically sport outside of school, or and more uniquely to this group through the influence of their fathers.

*: I would say my dad likes fish so I eat fish loads. *: My dad likes chicken, so he gives me chicken cos after school I do sport, like boxing, he gives me a sandwich with loads of different toppings in cos meats a muscle maker and vegetables is like an energy maker, so if you eat those you will get fitter and healthier. Boys year 6 Open in a separate window

It is evident where the ability exists, or is encouraged, to apply knowledge they have in a context relevant to their own lives, the knowledge becomes embedded in their understandings; it is applicable to them and, therefore, moves from being written on the board in school to being important to their own existence. This is exhibited by those participants, in particular the boys who participated, who have an involvement in sport. Having a motivation to understand nutrition and exercise leads to a desire to apply it because they comprehend the potential benefits. This aspect within the initial theme of knowledge through education leads directly on to the next theme of role models. The key difference between these two themes is the first relates to information that is directly and intentionally meant to inform the children about healthy lifestyles in an institutional setting, while the second theme is typified by understandings that are formed through interactions with other people.

Role models

The application of knowledge gained through education is often facilitated by role models such as family members who reiterate this information through example. Role models play an important role in the concepts described by all the groups, for example, the older boys reported that their fathers helped encourage healthy behaviours, above and beyond the nutritional knowledge in the previous theme.

*: Like sometimes on an afternoon my dad goes to the gym, then there is these tracks outside, and I practice every day on my 100 meter sprint and I can do it in 12 seconds, and when I started doing it I was 21 second, so I keep practicing. Boys year 6 Open in a separate window

This demonstrates some of the participants’ understandings have developed by examples set for them by significant individuals in their lives. This is evident in the younger children's understandings in a less explicit manner; the example below demonstrates good health behaviours can be established through everyday behaviour exhibited by role models.

I: What about this one, walking to school? … Why is it good for you? *: Because me and my mam walk to school and its good. Girls reception Open in a separate window

There is some evidence that examples set to the girls who took part in this study, at home and by other role models, can encourage behaviours or ideals that are not beneficial to the girls health. Girls appear to look up to older female family members who aspire to be skinny.

*: I like to be skinny, my nana does as well, and she wants to be skinny because she's fat now but I still love her. Girls reception Open in a separate window

They also appear to have developed unrealistic ideas about weight loss and the consequences in terms of treatment. Viewing hospital treatment as a solution to obesity, demonstrates a lack of understanding about the role of lifestyle behaviours in the condition. This may also suggest that these participants don't appreciate the importance of lifestyle behaviours in the onset of obesity.

*: Guess what, I seen this film right the boy was fat right, his legs was right down to the bottom, he had a fat tummy, I was hiding cos I hated him, he was horrible, he will have to go to hospital, he was fat. Girls reception I: So what would you tell somebody if you pretend that I was really, really fat, what would you tell me to do. *: Go to the doctors … hospital, operation. Girls reception Open in a separate window

There was some evidence that the older girls in this study had a more balanced outlook on what sort of body shape was healthiest, because they were aware of the negative health consequences associated with being underweight. It is interesting, however, that they are aware that maintaining a healthy lifestyle may be a challenge and this may result in a barrier to adopting healthier practices.

I: What about the other end of the scale, you know if you've got overweight being fat on this side what about being underweight at this end? *: It's bad cos you're all bony and you can't do anything cos you're not strong enough, you're weak. *: So you need to be in the middle. I: Is it easy to stay in the middle? *: No, because sometimes you can't be bothered to eat well and exercise. Girls year 6 Open in a separate window

Within the theme of role models, there was some evidence of a difference between the genders in terms of available role models. The participating boys often cited football heroes as people whom they looked up to and aspired to be like. This highlights the role of the celebrity in providing a role model for today's children; the evidence from the participants in this study may suggest that typically boys look to footballers and other sporting heroes. It can be argued that such individuals do not always provide a strong moral code; they are seen as following a healthy lifestyle in terms of diet and exercise. It would seem that the female participants in this study often looked up to celebrities who weren't so explicitly seen to be following healthy lifestyles, or a sense of caution was attached to following healthier behaviours.

*: Yeah like Wayne Rooney. I: And why is he fit? *: Cos he's good at footballing. I: Do you think that they have to eat special food? *: Yes I: And what special food do they have to eat? *: Bananas and apples. Boys reception *: Actually you can put weight on running cos muscle weighs more than fat so you can put weight on—like Katie Price she put on 10 pounds cos she started running. Girls year 6 Open in a separate window

Another interesting aspect of the notion of role models’ is that the girls were more concerned with how they appeared in a physical sense; it was particularly striking that the Year 6 boys identified unhealthy behaviour in their female peers attributing this to a desire to be like models.

*: Yes, she wants to be a model so she starves herself, her mam gives her a big packed lunch and she puts most of it in the bin, she's like that skinny then she walks out of the dinner hall. Boys year 6 Open in a separate window

There were many aspects of the transcript that highlighted participants were aware that being underweight was as worrying as being overweight. However, across the board they were far more critical of individuals who were overweight and discussed wide ranging consequences for these individuals, this leads on to the next theme evident in the analysis.

There was a united consensus that being fat was something to avoid, that it was a bad thing, and had typically negative consequences. Elements of this theme have been demonstrated throughout the discussion of the previous two themes; however, this illustrates how their understanding impacts on their attitudes toward obesity.

*: Like all the fat goes through your blood and stuff. *: Like sugar, like all the sugar goes through your blood if you eat too much of it would clog up your arteries and you might die. Boys year 6 I: Like how? What would happen to you? Is something going to happen straight away or is it something that's going to happen to. *: You would get rotten teeth and you would not be as strong as you would be if you ate healthy and stuff. *: You could die. Girls year 6 *: Because fat would be horrible. *: Because it's bad for you, because it looks bad. *: Because people call you big fat. Girls reception Open in a separate window

In addition to the health issues and those relating to physical attractiveness were the issues of bullying and social exclusion, which seemed to play a big role in the children's understandings of what it would be like to be overweight. The stigma attached to being overweight is evident as participants often started giggling when talking about people being overweight.

I: Is it important to eat things that are good for you? *: Laughter I: What do you think happens to you if you eat lots of these biscuits? *: Fat I: And what good would stop you from getting fat, or would help you not be fat? *: Giggling Boys reception Open in a separate window

Inability to have a successful career and even death were understood to be the results of obesity. Participants felt people who were overweight were in some way bad or an embarrassment. There was even a sense of fear toward people who they considered overweight, indicating that they would avoid being seen with somebody who was obese.

I: So … so what do you think about being fat, like if you see somebody in the street who looks like they are not very healthy do you think? *: They can't do much, like most of the things you want to do in life, like swimming, jogging. *: Jobs when you grow older. Girls year 6 *: Like if my parents were proper massive and I went to the town with them I would just say they took me to the town and I don't know them. Boys year 6 Open in a separate window

It is clear that the participants’ understanding is that obesity is a very negative issue. However, there is also evidence that they understand the complexity of the condition and are also aware being underweight maybe as much of a problem. The older children in this study seemed to understand that it is a complex issue and fully grasped the concept of moderation. They often refer to the fact that you can have a small amount of things that maybe classified as unhealthy, as long as you don't eat them all the time or balance them out with exercise.

I: And what sort of things for eating well? *: Like fruit and vegetables. *: Some Sugar. *: If you eat vegetables and fruit and you might get back to underweight. *: And you want to be in the middle. *: You need a bit of fat on you. Girls year 6 Open in a separate window

This category of Fat is Bad highlights an issue that clouds all the children's understandings of issues surrounding obesity and that is of conflicting messages. This notion of mixed messages forms the final theme evident in the data.

Mixed messages

The evidence presented here would suggest the information intended to educate and inform children is often met with equal amounts of contradictory or confusing messages and behaviours. The result of this is easily demonstrated by comparing what the children know they should be doing with what they actually talk about doing. For the majority of the participants their knowledge did not always match with their described behaviour, their food preferences often overriding their knowledge. This was perhaps not so surprising; knowledge does not by any means dictate behaviour.

I: Do you have breakfast most mornings? Do you normally have some breakfast, what do you normally have for breakfast? *: Miss I have chocolate cookies. I: What did you have for your tea last night? *: I just had for my supper. I: What did you have last night for your supper? *: Err sandwiches, cake and I: What about what did you have last night for your tea? *: Pizza Girls reception I: You eat two, two pieces of fruit? *: Yes, cos my mam chops it into two halves. Boys reception Open in a separate window

Conflict existed in a number of forms in the understandings expressed by the participants. It is worth reiterating that the younger girls who participated believed treatment for obesity was to go to the hospital and have an operation—something they have picked up from a TV documentary—this conflicts with diet and exercise education they receive at school. Other participants gave more specific and direct examples of receiving contradictory information. This ranged from conflicts in direct health messages to conflicting information and action between school and home. They felt that at times it was difficult to know which information was the right information, not only was it conflicting but it was forever changing.

*: And people say if you make fruit smoothies its healthy for you but it said in the news something about being obese again it said that if you drink a smoothie one a day you'll put on 13 pounds, that's nearly a stone in a year. Boys year 6 I: What about at home? You know if you're taught all this stuff at school what happens when you go home? Do Mum and Dad teach you the same things or is it different? *: Different I: And why is it different? *: I eat more sweets. Girls year 6 Open in a separate window

In addition to this, older children also pointed out they felt that healthy lifestyle information wasn't always delivered in the correct manner, there was a belief that stigmatising people who were overweight was negative. There was an awareness that there is a psychological aspect to overeating, and in some individuals it is this that needs to be addressed. Moreover, there was a feeling again demonstrated solely by the older participants that being overweight/obese could be difficult to rectify and maintaining a healthy weight could be a challenge.

*: So you need to be in the middle. I: Is it easy to stay in the middle? *: No, because sometimes you can't be bothered to eat well and exercise. Girls year 6 I: Do you think it's quite easy to lose weight? *: Yes *: Well for some people. *: If you put your mind to it, it is. I: No go on cos everyone's got different ideas. *: You can't just lose weight quickly. *: Cos my dad when he was young he was obese so he told me, but he's sort of addicted really. *: Addicted to what. *: Addicted he cannot stop but he's trying. *: He cannot stop what. *: Eating when he was young, he like learnt now he's saying to me about being fit cos he tells me about what happened when he was young so I try it. Boys year 6 Open in a separate window

This understanding of the complex nature of the obesity problem, coupled with the confusion and conflict in both the information and behaviours the participants are exposed to, can help explain some of the barriers to individuals adopting a healthier lifestyle.

Comprehensive understanding

The results detailed above highlight some important findings as to how children understand obesity in terms of some of its causes and consequences. It was particularly clear that knowledge, often imparted in a school setting, is getting through to the children who participated in this study. However, it appears equally evident that this knowledge in many cases does not transfer to behaviour. Further examination of the results allows us to explore the potential reasons behind the knowledge-behaviour gap.

Role models by their nature provide examples for both the children's beliefs and their behaviour. There are a wide variety of potential role models for children from parents, teachers, peers, and celebrities. What seems particularly important, in terms of being a positive role model with regards to healthy lifestyles, is that children have an opportunity to view the process of being healthy. In this study, this was typified by the examples of the Year 6 boys who participated in sport with their fathers. It appears this close and active relationship allows the knowledge that has been started at school to grow. Allowing children the opportunity to apply their knowledge and see the steps taken by a role model to get or stay fit help translate this knowledge into behaviour. What is interesting, however, is that it seems passive behaviours by role models can have the same impact. It was the case with these participants that the effect of passive knowledge transfer seemed to be more negative, but that is by no means to say that passive behaviours by role models will not also encourage positive lifestyle behaviours in other cases. The most obvious example of this within this data set was the seemingly implicit messages that the girls received about being skinny. There was not an overtly explicit attempt on the behalf of the role models described here to encourage a “skinny” ideal; however, messages seemed to reach the participants that would indicate this is the case. The key difference between these active and passive role models appears to come from whether the role models place focus on the process; taking part in sport (in the example of the older boys) or outcome being skinny (in the example of the girls). Focus on the action of being physically active or enjoying a healthy diet in the case of these participants produces a healthier outlook on maintaining a healthy body weight. When that focus is on the outcome—the weight loss or the weight gain—there seems to be less concern for actually “being healthy” in terms of body weight and lifestyle. This notion about process and outcome is intrinsically linked to the theme of Fat is Bad.

It is interesting to note that whilst the children expressed an understanding of fat as a component of diet and were able to identify high fat foods and their link to obesity, the focus was on fat as an outcome and not so much about it as input. It is a well-documented fact that fat is a requirement of a balanced diet. The participants were able to recite in great detail the consequences of becoming fat but were not so forthright about the processes involved in becoming fat. It can be suggested that by focussing on the process of becoming fat and understanding the need for fat in moderation and being physically active it may help to discourage fat becoming the output. This may also help to draw away the focus from physical appearance that is so closely tied to the stigma attached to being overweight and place it on living a healthy lifestyle and being healthy.

The key finding of this study is that it is evident that children receive contradictory messages when it comes to following a healthy diet and taking part in exercise. The research presented here highlights children's understandings of some of the causes of obesity and the consequences of becoming overweight. However, it is equally evident that this information has reached them on a knowledge level but has not or cannot be fully translated into behaviour. It appears that central to this problem are the multiple discourses that exist around diet and exercise. Whilst government campaigns may impart facts and figures and provide advice on changes that can be made, there are a whole host of other sources to contend with. There is an undoubted role played by the media both in terms of active advertising campaigns for junk food or sedentary games and the passive portrayal of unattainable body shapes and sizes in magazines and by celebrity culture. However, more than this, health messages are competing against a variety of cultural values, social, and personal norms that may well go against messages that encourage certain behaviours. What is more is that ultimately individuals have the power and autonomy to make their own choices about diet and exercise. Stakeholders need to ensure that people are in a position to make an informed decision and not one where their judgement is clouded by an array of contradicting messages. There is also a responsibility to ensure that individuals are able to act on advice given and to provide advice that is relevant and tailored to individual circumstances. It is easy to understand why parents on a low income may struggle to incorporate “5 a day” into their families diets when they perhaps don't have access to a car and the nearest shop selling fresh fruit and vegetables is several miles away. Ensuring people know that frozen fruits and vegetables are just as good and, in some cases better, is a far more useful and usable message.

Comparisons with past research

The objective of this study was to explore children's understandings of obesity in terms of diet and physical activity; the children included were considered high risk because of their socio-economic status. To meet this objective, focus group data was analysed using thematic analysis. This analysis produced key themes pertaining to the understandings of the participants. There is not a wealth of prior research in this domain and it was for this reason thematic analysis was chosen to analyse the data. The method proved to be particularly useful in generating these exploratory data that are discussed here in relation to previous findings.

The theme of knowledge has previously been identified by Hesketh et al. ( 2005 ) in terms of information and awareness that is pertinent to children's perceptions of healthy eating, activity, and preventing obesity. Increasing knowledge relating to diet and physical activity cannot prevent obesity but it can encourage children to make informed choices.

This study, as have others (Hesketh et al., 2005 ; Borra et al., 2003 ; Musaiger, Mater, Alekri, & Mahdi, 1991 ), identified misunderstandings in children's knowledge as barriers to healthful behaviour. It might be useful to address this issue, particularly with younger children who are developing their knowledge. Previous literature has identified young children often consume their recommended daily intake of fruit but fall well short when it comes to vegetables (Dennison, Rockwell, & Baker, 1998 ). Government campaigns encourage people to eat five portions of fruit and vegetables a day ( www.5aday.nhs.co.uk ); however, nutritionists would encourage three portions of vegetables and two of fruit—fruit having high sugar content. There was no evidence in the transcripts that any of the children were aware of or understood this distinction. This needs further investigation; however, education should encourage an understanding of fruit and vegetables as separate entities to help increase the consumption of vegetables (Gibson, Wardle, & Watts, 1998 ).

The evidence in this study suggests children grasp the causes of obesity, overeating, and low levels of physical activity; however, there was a general lack of understanding of the underlying physiological processes. There was a limited understanding of the concept of energy balance or that there might also be medical reasons for the obesity. Bell and Morgan ( 2000 ) demonstrated providing medical explanations for obesity can have a positive effect on children's attitudes to obese individuals. Overweight individuals were generally stigmatised by the participants in this study, so providing better medical information could help to alleviate these negative attitudes. It is fair to say those children who did have more in-depth knowledge of obesity were more sympathetic in their considerations of overweight individuals acknowledging the difficulty in making lifestyle changes.

The influence of parents concerning diet and exercise behaviours is well documented (Prout, 1996 ). Hesketh et al. (2005), Borra et al. (2003), and Young-Hyman et al. ( 2000 ) consider parental influence to be a determining factor in children's attitudes and understandings of obesity. It is clear this influence can be as detrimental as it can be beneficial. Previous research (Borra et al., 2003 ) argues interventions need to be developed that consider the role of the parent. Children cannot be expected to apply the information they receive at school to themselves if it is not reiterated at home. Nutritional education and physical education have not formed a core or extensive part of school curriculums in the United Kingdom in previous years, and there is now a generation of young parents who do not have the skills to attractively present appropriate foods (Tuttle & Truswell, 2002 ) or who regularly take part in sport themselves. The impact of this on their children's behaviour is that they don't always have examples of healthy behaviour to model their own on.

Of particular importance was the finding that children feel that they often receive mixed and contradicting messages. This is of great relevance when considering the development of policies and strategies that can be more effective. More over this backs up the findings of Dorey and McCool ( 2009 ) who conclude that nutritional messages evident in health promotion and advertising were often perceived by child audiences to be ambiguous. The authors warn that these contradictory messages could potentially serve to weaken the trustworthiness viewers have in health promotion initiatives. This really points to a key area in which health professionals can target efforts to tackle obesity. Clarity and consistency in healthy messages and recommendations are central to helping people take on board and act on the information they receive. Contradiction allows room for people to question the advice given and when effort is required to make a change in behaviour that change is less likely to be made if there is reason to doubt the accuracy of information. Furthermore, coherent messages need to consider person specific factors that may inhibit behaviour change; when individuals are encouraged to behave in a certain way but the constraints of day-to-day life lead to another, the results are confusion and hostility to the initial message (Owens & Driffill, 2008 ).

Procedural issues

The main methodological issue arising was participants from Reception struggled to engage fully in conversation, and the sessions followed a structure more a kin to an interview (i.e., question and answer). It was difficult to encourage responses that were longer than a few words; often one word responses were given. There is the potential to gain some very useful information from children in this age group; however, it can be a long and time-consuming process to elicit enough information to make the analysis process worthwhile. The length of the sessions also must be kept relatively short because attention spans are not long lasting; this was a finding similar to that of Miller ( 2000 ). The replica food items selected to help provide structure to the focus groups were useful and did provide a catalyst for discussion; however, for very young children (i.e., those in Reception) they resemble toys too closely, this then leads to them becoming more of a distraction, hindering the discussion. The use of the picture cards and pens and paper as suggested by Backett and Alexander ( 1991 ) provided a more a suitable means of structuring focus groups for young children.

There were at times issues with certain members of the groups making themselves heard more than others, thus the researcher had to encourage those happier to sit back and let others take the lead (Kirk, 2007 ). However, through a little encouragement all participants appeared comfortable talking with each other and participated equally, a result of the careful selection process. It also appeared to be beneficial speaking to boys and girls separately, with the boys often more excitable in their discussion style in comparison to the girls. It also facilitated the identification of some important issues, for example, the Year 6 boys identified eating behaviours present in the Year 6 girls that the girls themselves did not discuss.

Implications for the future

The Foresight Report (Department of Innovation Universities and Skills, 2007 ), in tackling obesity, points out that current policies are failing because they do not provide the depth and range of interventions needed. This present study has determined that central to children's understandings of the causes and consequences of obesity are the concepts of knowledge, the opportunity to apply this knowledge to their own lives, and the existence of role models to set an example. There exist certain myths and misconceptions that need to be addressed and children need to believe they can trust the health messages they receive because they are aware some messages are misleading or forever changing.

The key to this issue seems to be children learn by example, they can have all the knowledge in the world provided to them through an institution such as a school but this information needs to be supported by life at home. This provides evidence that campaigns need to target parents to tackle childhood obesity; this is an issue that policy makers are already aware of ( National Institute for Health and Clinical Excellence, 2006 ). However, this means health messages delivered to the general public need to be clearer and avoid ambiguity. There needs to be careful considerations of the context in which health messages are received, taking into account the understandings of the target population (Hesketh et al., 2005).

There were some issues raised in the focus group that were beyond the scope of this particular study. There was a representation of different ethnic minorities in the groups, and slight differences in the understandings of these different groups were identified. Further research should investigate the understandings of different minority groups to see if ethnicity influences or results in divergent concepts. Future study also needs to look at strategies that enable children to apply healthy lifestyle information to their own lives.

Children spend, on average, a quarter of their waking lives in schools; therefore, schools can be seen as an effective environment and source to help encourage healthy lifestyles. However, that leaves three quarters of a child's time in which they are out of the control of the school environment. Strategies must be developed to unite the teaching at school with practices in the home. This supports the conclusions of Hughes, Sherman, and Whitaker ( 2010 ) who write that strategies need to be framed in a manner that makes low income mothers feel more supported in addressing issues their children may have with their weight. Ensuring that approaches to encourage healthy lives take on a holistic format will also help to provide consistent and realistic role models. There needs to be a concerted effort from within society to develop role models who have a healthy relationship with food and exercise. These seem to already exist for young boys in the form of sporting heroes but seem in short supply for young girls who already consider that being healthy is the ideal but then look to surgery as a form of weight loss. Lieberman, Gauvin, Bukowski, and White ( 2001 ) highlight the importance of role models and peer influence in the onset of disordered eating in young girls and this needs to be seriously taken into account when sending out messages that being overweight is bad, girls need to be aware that being underweight also has severe health consequences.

In conclusion, the time children spend eating and taking part in physical activity out of school is likely to be the biggest challenge to preventing the continuing obesity problems in the United Kingdom, and this is where current strategies appear to be failing. Children understand obesity and its contributing factors in terms set out to them by those people they consider role models. It is only by helping these role models to provide consistent and reliable information by setting suitable active examples and by being aware of the impact of their passive actions that we can begin to address the problem of obesity.

Acknowledgements

The authors would like to thank Sunderland Children's Centres and Back on the Map for their support in facilitating this research.

Conflict of interest and funding

The author have not received any funding or benefits from industry or elsewhere to conduct this study

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Sample Dissertations

Sample Dissertations | University Dissertations | Dissertation Examples

Childhood Obesity

Physical inactivity, nutrition, genetics and psychological factors are the main causes of prevalence in childhood obesity, sources: langwith, j. (2013). childhood obesity. detroit: greenhaven press.

This book by Jacqueline gives an overview of what childhood obesity encompasses. In the book, she talks about childhood obesity being a global health concern and health risk factors associated with childhood obesity. She also talks about the various causes of childhood obesity. They include Type II Diabetes, cardiorespiratory diseases, cancer, and hypertension, stroke, and sleep apnea and liver disease. She argues that children who are obese have a high risk of having a shorter life expectancy and also the controversies surrounding childhood obesity.

In her book, she talks of two main causes of childhood obesity which are genetic factors and stress, the effectiveness of anti-obesity programs, and whether bariatric surgery is appropriate for children the role government should play, focusing on contributing factors, and personal stories of people dealing with childhood obesity. This book is a credible source that will prove useful in the final research paper since it gives detailed information on the issue of childhood obesity. Jacqueline provides general views and clear evidence, and she is not biased in any way. This book will be useful in putting up a strong argument on genetic and psychological factors being causes of childhood obesity. (Langwith, 2013)

Jimerson, M. N. (2009). Childhood Obesity, Farmington Hills, MI: Lucent Books

The author of the book touches on childhood obesity, by talking about what it is its causes and the effects it has on the affected kids, its health risk factors, how it is to live with it as a child and future prevention measures. He says that childhood obesity could be prevented if parents carefully determined the environments they bring up their children. By parents and guardians encouraging their kids on healthy eating habits and an increase in participation in physical activity, cases of childhood obesity will be reduced. He urges parents to maintain their kids body weight, reduce the number of adverts promoting unhealthy food.

To support the suggested preventive measure, he provides information about medical issues of childhood obesity such as diabetes, emotional problem. This book is a credible source in the research as it talks about the main causes of childhood obesity. The book’s details are based on evidence making it of undoubted quality. The book having discussed diet and physical inactivity as the main causes of childhood obesity will help me in arguing out my case (Jimerson, 2009).

Juettner, F. B. (2010). Childhood Obesity. San Diego, CA: Reference Point Press

This book is a reliable and provides unbiased information on the issue of childhood obesity. Source to research on whether physical inactivity, nutrition, genetic factors and psychological factors are the main causes of prevalence in childhood obesity; The books discusses in depth on the origins of childhood obesity, how much of a problem childhood obesity has been all over the world. It also focuses on the causes of obesity which the author discusses in depth. He also tries to answer the question: can obesity in children be prevented and can it be reserve. It also discusses a few controversies that exist on the issue of childhood obesity. The information in the book goes a long way in helping one understand childhood obesity better and what exactly it entails. This source is credible and can be used towards the final projects. The book will provide information to strengthen the argument that the main causes of childhood obesity are physical inactivity, nutrition, genetic factors and psychological factors (Juettner, 2010).

Smith, J. C. (1999). Understanding Childhood Obesity. Jackson: University Press of Mississippi

The author of this book talks of physical inactivity as the main cause of childhood obesity. He urges growing children to exercise daily to help them grow healthy and avoid cases of childhood obesity and the health risk factors associated with it. He outlines the type of physical activities that kids need to undertake, through the help of their parents to remain physically fit. By parents acting as role models to their children in terms of physical activity, obesity in children will be reduced. This will act as a source motivation and could influence the child to do the exercises by themselves at a different time to help reduce some of the weight they have. This book is a reliable source to the research paper as it will because it in figuring out what motivates the child to exercise; is it an incentive by their parents? It will give an understanding on the causes of childhood obesity or is it through only bad eating habits. The information quality of this book is great though it does not focus on all the causes of obesity. This source is supportive to the argument that physical inactivity is associated with childhood obesity (Smith, 1999).

Institute of Medicine (U.S.). Koplan, J., Liverman, C. T., Kraak, V. I., Institute of Medicine (U.S.). & Institute of Medicine (U.S.). (2005). preventing childhood obesity: Health in the balance. Washington, D.C: National Academies Press

The authors of this book talk more on the extent of childhood obesity and the consequences it has on children with it. It also develops an action plan to fight with childhood obesity and make it a national public health priority. The authors also try to create awareness on the existence of childhood obesity through advertising, public education, through the media groups. This information passed to the local communities, homes and schools to help them eradicate the issue of childhood obesity in the society. This book is a credible source in the research paper as it talks about of the preventive measures of childhood obesity. The book mainly looks at childhood obesity in the United States and may seem biased to other areas in the world. The book will only help in arguing out what the consequences of childhood obesity are (Koplan, Liverman and Kraak, 2005).

Dehghan, M. Akhtar, N. and Merchant, A (2005) Nutritional journal: childhood obesity, prevalence and prevention

This article talks more on the causes of childhood obesity such as physical inactivity in that, children prefer playing video to having healthy activities such as swimming or playing in the playgrounds, poor dietary such as high caloric intake, foods with a high level of sugars, genetic factors, how cultural environment influences obesity among children and psychological factors. Impact of advertising junk food and also the preventive measures towards eradicating childhood obesity such as Parents being role models to their children on healthy eating and exercising at an early age. The article has a lot about the health risk factors associated with childhood obesity like type II diabetes, cardio respiratory diseases and stroke. It is a credible source as it has detailed information on the causes and prevention of childhood obesity. The information in the article will strengthen the argument on how poor diet or nutritional habits cause childhood obesity (Dehghan, Akhtar and Merchant, 2005).

Donahue, E. Paxson, C, Haskins and Ron (2006) Future of children: fighting obesity in the public schools

The article acknowledges how childhood obesity has increasingly grown the United States. It recognizes efforts schools are making toward fighting childhood obesity and encourages that more should be done such as including physical activities in the schools’ curriculum and making it mandatory as it will increase the chances of every child being physically active. Also, the article gives detailed information on how and why the government should take part in fighting this pandemic of childhood obesity. Information on the call to take action from congress to put more restrictions on the diet program in the school system; It gives more detail on setting up detailed goals and objectives for change in public school thus making it a credible source (Donahue, Haskins, Paxson and Ron, 2006).

Clinic, M (2006) Child Obesity

In the article, it is clear that childhood obesity is a serious problem globally and especially the industrialized nations. The article continues to give an explanation on the main causes of childhood obesity such as eating fast foods, foods with a high level of sugars and the e health risk factors associated with childhood obesity. It explains the processes of diagnosis and screening, effects it has on children and preventive measures that can be taken. This article is a very credible source in the research paper as it has detailed information on the causes of childhood obesity. Though it has great information, it lacks to provide enough supporting material of their conclusions (Mayo Clinic, 2006).

Centers for Disease Control and Prevention. (2010.) Childhood Obesity

This source states the many facts which have accrued as a result of childhood obesity. It shows how cases of childhood obesity have increased over the past thirty years with a higher percentage of children in the United States of age6- 11years being obese. This source defines obesity as having excess weight for a particular height. The causes of obesity Are also given in this article such as high caloric intake, environmental factors, genetic factors, behavioral factors and physical inactivity. It is clear that kids are the most affected and fall in this unhealthy balances and standards. This is a very credible source as it has information on the causes of childhood obesity as it also gives the preventive measures of this disorder among children. This source is very credible since it provides statistical evidence on issues relating to childhood obesity. The article looks at childhood obesity in the United States and may be questionable in terms of quality when talking about obesity globally. The source will support the argument that childhood obesity is on the rise (Centers for Disease Control and Prevention, 2010).

Centers for Disease Control and Prevention. (2006). Nutrition and the Health of Young People

This is a helpful source as gives more information on healthy eating, associated with the reduction of diseases associated with poor diet such as heart diseases, diabetes, cancer and stroke. Information on healthy eating among kids is given in order for the proper growth of children and prevents cases of child obesity. The article gives detailed guidelines for a recommended diet rich in grains, low fats dairy products, fat free for children. Schools are also are able to promote healthy eating among children by ensuring that only nutritious and the. The school food programs should provide appealing foods. Also, physical activity and nutrition program should be included in the school curriculum. The source will be supportive in the argument that poor diet causes childhood obesity (Centers for Disease Control and Prevention, 2006).

Did you find any useful knowledge relating to childhood obesity in this post? What are the key facts that grabbed your attention? Let us know in the comments. Thank you.

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Steve Jones

My name is Steve Jones and I’m the creator and administrator of the dissertation topics blog. I’m a senior writer at study-aids.co.uk and hold a BA (hons) Business degree and MBA, I live in Birmingham (just moved here from London), I’m a keen writer, always glued to a book and have an interest in economics theory. View all posts by Steve Jones

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