This article is based on a study carried out from October, 2007 to May, 2008 that investigated the extent to which overweight and obesity were challenges among primary school children in Kinondoni and Njombe Districts in Tanzania. Systematic random sampling was used to select schools while stratified sampling and simple random sampling were used in selecting pupils and teachers who participated in the study. Measurement of weights and heights was done to determine Body Mass Index (BMI), while measurement of skin folds was done to determine body fat percentage. Close-ended questionnaires, semi-structured interviews and focus group discussions were used to collect data on the implications of overweight and obesity on health and learning behaviours. Findings of the study revealed that an average of 13.5% of children were overweight or obese. Hypertension, excessive sweating, teasing and peer rejection were common to obese children. In addition, overweight and obese children were reported to perform less than their peers in academic and physical activities. This study rerecommends among other things the establishment of education programs through mass media to raise people’s awareness of how overweight and obesity affects children’s health, social and classroom learning behaviours as well as performance.
Overweight and obesity are worldwide problems now days. Tanzania, like many countries in the world, is currently experiencing the problem of overweight and obesity not only among adults, but also in children. Literature shows that a high percentage of the world’s population is overweight or obese, with the USA having 50%, Australia 37%, Western Europe 30% and India 17% (Gavin, 2005). According to WHO (2005), this may mean that, a big number of worlds’ population is at risk of developing cancer, cardiovascular diseases, non-insulin-dependent diabetes, severe articular dysfunctions, and hypertensions worldwide.
Overweight and obese children are reported to be at risk of serious health conditions such as high cholesterol, insulin resistance, bone problems, joint problems and shortness of breath, which make exercise and physical activity difficult (Johnson, 2002). Accordingly, problems of restless or disordered sleep patterns and tendency to mature earlier than usual are common to overweight and obese children. Overweight girls may experience irregular menstrual cycles that can lead to fertility problems in adulthood. Gall bladder diseases and depression are also common to overweight and obese children (Ekblom, 2005). Overweight and obese children may also become more susceptible to easy fracture due to osteoporosis and too much weight that cannot be sustained by leg bones (Gavin, 2005; Diertz, 1998). Accordingly, many people have been suffering from degenerative diseases of weight-bearing joints, such as knees. Such problems were once considered exclusively adult diseases. Pains in the lower back are also common in obese people and may be one of the major contributors to obesity-related absenteeism from work and schools (Newbold, 2004).
There are other several risks associated with childhood overweight and obesity. Johnson (2002) describe that overweight and obesity entail health risks to the affected individual and the public. The Australian Institute of Health and Welfare (2004) lists the relationship between different body weight level and associated ‘co-morbidities’ or health risks (see Table 1).
Table 1: Classification of Body Mass Index (BMI) versus Risk Level
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Source: Australian Institute of Health and Welfare (2004)
From Table 1, BMI beyond 30 has a lot of associated risks that can lead to health, social and psychological problems. BMI above 40 is dangerous and requires closer medical attention (Newbold, 2004). Overall, overweight and obesity entail health risks (Diertz, 1998) with potential effects to the social and economic wellbeing of an individual and the community at large. Poor health conditions resulting from overweight and obesity among children may act as a barrier to the development of a healthy mind, and thus pave the way to poor learning behaviours and outcomes (Rowland, 1990).
Some studies show that obese children are likely to experience social rejection and bullying from peers as well as teachers (Swan, 2002; Janssen, Craig, Boyce, & Pickett 2006; Trost 2007). Bullying and teasing of obese children undermine their academic potential and future social wellbeing (Jansen et al., 2006). Understanding causes of overweight and obesity can help in identifying preventive measures, thus reducing the number of children likely to experience bullying at school.
In 2001, the Tanzanian government abolished competitive sports and physical education in schools (Bulamile, 2002). From this time new schools were being registered without meeting the criteria of having play grounds and reserved areas for sports and physical activities, where children can play. Although the situation was corrected in early 2008, many urban schools in Tanzania have neither a garden nor space for sports activities. Urban school children thus, have limited opportunity to participate in farming, sports or other physical activities, and so are becoming more vulnerable to overweight and obesity than their rural counterparts.
Participation in physical activities such as sports has a significant impact on the quality of children’s lives. Mood, Musker & Rink (1995) argue that in order to provide and maintain optimum health, it is necessary for people of all ages to participate in physical exercise such as walking, jogging, swimming or cycling. Such activities are considered important to enhancing physical fitness and physical health as well as the development of cognitive ability. The ancient Greeks believed that a sound mind exists in a healthy body as Plato said, “ mens sana en corpore sano ” (cited in Rowland, 1990). According to Mabagala (2002), sports and physical activities have a potential role in the development of good physical health and fitness. It is also important in developing mental health and thus improving academic performance among school children (Mabagala, 2002).
The present study discusses the effects of overweight and obesity on learning behaviours and outcomes among primary school children in Tanzania. The study tested the following hypotheses:
i. There is no significant difference in prevalence of overweight and obesity between urban and rural primary school children.
ii. Overweight and obesity have no significant ‘impact on the health and social wellbeing of primary school children
iii. Overweight and obesity have no significant impact on children’s learning behaviours or outcomes.
This study, investigated obesity related health problems which had impacts on children learning behaviours and learning outcomes. Also it investigated social interaction between children who are overweight and obese, and those who are not. In addition, it proposed some control measure that can be taken by pareants and policy makers to minimize the impact of overweight and obesity in the country.
Effects of obesity on learning behaviours and outcomes
Overweight and obesity are reported to affect children’s psychosocial outcomes, leading to low self-esteem and depression which together affect other aspects of children’s lives, such as academic performance, with potentially even more serious long-term social outcomes (Swan, 2002). Datar, Sturm & Magnabosco (2004), reported that lower educational achievements among adults are associated with obesity while obese adolescents consider themselves worse students than ‘normal-weight’ students.
Social and psychological effects of obesity, which result from teasing and bullying, have also been undermining these children’s academic performance (Datar et al., 2004). Bullying is reported to be the highly prevalent (30%) form of aggression that involves repeated use of power and aggression. Social and psychological ramifications induced by bullying-victimization processes are reported to hinder the social development of overweight and obese children, since they are particularly reliant on peers for social support, identity, and self-esteem (Morrison, 2002). Janssen et al (2006) and Swan (2002) revealed that teachers also have negative attitudes toward obese children. Swan observes that teachers appear to pay less attention to overweight and obese children in the classroom than those who are not. According to Swan, both pre-service and in-service teachers perceive obese children more negatively than average-weight children. Rejection from teachers and peers causes the majority of overweight and obese children to drop out of school have higher levels of stress, anxiety, depression and illness which in turn affect children’s academic performance records (Morrison, 2002).