Challenging Dogma - Spring 2011

Friday, May 6, 2011

Combating Childhood Obesity: A Critical Review of Jamie Oliver’s Food Nation—Sarah Weas

Childhood obesity has become a major problem in the United States. The health of our youth is at risk with the alarming statistics that indicate that approximately 17% or 12.5 million children and adolescents in this country are obese1. This number is on the rise and has nearly tripled in the past 30 years. Childhood obesity is seen across all ethnic backgrounds, sexes, and income levels and can be attributed to several factors: a child's eating habits, physical activity level, hormones, genetics and environment2. Obesity carries with it both physical and emotional problems. Children who are overweight or obese have an increased risk of heart disease, Type II Diabetes, high blood pressure, depression, and sleep disorders to name a few1. Furthermore, overweight children face an increased risk of suicide, depression, bullying, and low self-esteem, which can have equally devastating effects on child development.
Limited access to affordable and healthy food has led to higher levels of childhood obesity. Millions of low-income children live in “food deserts,” neighborhoods saturated with fast-food restaurants and convenience stores but that lack convenient access to supermarkets3. Additionally, healthy, low calories meals that contain fruits and vegetables can be almost twice as expensive as the high-energy meals so often purchased at fast- food restaurants and convenience stores4. Our over reliance on packaged and overly processed food is causing real harm that is not just damaging the health of our children but the health of all of us.
We have created an entire generation that has a severely limited understanding of where food comes from and how it is produced. Modern agricultural practices, in order to produce mass quantities of the highly packaged and processed foods consumed by so many Americans, have resulted in polluted soil, air and water, a dependence on imported oil and a loss of biodiversity5,6. In a time of global climate change, where the consequences of our over consumption of finite natural resources is being revealed, there has been a call for a revolution: to attain sustainable food production in order to reduce the environmental impact of the agricultural system.
When we examine school food service across the United States, we become acutely aware of the reasons for childhood obesity rates and the environmental impact of our eating habits. The school food programs heavy reliance on factory pre-cooked and processed foods combined with the fact that French fries are considered a vegetable make these problems apparent7. Recently, there has been a call for a revolution across the country. Advocates motivated by childhood obesity rates and the environmental impact of eating behaviors have pushed for a change in the foods served in our schools8. Grass root campaigns across the country are urging schools to use fresh, local foods in schools to make meals that include nutritious fruits, vegetables, and whole grains in hopes of changing our eating habits as well as the health of our children and our environment.
Celebrity chef Jamie Oliver has joined this movement by creating a campaign calling for a dramatic change in eating habits of our children. Through his “Food Revolution” movement, Oliver has waged a war against obesity9. Through his American television series aptly named “Jamie Oliver’s Food Revolution,” Oliver has brought much needed attention to the quality of food we offer to our children in schools. During the first season, Oliver visits Huntington, West Virginia, identified as one of the unhealthiest cities in the country with staggering obesity rates to try to improve eating habits7. He does this by both working with school kitchens and by providing some community education. While Oliver’s television program brings the school food situation to the national stage, his movement has fatal flaws that will cause him to be unable to bring about the changes that he hopes to see. Without considering limitations of the Health Belief Model, the impact of reactance, or the importance of self-efficacy, Oliver’s goal of bringing the “food revolution” to schools and communities across America falls short and could do more harm than good.
Health Belief Model
According to Oliver, knowledge about food will make families self-sufficient so that they will be able to prepare their own meals and eliminate their need for junk foods. Oliver argues that a major problem with eating behaviors in the United States stems from the household. In a recent TEDtalk presentation, Oliver demonstrates the need to educate families. In one scene, Oliver examines one mother’s weekly food choices for her family (pizza, corn dogs, casseroles, and soda):
Oliver: “I need you to know this is going to kill your children early. How does that make you feel?”
Mother: “I’m feeling sad and depressed. I want my kids to succeed in life… but I’m killing them.”
Oliver: “Yes you are. But we can stop that.”10
Oliver emphasizes that to stop parents from killing their children, we need to teach them how to shop and how to cook healthy meals at home. To do this, he strives to create educational programs within the community to teach and promote home cooking. This emphasis on individuals making better choices through education is problematic because of its reliance on the Health Belief Model to predict a change in behavior. Developed in the 1950’s by the U.S. Public Health Service and refined in 1966 by Irwin Rosenstock, this model was created to predict the conditions in which people take action to prevent, detect, and diagnose disease11,12. The premise of the Health Belief Model is that individuals make decisions by considering their perceived susceptibility to disease and their perceived severity of disease along their perceived costs and benefits of the behavior change11. It expects that individuals weigh the positives and negatives and will then make a rational choice of which action to take. For instance, individuals will adopt a healthy behavior if they perceive that the threat of disease is very immenent and severe, that there are benefits to their health, and that there are few barriers.
A limitation of the Health Belief Model is its reliance an individual’s perceived susceptibility to and severity of disease. Several studies have shown that individuals do not recognize increased personal risks and tend to underestimate their susceptibility to disease13-15. On account of this optimism bias, the Health Belief Model cannot accurately influence personal behavior because the individual’s perception of risk and severity is inaccurate. Oliver’s reliance on this model and the lack of accountability for optimistic bias may make his campaign ineffective. The tear-jerking moments of his television program that depict scenes of morbidly obese children and mothers realizing that they are killing their children will unlikely be able to convince viewers that this could be them and that they are just as susceptible to the effects of their eating habits.
The Health Belief Model is widely criticized for its over simplification of the decision making process11. It overemphasizes individual decisions and fails to address the larger social and environmental factors that can affect an individual’s actions. What is more, it assumes that individuals are rational when in reality, their behaviors are quite irrational and often spontaneous. Oliver’s “Food Revolution” campaign places much of the blame and responsibility on families without addressing the current food environment, societal factors, or socioeconomic factors that affect access to healthy foods. By limiting the focus of the campaign to the behavior of the individual, the “Food Revolution” fails to account for the influence of society on behaviors.
Psychological Reactance
Despite Oliver’s attempt to overhaul school lunches by providing fresh, healthy meals and eliminating flavored milk, a boomerang effect occurred causing children to receive less nutritious meals than before his intervention was implemented. In the first two months after Oliver’s “Food Revolution” started in the public schools of West Virginia, the lunch participation rate dropped from 75% to 66% and there was a 25% reduction in milk consumption16. Children who dropped out of the school lunch program in turn brought food from home that was ultimately less nutritious than the school lunches provided before Oliver’s intervention. Furthermore, the drastic drop in milk consumption indicates that the students were no longer receiving the vitamins and nutrients that the flavored milks had been providing.
This boomerang effect can be explained by Jack Brehm’s Psychological Reactance Theory, which states that people value their ability to choose between different options17. When a person’s perceived freedom is threatened or eliminated, they enter into a reactance state and try to regain control by not complying.
Psychological Reactance Theory attempts to explain behavior changes that occur when individuals are told not to do something. Psychological reactance can create adverse responses to regulations or impositions that impinge on an individual’s freedom and autonomy. People are motivated by their basic need of independence and their ability to influence their environment17. They often feel vulnerable when a choice of behaviors is threatened or eliminated and will react emotionally rather than making reasonable and calculated responses. As a result, most people will do the opposite of what is expected in an attempt to restore their freedom. As a core belief, the need to control the food one consumes is discounted by Oliver’s removal of flavored milk. Removing control of food selection by reducing preferred, less healthy foods will intensify psychological reactance and increase the students’ desire for junk food.
The magnitude of reactance is proportional to how much a person values the threatened freedom18. The greater the threat to a behavior, the more likely a person is to commit those same behaviors again once told not to. Thus Oliver’s demand of eliminating flavored milk would cause varying levels of reactance depending on the extent of the student’s unhealthy eating habits. Oliver’s elimination of choice threatens to cause children with the unhealthiest of eating habits to assert their freedom by refusing to drink milk at all and most likely consume a less nutritious drink instead.
Oliver’s “Food Revolution” campaign failed to address the importance of self-efficacy in promoting behavior changes. Self-efficacy is one of the main principles of Albert Bandura’s Social Cognitive Theory that suggests that behavior is best predicted by an individual’s confidence in their ability to accomplish a given task19. An individual’s decision to engage in a particular behavior is influenced by the perception that he or she can successfully complete the behavior and achieve the desired outcome. People with high levels of self-efficacy are more likely to try new behaviors and stick with them. Self-efficacy can influence the adoption of healthy behaviors, the cessation of unhealthy behaviors, and the maintenance of behavioral changes when faced with difficult situations19. Self-efficacy is influenced by an individual’s accomplishment of completing the behavior as well as encouragement or discouragement from others.
Providing healthly food options at lunch is not enough to promote self-efficacy and bring about a permanent behavior change. Children need to feel as though they can be successful engaging in these behaviors in all aspects of their lives. Oliver’s campaign will not succeed unless the parents provide their children with emotional support and encouragement to try eating the healthy foods. Several studies have found that family social support has a positive influence on promoting healthy behaviors and that students with a negative social support network are especially at risk to develop poor health behaviors20,21. Without providing both children and parents the tools necessary to promote self-efficacy, just implementing healthy lunch foods in schools will be unable to do anything about improving the eating habits of our children. Jamie Oliver’s campaign in West Virginia did include some aspects of community education, but at most, it was a one-time only event which could not provide ongoing support to parents. Thus, it could not promote self efficacy over time.
As discussed above, the high rates of childhood obesity and the environmental impact of our food system needs to be addressed. Despite the flaws in Oliver’s “Food Revolution,” he made a strong effort to bring about a much-needed change in the foods our children are eating. Through his television program, Oliver has brought this issue to the attention of the nation. However, it has proven unsuccessful in not only changing the eating habits of students but also as a popular television program. The program was pulled from its prime-time slot during the middle of its second season due to disappointing ratings22. This provides insight to the situation showing that Americans are not ready for a food revolution.
Support should be applied instead to the grass root campaigns that have popped-up around the country such as the one described below. These grass root campaigns are often started by community members and offer a more approachable and acceptable method of instigating change. These groups are working to make local and organic food ever more appealing, accessible, and economical to a wide variety of people.
We propose to create our own grass root campaign called “Healthy Foods, Healthy Me!” that will integrate healthy activities into school curriculum in order to educate students about healthy food and to promote healthy eating habits. Integration of healthy activities into the school curriculum would start at the elementary level. This campaign would provide teachers with various lesson materials on ways to encourage healthy choices.
An integral part of this campaign will be to provide students with a complete understanding of all the steps required to eat the foods they enjoy. Teachers will be encouraged to start gardens with their students, planting fresh herbs and vegetables. This will allow students to learn how fresh herbs and vegetables are grown and all the different requirements that are needed to make them flourish. This will allow for the incorporation of lessons about different agriculture methods and their environmental impacts. The importance of local and organic foods can be taught to students during these lessons as well.
Once the gardens are harvested, teachers will work with the children teaching them different cooking skills using the vegetables that they cultivated together. This will provide students with a sense of pride and ownership, as they are able to experience all of the hard work they put into the garden when they are able to create a tasty and nutritious meal that they can enjoy. Furthermore, this will help encourage students to make healthy choices about all of the food that they eat while they are learning about where food comes from.
Additionally, throughout the curriculum, the teachers will be able to engage the parents by providing monthly or bi-weekly letters to the parents. These letters will update the parents on the progression of the garden as well as provide an opportunity to educate parents on ways to support their child’s growing education of the way food is grown and produced. The parents will be able to discuss the vegetables and herbs that the students are growing and support further education by showing their children what the vegetables look like in the grocery store. The letters could include simple recipes that the children have used in class and could also be enjoyed at home. They could also encourage parents to pack healthy snacks as well as provide simple nutrition facts that will help continue the students’ education of healthy eating habits in the home.
Reshape Food Environment
Unlike the “Food Revolution” campaign, we would not base our intervention on the Health Belief Model. We understand that an individual’s food choices are shaped by many other influences than simple knowledge about the health topic, benefits and risks of certain diets. Societal pressures, food environments, and the availability of healthy foods shape food choices. The decision of choosing what to eat is a complex topic and the simple communication of the health risks and benefits will likely be unable to create sustained behavior changes.
Instead, we need to recognize the social context in which these eating habits appear in order to create a healthier food environment for our children. There are numerous systemic issues that have influenced the unhealthy eating habits of our children: widespread poverty, junk-food advertising to children, corporate control of the food system, the prevalence of cheap fast food, and subsidies and policies that make meats and sugars cheaper than fresh fruits and vegetables2. Most of these issues are multifaceted and a substantial amount of effort is needed to change them. Although all of these issues need to be addressed, this campaign will be unable to address all of them.
We can help to shape the environment in which children eat through this campaign. By adding agriculture to the school curriculum, students will be able to learn where food comes from and how it is produced. It will provide an opportunity to educate children about modern agricultural practices as well as the environmental consequences of producing mass quantities of highly packaged and processed foods. Teachers can also provide students with different techniques to encourage students to make healthy choices amidst advertisements for unhealthy food that surrounds them. Such activities as learning about foods in the major food groups and their relationship to the food pyramid and keeping a food journal can be used to teach children about all kinds of food and food choices. These modifications in the food environment will help reduce the burden of making positive health decisions.
Minimize Reactance
As mentioned above, one of the main flaws in the “Food Revolution” campaign is the negative reactions caused by the implementation of healthier foods at lunch. The campaign restricted the freedom of the students and took away their ability to decide their own actions. This caused a boomerang effect that may have actually increased the likelihood of unhealthy eating behaviors in the students.
The “Healthy Foods, Healthy Me!” campaign does not utilize any restrictive or authoritative language to force children to change their eating habits. Rather, the newly proposed campaign features hands on learning and promotion of self-efficacy that encourages children to choose healthy foods for themselves. Children will be praised for bringing healthy snacks from home and praised for making good food choices. We will not refer to “good” foods and “bad” foods but rather to the benefits of eating a particular food. If we can link that to the individual interests of the child, it will be all the better. It is expected that the limited use of restrictive mandates will decrease the tendency for students to react against the intervention. If we are successfully able to limit reactance, then we could also expect greater compliance with the healthy eating habits among students as promoted in the intervention. If psychological reactance can be minimized, we can decrease the number of unhealthy eating habits in our children as well as increase the awareness of the population about healthy eating habits.
Promote Self-Efficacy
The “Healthy Foods, Healthy Me!” intervention addresses one of Oliver’s major flaws by providing students with the necessary tools to enhance their self-efficacy. The integration of starting a garden and cooking lessen in school would promote self-efficacy by providing the opportunity for modeling from other students and encouragement from teachers. Students will be able to participate in all aspects of food preparation, from the growing of the food to the cooking and preparation of a meal. This will help support students’ perception of successfully engaging in healthy eating habits.
Additionally, through the monthly letters to parents, parents will learn to provide emotional support, encouragement, and further education on the importance of healthy eating habits. This parental support will provide additional opportunities for modeling from those who are closest to the child. By providing both children and parents with the tools necessary to promote self-efficacy and environment supports at school, “Healthy Foods, Healthy Me!” would be effective in increasing healthy eating habits.
There have been a number of calls for action across the country to make changes in our food habits in order to stop the spread of childhood obesity and to reduce the environmental impact of our agricultural system. Jamie Oliver’s “Food Revolution” campaign brought national attention to the fact that drastic behavior changes are needed to secure our children’s futures. However, his efforts have not show any significant results, which can for the most part be blamed on the structure and implementation of the campaign. The way in which the campaign is delivered does not incite any new behaviors in the students or within the community. And at least in West Virginia, Oliver’s interventions that have been forced on children actually encouraged negative behaviors as fewer students now participate in the school lunch program and drink milk at school. As a result, there would be no expected change in the unhealthy eating habits of children across the United States. By creating a more inclusive school curriculum that educates students about how food is grown, processed, and consumed and provides support both in the school and home environment, we are expecting to promote healthy behavior changes. I believe that this campaign along with other grass root campaigns across the country will decrease the frequency of childhood obesity across the country.


1. Centers for Disease Control and Prevention. Childhood Overweight and Obesity. 2010. Available at: Last accessed: May 1, 2011.

2. Sallis, James F. The Role of Built Environments in Physical Activity, Eating, and Obesity in Childhood. The Future of Children 2006; 1631: 89-1008.

3. Centers for Disease Control and Prevention. Children’s food environment state indicator report, 2011. Available at: childrensfoodenvironment.pdf. Last accessed: May 1, 2011.

4. Access to Healthy, Affordable Food. Washington, DC: Let’s Move! Available at: Last accessed: May 4, 2011.

5. Leitzmann,C. Nutrition ecology: the contribution of vegetarian diets. Am J Clin Nutr 2003;78: :657S–9S.

6. Pimentel, D, Pimentel, M. Sustainability of meat-based and plant-based diets and the environment. Am J Clin Nutr. 2003 Sep; 78 (3): 660S-63S.

7. Del Barco, M. 'Food revolution,' L.A. schools spar over lunches. Washington, DC: National Public Radio. Available at: Last accessed: May 2, 2011.

8. Martin, A. Is a food revolution now in season? NY Times 2009 Mar 22: BU1.

9. Oliver, Jamie. “Jamie Oliver’s Food Revolution.” Available at: Last accessed: May 4, 2011.

10. Jamie Oliver's TED Prize wish: Teach every child about food. New York, NY: TED. Available at: Last accessed: May 3, 2011.

11. Airhehenbua C., Obregon R. A critical assessment of the theories/models used in health communication for HIV/AIDS. Journal of Health Communication 2000; 5:5-15.

12. Edberg M. Individual Health Behavior Theories. Essentials of Health Behavioral Social and Behavioral Theory in Public Health. 2007:38-42.

13. Weinstein ND. Unrealistic optimism about future life events. J Pers Soc Psychol.1980; 39:806-820.

14. Ayanian JZ, Cleary PD. Perceived risks of heart disease and cancer among cigarette smokers. JAMA 1999; 281:1019-1021.
15. Clarke V. el al. Unrealistic optimism and the Health Belief Model. Journal of Behavioral Medicine 2000; 23:367-376.
16. Gupta, A. How TV superchef Jamie Oliver’s “Food Revolution” flunked out. 2010 Apr 10. Available at:'s _'food_revolution'_flunked_out. Last accessed: May 4, 2011.
17. Brehm S. Psychological Reactance and the Attractiveness of Unobtainable Objects: Sex Differences in Children's Responses to an Elimination of Freedom. Sex Roles 1981; 7:937-949.
18. Miller, C.H., Lane, L.T., Deatrick, L.M., Young, A.M, Potts, K.P. Psychological Reactance and Promotional Health Messages: The Effects of Controlling Language, Lexical Concreteness, and the Restoration of Freedom. Human Communication Research, 20(33), 219–240.

19. Maddux JE, Brawley L, Boykin A. Self-efficacy and health behavior. Prevention, promotion, & detection. In: Maddux JE, editor. Self-efficacy, adaptation, and adjustment: Theory, research, and application. Plenum Press: New York; 1995. pp. 173–202.
20. Chassin L, et al. Changes in peer and parent influence during adolescent: longitudinal versus cross-sectional perspectives on smoking initiation. Developmental Psychology. 1986;22:327–334. doi: 10.1037/0012-1649.22.3.327.
21. Milligan RAK, Burke V, Beilin LJ, Richards J, Dunbar D, Spencer M, Balde E, Gracey MP. Health-related behaviours and psycho-social characteristics of 18 year-old Australians. Social Science & Medicine. 1997;45(10):1549–1562. doi: 10.1016/S0277-9536(97)00092-0.
22. Jamie Oliver show loses US primetime TV slot. 2011 May 5. Available at: Last accessed: May 5, 2011.

Labels: , ,


Post a Comment

Subscribe to Post Comments [Atom]

<< Home