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      Elucidating knowledge and beliefs about obesity and eating disorders among key stakeholders: paving the way for an integrated approach to health promotion

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          Abstract

          Background

          Understanding the knowledge and beliefs of key stakeholders is crucial in developing effective public health interventions. Knowledge and beliefs about obesity and eating disorders (EDs) have rarely been considered, despite increasing awareness of the need for integrated health promotion programs. We investigated key aspects of knowledge and beliefs about obesity and EDs among key stakeholders in Australia.

          Methods

          Using a semi-structured question guide, eight focus groups and seven individual interviews were conducted with 62 participants including health professionals, personal trainers, teachers and consumer group representatives. An inductive thematic approach was used for data analysis.

          Results

          The findings suggest that, relative to obesity, EDs are poorly understood among teachers, personal trainers, and certain health professionals. Areas of commonality and distinction between the two conditions were identified. Integrated health promotion efforts that focus on shared risk (e.g., low self-esteem, body dissatisfaction) and protective (e.g., healthy eating, regular exercise) factors were supported. Suggested target groups for such efforts included young children, adolescents and parents.

          Conclusions

          The findings indicate areas where the EDs and obesity fields have common ground and can work together in developing integrated health promotion programs.

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          Most cited references44

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          Advancing Tailored Health Communication: A Persuasion and Message Effects Perspective

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            Mobilisation of public support for policy actions to prevent obesity.

            Public mobilisation is needed to enact obesity-prevention policies and to mitigate reaction against their implementation. However, approaches in public health focus mainly on dialogue between public health professionals and political leaders. Strategies to increase popular demand for obesity-prevention policies include refinement and streamlining of public information, identification of effective obesity frames for each population, strengthening of media advocacy, building of citizen protest and engagement, and development of a receptive political environment with change agents embedded across organisations and sectors. Long-term support and investment in collaboration between diverse stakeholders to create shared value is also important. Each actor in an expanded coalition for obesity prevention can make specific contributions to engaging, mobilising, and coalescing the public. The shift from a top-down to a combined and integrated bottom-up and top-down approach would need an overhaul of current strategies and reprioritisation of resources.
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              Quality of life impairment associated with body dissatisfaction in a general population sample of women

              Background In order to elucidate the individual and community health burden of body dissatisfaction (BD), we examined impairment in quality of life associated with BD in a large, general population sample of women. Methods Self-report measures of BD, health-related quality of life (SF-12 Physical and Mental Component Summary scales) and subjective quality of life (WHOQOL-BREF Psychological Functioning and Social Relationships subscales) were completed by 5,255 Australian women aged 18 to 42 years. Results Most participants (86.9%) reported some level of dissatisfaction with their weight or shape and more than one third (39.4%) reported moderate to marked dissatisfaction. Higher levels of BD were associated with poorer quality of life for all items of both quality of life measures, the degree of impairment being proportional to the degree of BD. Associations were strongest for items tapping mental health and psychosocial functioning, although greater BD was associated with substantially increased risk of impairment in certain aspects of physical health even when controlling for body weight. Post-hoc analysis indicated that the observed associations between BD and quality of life impairment were not accounted for by an association between BD and eating disorder symptoms. Conclusions In women, BD is associated with marked impairment in aspects of quality of life relating to mental health and psycho-social functioning and at least some aspects of physical health, independent of its association with body weight and eating disorder symptoms. Greater attention may need to be given to BD as a public health problem. The fact that BD is “normative” should not be taken to infer that it is benign.
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                Author and article information

                Contributors
                bbul5619@uni.sydney.edu.au
                aaron.denham@mq.edu.au
                stephensc1990@gmail.com
                r.olson@uq.edu.au
                deborah.mitchison@mq.edu.au
                tim.gill@sydney.edu.au
                sarah.maguire@sydney.edu.au
                jlatner@hawaii.edu
                P.Hay@westernsydney.edu.au
                bryan.rodgers@anu.edu.au
                dick.stevenson@mq.edu.au
                stepehn.touyz@sydney.edu.au
                jon.mond@utas.edu.au
                Journal
                BMC Public Health
                BMC Public Health
                BMC Public Health
                BioMed Central (London )
                1471-2458
                16 December 2019
                16 December 2019
                2019
                : 19
                : 1681
                Affiliations
                [1 ]ISNI 0000 0004 1936 834X, GRID grid.1013.3, Boden Institute of Obesity, Nutrition, Exercise and Eating Disorders, Faculty of Medicine, , The University of Sydney, ; Sydney, NSW 2006 Australia
                [2 ]ISNI 0000 0001 2158 5405, GRID grid.1004.5, Macquarie University, ; Sydney, New South Wales Australia
                [3 ]ISNI 0000 0000 9320 7537, GRID grid.1003.2, The University of Queensland, ; St. Lucia, Queensland Australia
                [4 ]ISNI 0000 0000 9939 5719, GRID grid.1029.a, Western Sydney University, ; Penrith, New South Wales Australia
                [5 ]ISNI 0000 0001 2188 0957, GRID grid.410445.0, University of Hawaii at Manoa, ; Honolulu, Hawaii USA
                [6 ]ISNI 0000 0001 2180 7477, GRID grid.1001.0, Australian National University, ; Canberra, Australian Capital Territory Australia
                [7 ]ISNI 0000 0004 1936 826X, GRID grid.1009.8, University of Tasmania, ; Launceston, Tasmania Australia
                Author information
                http://orcid.org/0000-0002-5601-778X
                Article
                7971
                10.1186/s12889-019-7971-y
                6916014
                31842820
                67bf2d81-bcc3-43ce-af66-cf36024dac0d
                © The Author(s). 2019

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 20 January 2019
                : 19 November 2019
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2019

                Public health
                eating disorders,obesity,integration,health promotion,stakeholders
                Public health
                eating disorders, obesity, integration, health promotion, stakeholders

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