Trim and Fit

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

Overview

Overall, the program was highly successful in bringing down the obesity rate of schoolchildren from 14% to 9.8% by 2002, but it came at a psychological cost of participants being stigmatized and in some cases, reportedly diagnosed with eating disorders. [http://findarticles.com/p/articles/mi_kmafp/is_200505/ai_n14750552 Singapore schools' weight-loss program linked to eating disorders: study] , Agence France-Presse, 24 May 2005] [http://www.moe.gov.sg/forum/2005/forum_letters/20050520.pdf School link to eating disorders possible] , Sandra Davie, The Straits Times, 16 May 2005] [http://www.theworld.org/?q=node/14022 Obesity series part III: Singapore] , The World (radio program), 14 November 2007] The TAF has since been replaced by a program encompassing the inclusion of all schoolchildren.

The program

The Trim and Fit Programme was introduced into schools in 1992 as part of the National Healthy Lifestyle Campaign, a result of a national committee appointed in 1991 to review the nation's health plan. Students aged 9 to pre-tertiary education had to undergo annual BMI measurements and National Physical Fitness Award (a precursor fitness test similar to Individual Physical Proficiency Test for National Servicemen). The country's population at that time was showing an increase in obesity that became associated with health problems and loss of manpower for male conscripts in National Service, which were deemed unfit to be deployed for combat service. [http://www.time.com/time/asia/covers/501041108/obesity_singapore.html Singapore Shapes Up] , Bryan Walsh, Time Asia, 1 November 2004]

The program was deemed by observers as an interventionist measure, required students which were deemed overweight to be subject to additional intense exercises or physical activities for at least one and a half hour per week, organized during recess or at times set aside before or after lessons at schools' discretion. They were also issued with "calorie cash" - food ration coupons of which no more than a certain number of calories may be purchased and consumed in a recess break, which was inversely proportional to the child's obesity rate. [http://www.singapore-window.org/sw05/050222a4.htm Schools making fat students thin, but emotional burden is heavy] , Agence France Presse, 22 February 2005] Children which exceeded the 160% of the ideal BMI were referred to the Health Promotion Board for follow-up action.

A direct impact of the TAF Programme was the reduction of the obesity rate of schoolchildren from 14% to 9.8% by 2002. [http://www.diabetesvoice.org/issues/2003-05/Fighting_fat_with_TAF_in_Singapore.pdf Fighting fat: with TAF in Singapore] , Warren Lee, Diabetes Voice (International Diabetes Federation), May 2003] In this aspect of success, public health experts have evaluated this model for a possible replication around the world.

Psychological factors

Psychological motivation and peer pressure was emphasized in implementation of the program, which formed the bulk of criticisms towards the program as being insensitive and heavy-handed. Several participants which were previously subject to TAF report experiences of stigmatization, teasing, physiological stress and lower self-esteem as they found themselves being singled out for being obese. [http://www.washingtonpost.com/wp-dyn/content/article/2007/03/20/AR2007032001145.html Singapore to Scrap Anti-Obesity Program] , The Associated Press, 20 March 2007] "HuHF, it's not TAF to get fit", Samantha Eng, The Sunday Times, 24 February 2007] It was also quickly pointed out that the name of the program contained a negative connotation, as its reverse acronym was 'FAT'. Despite such criticisms, education officials continually insisted that the program was not out to stigmatize overweight children.

A carrot-and-stick approach was adopted in putting pressure on schools to meet the targets of fitness and obesity set by the ministry. Cash incentives were awarded by the ministry to school management were that exceeded targets and invented new strategies in keeping students thin, while those who fail to do so face humiliating "consultation" sessions by ministry officials. Schools were also ranked annually to how well the targets were met at national level. Schools were given wide discretion in determining how TAF was to be implemented, which resulted in few schools going as far as apartheid-like segregation - for instance, where children categorized were grouped as normal or overweight to sit in different tables to eat during recess.

In 2005, a National University of Singapore study on 4,400 schoolgirls linked TAF to an increase in eating disorders. It found that girls were more likely to have poorer relationship with their parents and their female friends. The findings correlated to a Singapore General Hospital study released a week earlier which found that instances of anorexia and bulimia have increased six-fold from 1994 to 2002. [http://thestar.com.my/news/story.asp?file=/2007/6/24/focus/20070624074044&sec=focus Hell-bent on looking thin] , Ng Cheng Yee, The Star (Malaysia), 24 July 2007] The Ministry of Education quickly rejected these findings that claimed TAF was a factor in the increase in anorexia. [http://www.moe.gov.sg/forum/2005/20050520.htm TAF students not at higher risk of anorexia] , Ho Peng, Ministry of Education, Singapore, 20 May 2005]

Two years later, in 2007, the Ministry of Education decided to scrap the program, replacing it with the Holistic Health Framework (HHF). The new program intends to include all schoolchildren in ensuring their fitness and health. [http://www.smh.com.au/news/opinion/spare-the-rod-and-correct-the-policies-that-cause-childhood-obesity/2007/04/11/1175971177269.html Childhood obesity's about good choices] , Melinda Tankard Reist, The Sydney Morning Herald, 12 April 2007]

References

External links

* [http://www.moe.gov.sg/cpdd/pe/taf/ MOE website on TAF]