Singapore’s “Trim and Fit” (TAF) Program

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Childhood Obesity News has been looking at Singapore‘s 15-year experiment that ended when a government that is often perceived as oppressively authoritarian made a surprising reversal. Under the “Trim and Fit” (TAF) program, the policy had been to closely monitor the caloric intake of overweight students during school hours, and to require them to undergo extra sessions of physical education.

This caused a certain amount of peer-group discrimination against the TAF kids (perhaps not helped by the unintended coincidence that, backwards, the acronym spells FAT). The authorities took under consideration the fact that many children and parents were unhappy, as were some of the school personnel who had to administer the program. Feelings counted, but more important was the pragmatic consideration that, according to expert consultants, “[w]eight-teasing in schools has been associated with eating disorder behaviors that may place overweight children at risk for further weight gain.”

In other words, it appeared that singling out the heavy kids just might be counterproductive. With the new Holistic Health Framework program, the focus switched to increased fitness for all, without discrimination, and schools were allowed the autonomy to design their own ways of accomplishing this.

How authoritarian is it?

If the educational system can convince children that every individual’s health is vital to the functioning of society as a whole, is there anything intrinsically wrong with that? Because in the big picture, each member of any society is a contributing factor to the success or failure of that society, however those terms are defined. In the West, we tend to express the problem as, “Your obesity will cost the overburdened medical infrastructure x number of dollars.”

Even though Singapore is a very wealthy and financially driven country, the treatment of illness is much less tax-supported than in the United States. The Singapore leadership specializes in prevention and sends a message to its people that, loosely interpreted, goes something like this: “The government will do everything in its considerable power to help you achieve and maintain peak health, and if you insist on messing up anyway, you will probably have to pay your own medical bills.”

Likewise, it does not seem insultingly bossy for a government to facilitate endless opportunities for physical activity, both in schools and in the larger community. Exercise has an amazing number of benefits, many of which carry over into the formation of a personality capable of doing what is necessary to prevent obesity. Calories in, calories out. If government concerns itself on those two fronts, to a difference-making extent, it is doing about all a government can be expected to do, and more than many U.S. citizens prefer that it do. In the eyes of many Americans, the Singapore administration looks dictatorial. But the local citizens appear to be okay with it and don’t seem to mind living in a “nanny state.”

The Asian Journal of Exercise & Sports Science listed Singapore’s Ministry of Health, Ministry of Education and Health Promotion Board as the major official bodies working with public health professionals, non-governmental organizations, businesses, workplaces, industries, local communities and schools. Additionally, programs are designed and tailored for the society’s various age groups. The main focus of all programs is to “modify the diet pattern and physical activity behaviors, the common causes of obesity.” But to give credit where it’s due, the establishment evolved beyond a strict “calories in/calories out” view of the cause of obesity. The Journal says:

Obesity is a multi-dimensional disease which occurs due to a number of factors, such as a sedentary lifestyle, poor nutrition including higher saturated fat and cholesterol, greater stress and depression, poor socioeconomic status and lack of education.

(to be continued…)

Your responses and feedback are welcome!

Source: “Obesity Prevention in Singapore,” nie.edu.sg, 2010
Image by whyohgee singapore 2010

 

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About Dr. Robert A. Pretlow

Dr. Robert A. Pretlow is a pediatrician and childhood obesity specialist. He has been researching and spreading awareness on the childhood obesity epidemic in the US for more than a decade.
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Presentations

Dr. Pretlow’s invited presentation at the American Society of Animal Science 2020 Conference
What’s Causing Obesity in Companion Animals and What Can We Do About It

Dr. Pretlow’s invited presentation at the World Obesity Federation 2019 Conference:
Food/Eating Addiction and the Displacement Mechanism

Dr. Pretlow’s Multi-Center Clinical Trial Kick-off Speech 2018:
Obesity: Tackling the Root Cause

Dr. Pretlow’s 2017 Workshop on
Treatment of Obesity Using the Addiction Model

Dr. Pretlow’s invited presentation for
TEC and UNC 2016

Dr. Pretlow’s invited presentation at the 2015 Obesity Summit in London, UK.

Dr. Pretlow’s invited keynote at the 2014 European Childhood Obesity Group Congress in Salzburg, Austria.

Dr. Pretlow’s presentation at the 2013 European Congress on Obesity in Liverpool, UK.

Dr. Pretlow’s presentation at the 2011 International Conference on Childhood Obesity in Lisbon, Portugal.

Dr. Pretlow’s presentation at the 2010 Uniting Against Childhood Obesity Conference in Houston, TX.

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