Health and PE: Fixing fitness and fatness or celebrating everyBODY

This blog is prompted by World Health Day 2022 which comes a day after Annual World Day of Physical Activity. Awareness days allow us an opportunity to reflect on key themes, in this case, Health; in this short piece I would like to explore its relationship with PE. We have also prepared a FREE resource, Top Tips for Supporting your Students’ Health, to help apply some of the points discussed into practice. Click here to receive it.

A few years ago, a Year 11 student requesting to miss PE to complete important English GCSE coursework, was refused on the grounds that all the qualifications in the world would be irrelevant if his life was cut short by preventable diseases ‘caused’ by a sedentary lifestyle.

Does this line of argument really stack up? Do we really think that PE extends life expectancy? Public Health Research carried out by the University of Edinburgh (2016) found the longest life expectancy is amongst Scottish Pakistani women, a demographic group that were also significantly under-represented in the physical activity data. How are physical educators to make sense of the complex relationship between PE and Health in a way that is safe and coherent to students and aligned to the aims of the subject?

PE (and youth sport) has increasingly been medicalised and healthified over the last 20 years (Quennerstedt, (2019, Wright et al, 2009). When working with pre and in-service teachers, the most frequent answers given to questions regarding the purpose of PE are ‘exercise is good for mental and physical health’, ‘to tackle obesity’ and ‘get children fit’. These themes are evident in a wide range of policy documents and were discussed extensively in the recent Westminster debate on PE being a Core Subject. So should PE teachers wear a white coat and/or look like Michael Vazquez/Joe Wicks? 

In an attempt to bring a tad more clarity, the obvious starting point is to consider what we mean by health. Who is defining this and for what purpose? The idea that health is a matter of personal responsibility is prevalent, persuasive but simplistic. It also implies that many people in bad health have neglected their responsibility and made ‘bad choices’ along the way. This is particularly evident in the discourse around obesity. These assumptions might explain why it is attractive to think that these problems can be fixed by ‘educating’ children on the ‘importance of healthy eating and regular exercise’, with ‘educating’ in this context being interchangeable with ‘providing information’. This largely ignores the fact that nutrition, exercise and weight gain are highly contested topics, for example, in his recent book, Burn, biologist Norman Pontzer presents a convincing case that exercise has very little, if any impact on weight management! Paul Gately, Professor of Child Obesity and world leading expert in the field, has argued for many years that obesity is no more a matter of personal responsibility than cancer and we rarely blame cancer sufferers for their illness. 

The fixation with ‘fixing’ drives policy and shapes practice. Promoted panaceas like The Daily Mile are widely and enthusiastically adopted as ways to improve Health and Wellbeing and in so doing, claim to bring about a broad range of ‘benefits’ including improved academic performance. (For a brilliant critique see Thorburn 2020.) In much of the literature around Health and Wellbeing in Schools, Health is presented in narrow terms. Mental health is now viewed as a current crisis and another thing to fix so the terms of reference are perhaps a little broader than 10 years ago when it was all about ‘tackling obesity’. Nevertheless, health is still viewed as disease/unwellness avoidance with the focus on quantity rather than quality of life. Andrew Milne’s podcast and Nathan Horne’s blog (listed below) offer excellent summaries and applications of a salutogenic (as opposed to a pathogenic) approach to health (Antonovsky, 1996). This disease avoidance approach is underpinned by the declarative knowledge mentioned above. The assumption here is that if young people ‘know’ they will ‘do’, thus the frequent references to health ‘choices’. Advertising executives have known for years that we are not rational beings. Our decisions are based on emotions, on connections and associations. Michelle Seger (2015) explains in No Sweat, how the best way to hook people into physical activity is to not flog the ‘it’s good for you’ line but to focus on how people perceive the benefits it brings to their lives. James Clear (2018) expands on this point too.

Returning to the complex relationship between PE and Health - how exactly does PE support young people’s health? A basic grasp of the FITT principles would indicate that lessons in themselves would have a negligible impact on a child’s health. It fails on frequency and intensity (with the exception of some children in some independent schools). At best, we might view improved health as a possible outcome of great PE not a driver. That’s to say it is NOT the reason to do PE but if young people have exceptionally good experiences it may impact their behaviour and that may support their health. Of course, some activities are not good for physical health like high risk, collision and combat sports. An over emphasis on competitive outcome in high performance sports leads to problems associated with stress and anxiety. So the correlation between leading an active life and improved health is not particularly straight forward. 

These issues can be burdensome for teachers too. Expectations that PE teachers need to be health and fitness ‘role models’ are commonplace. They certainly plagued my career in absurd ways like colleagues apologising for eating cake in front of me, or when I was part of a team interviewing PGCE applicants and in the decision-making conversation, a colleague had reservations about offering a place to an overweight applicant who had performed excellently throughout the day. The hypocrisy here runs deep. Is it really OK to drink alcohol as a regular and intrinsic part of socialising but being overweight is not? And that’s not to mention the sexism that admires the ‘strength’ of a male PE teacher who plays prop but disparages a woman doing the same job judged to be overweight. 

To finish, let’s return to the Scottish Pakistani women. The researchers explained their long lives by noting their avoidance of poisons like alcohol and tobacco, the clear sense of purpose (always busy) and the fact that they took most meals with people who they loved and who loved them. Unconditional acceptance and strong connections. Paul Gately says the same…the best thing schools can do for children living with obesity is not to fix them by making them run or policing school dinners but to make sure they are safe and free from the vicious bullying that plagues the lives of virtually every young person he works with. 

Helping young people develop a positive relationship with their bodies and equipping them with all they need so they freely choose to engage in physical activity for their reasons is challenging enough. Do we really have the expertise to fix fitness, fatness and mental wellbeing? And if we think the answer is YES, what on earth does success look like and how is it measured?

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References and further reading

Antonovsky, A. (1996) 'The salutogenic model as a theory to guide health promotion', Health Promotion International, 11(1), pp.11-18.

'Clear, J. (2018) Atomic Habits An Easy and Proven Way to Build Good Habits and Break Bad Ones.

Evans, J. (2013) 'Physical Education as porn', Physical Education and Sport Pedagogy, 18(1), pp.75-89.

Fitzpatrick, K. (2011) 'Obesity, Health and Physical Education: A Bourdieuean Perspective', Policy Futures in Education, 9(3), pp.353-366.

Guthold, R. et al. (2019) 'Global trends in insufficient physical activity among adolescents: a pooled analysis of 298 population-based surveys with 1·6 million participants', The Lancet Child & Adolescent Health, .

Harris, J. and Leggett, G. (2015) 'Testing, Training and Tensions: The Expression of Health within Physical Education Curricula in Secondary Schools in England and Wales', Sport, Education and Society, 20(4), pp.423-441.

Pontzer, N. (2021) Burn: The Misunderstood Science of Metabolism Penguin

Powell, D. (2014) 'Childhood obesity, corporate philanthropy and the creeping privatisation of health education', Critical Public Health: Schools and Public Health: Critical Perspectives, 24(2), pp.226-238.

Quennerstedt, M. (2019) 'Healthying physical education - on the possibility of learning health', Physical Education and Sport Pedagogy, 24(1), pp.1-15.

Seger, M. (2015) No Sweat, Amacom

Thorburn, M. (2020): A critical review of the Daily Mile programme as a contributor to lifelong physical activity, International Journal of Lifelong Education, DOI: 10.1080/02601370.2020.176

Tinning, R. (2020) 'School PE and ‘fat’ kids: maintaining the rage and keeping a sense of perspective', Curriculum Studies in Health and Physical Education, pp.1-9.

van Amsterdam, N. (2013) 'Big fat inequalities, thin privilege: An intersectional perspective on ‘body size’', European Journal of Women's Studies, 20(2), pp.155-169.

Wiltshire, G., Lee, J. and Williams, O. (2019) 'Understanding the reproduction of health inequalities: physical activity, social class and Bourdieu’s habitus', Sport, Education and Society, 24(3), pp.226-240.

Wright, J., Burrows, L. and Rich, E. (2012) 'Health imperatives in primary schools across three countries: intersections of class, culture and subjectivity', Discourse: Studies in the Cultural Politics of Education: The Impact of the New Health Imperatives on Educational Policy and Schooling, 33(5), pp.673-691.

Wright, J., Harwood, V. and Harwood, V. (2009) Biopolitics and the 'Obesity Epidemic'. London: Routledge.

Blogs and Podcasts

Andy Milne on PhysEdcastThis is not your parents health class available at ​​https://lnns.co/bHF7IO8oKJ3

iPhysEd (2021) The Role of Health in Physical Education by Nathan Horne
available at https://www.iphys-ed.com/blog/the-role-of-health-in-physical-education/

Westminster PE Debate (2022) available at here.

University of Edinburgh (2016) Usher Institute