Understanding Actors and Factors that Influence the Development of Obesity Among Pre-Schoolers in the Bangkok Metropolitan Area

In Thailand, obesity in children aged 0-6 increased by 40% between 2004 and 2009, and urban residence was a significant risk factor. My study investigates actors and factors that influence obesity among pre-schoolers in the Bangkok Metropolitan Area. I use ecological system theory as a framework and employ a qualitative inductive approach to data collection to capture the temporal and spatial specificity of consumption. Pre-schoolers and caregivers and their interactions around food are my focus; however, I also investigate policy and interventions at national and institutional levels that influence childhood obesity. As part of a nested case study design, I select three kindergartens used by families of varying socio-economic status, and the homes of 18 pre-schoolers attending these kindergartens. My main method is participant observation and I use formal and informal interviews to gain more understanding of the data derived from the observation.

I identify three domains of food consumption: main meals, milk, and snacks, which are also the focus of Thai government policy addressing undernutrition. The effectiveness of these policies is affected by caregivers’ values concerning child-rearing and feeding, and by children’s characteristics and agency, expressed through their negotiation of their food choices with adults. While the lifestyles of employed parents and the obesogenic environment of the metropolitan area contribute to adults’ decisions concerning children’s food, socio-economic status is found to be a minor influence. More important are the values that adults hold, shaped by campaigns from the government and the private sector; e.g. buying expensive fortified milk because milk is good for children. My thesis shows how this combination of social and economic factors leads to the consumption of food high in sugar and calories.