Child obesity: Psychological Review
Introduction
Obesity in
children is considered as complex disease or serious medical condition which
effect childhood. It occurs when child is overweight compare to height and age
with having a body mass index more than 25 or 30. It is also term as excessive
fat increase which can present a risk to health. Children’s BMI differ from
adults because body composition and unlike in females and males.
Childhood
obesity is a serious cause which is occurring worldwide in present time over
157 million children. A survey on obesity in England conducted by ‘The Health
Survey for England 2021’ mostly people are between over-weighted and obese. Estimated,
19.3% of children in US are also obese. Obese child can carry this condition
into adulthood. Commonly, these children are at higher risk of hypertension,
heart diseases, stroke, cancers, fatty liver, asthma, and sleep apnea.
Childhood
obesity can become problem of any child. However, few certain groups become
more effected. Socio-economic status and ethnicity play role in childhood
obesity. In general, in case a child belongs to an educated family will pursue
a healthy lifestyle compare to poor people. Recent statistics on this issue
explained lower income led 18.9% obesity, and higher income group, only 10.9%
obesity.
Psychologically
these children face bulling, depression, stress, anxiety, low self-esteem,
social isolation, and sometimes body dysmorphic disorder can be developed. This
article will majorly focus on psychological effects and approaches, previous
researches on child obesity, and psychological perspective on child obesity.
“The rise
of childhood obesity has placed the health of an entire generation at risk”
–Tom Vilsack
Causes of childhood obesity
Obesity in
children have many contributing factors. People preserve it as laziness of any
person or lack of willpower to reduce extra weight. Children in developing age
need certain amount of food for growth and development. Intake of calories more
than need can cause fat in body. There are several common causes:
Families'
shared behaviors, like eating habits and lack of physical activity, can
contribute to childhood obesity. Busy families often consume high-fat, sugary
foods and beverages that lack essential nutrients. Moreover, children are
spending more time indoors, being inactive due to the popularity of video
games, tablets, and smartphones. A study on Australian children provided
average of 2.5 hours on technology.
“Obesity
affects every aspect of a people’s lives, from health to relationships.” –Jane
Velez-Mitchell
Childhood
obesity is also cleared by behavioral susceptibility theory by Dr Mortitz Herle
in March 2023, after excessive increase in child obesity, in London. Childhood
obesity has been a significant research focus, with weight development
influenced by genetic, psychological, and environmental factors. Theory
suggested that some children are more prone to gaining weight due to their
behavioral responses to environmental cues and social pressures. Genetic
factors also play a role, as children with a genetic predisposition to obesity
may be more susceptible to weight gain.
In,
cultural role, fast food and unhealthy snack food advertisements can contribute
to childhood obesity. Children are exposed to these commercials on TV and
billboards, promoting calorie-dense foods and large portion sizes. While
hormone disorders and certain medications can increase the risk, diseases are
rarely the cause of childhood obesity. Medical examinations can help rule out
underlying medical conditions.
Psychological perspective on child obesity
Psychology
focus on factors i.e personal, parental, and family stress as a cause of child
obesity. Many psychologists think children overeat to tackle problems or with
emotions. Emotional and psychological conditions can influence food
consumption, potentially impacting overall health. A study aimed to explore the
relation of food consumption, emotional eating behavior, and emotional states
like stress, depression, loneliness, boredom eating, vigilance, and emotional
food consolation.
Thus, that
research confirmed the link between mood/emotional conditions and food choices,
as well as the perception that food can fill emotional voids caused by
loneliness, sadness, stress, and other life events. These emotions can have a
negative impact on eating disorders. Psychologically, using food as a source of
comfort can help reduce stress, but it's important to choose nutritious
options.
Another
study on psychological stress elaborated, a strong connection between stress in
early life and obesity in adulthood. Adverse childhood experiences, poverty,
food insecurity, and poor relationships with parents are major sources of early
life stress. Chronic and acute stress can disrupt the stress regulation system,
impact brain regions responsible for emotion regulation, and promote obesogenic
eating behavior and lifestyle factors that increase obesity risk.
A research
has highlighted the importance of addressing the mental health of obese
children, as they often experience psychosocial problems that impact their
overall well-being. These issues can act as causal or maintaining factors of
obesity and affect treatment outcomes. Clinicians and pediatricians should
expand their clinical assessments to include screening for important
psychosocial factors in childhood obesity.
Psychological impact of childhood obesity
A.
A research study in 2013 by
Daniel Stein explained, childhood obesity is increasing worldwide. Researchers
have long focused on understanding the psychological and social aspects of this
issue. Overweight children often face challenges such as poor school and social
performance, lower quality of life, bullying, and negative self-esteem. While
not all obese children show psychopathology, those referred for clinical help
may experience depression, anxiety, behavior problems, ADHD, and disordered
eating. Parental perceptions of their child's weight also greatly impact the
well-being of obese children and their self-perception.
Obese children have low self-esteem; negative body esteem is usually
associated with the severity of overweight. Negative attitudes towards
overweight peers are common among normal weight children, and obese adolescents
may face societal victimization and peer teasing. Obese children themselves
often have negative perceptions of their own characteristics related to their
weight. (it can become reason of body dysmorphic disorder).
Binge eating disorder (BED) in obese children can increase the
likelihood of all psychological issues. Diagnosing BED in children can be
challenging, as adult criteria may not be suitable. Some parents may
underestimate their child's overweight and their eating habits, while others
may be overly concerned. Parental unacceptance can negatively impact the
well-being of overweight children, even more than their actual BMI.
B.
Another research published in
2016, by Jean Rankin and colleagues which highlighted the ongoing uncertainty
surrounding the relationship between childhood obesity and psychiatric
disorders. While the prevalence of childhood overweight/obesity and associated
psychological issues is increasing, it remains unclear whether these factors
are causally linked.
This complex issue requires a strategic approach to combat the rising
trend and its impact on the health and well-being of the younger generation.
Urgent research is needed to identify the various mechanisms driving this
trajectory. By understanding these factors, we can develop effective
interventions to address childhood obesity and promote psychological
well-being.
Diagnosis of obese children
If parents
become concerned about their child's weight, it's important to consult a
healthcare professional. They can assess child's condition using a BMI-for-age
growth chart and help create a healthy weight loss plan. They may also discuss
healthy food choices and appropriate physical activity. If needed, they can
refer you to a suitable weight management program for your child.
Psychologists
should be mindful of warning signs that may suggest the presence of an
underlying psychological disorder. Some general indicators that can be noted
during the clinical assessment include changes in behavior (such as irritation,
hyper mood, anxiety, restlessness), recent weight gain, poor performance in
academics, low body esteem, family
issues, bullying, low mood, and unhealthy eating habits (such as restrained
eating, impulsive eating, and emotional eating).
In case,
the pediatrician notices any red flags, they can use screening questionnaires
like the Child Behavior Checklist. However, these questionnaires don't provide
a confirmative diagnosis. Comorbidity
with other psychiatric disorders can be treated, by collaboration with a mental
health professional is recommended.
Management plans and psychological interventions
Focusing on
child's overall health and supporting them in their journey towards better
health is crucial. Parents should remember, accepting child at any weight and
avoiding blame can help them feel good about themselves. Changing physical and
eating pattern of family can benefits each person. Make it habit, for at least
one hour of regular physical exercise each day for child can improve health and
obesity of child. Support child in finding enjoyable physical activities that
are suitable for their abilities.
Encourage
less screen time by limiting it to no more than two hours a day. Also, it’s
important to avoid putting your child on restrictive diets for weight loss.
Only do so under the supervision of a healthcare provider for medical reasons.
Restrictive diets can lead to eating disorders. Instead, focus on teaching
healthy eating habits by serving a variety of fruits and vegetables to your
family. And, limit sugary drinks to reduce calorie intake.
Instead of
dictating foods, guide your family's choices by ensuring a wide variety of
healthy options are available at home. Involve your child in food shopping and
meal preparation to teach them about nutrition and give them a sense of
accomplishment. Encourage them to eat slowly to better detect hunger and
fullness. Make mealtimes pleasant and avoid eating in front of the TV. Plan
nutritious snacks to avoid overeating.
Avoid using
food as a reward to prevent a child from thinking certain foods are better than
others. Monitor child's meals except of home and pack a balanced meal box. Choose healthier options and consider portion
sizes when dining out. Set a good example by taking leftovers home.
To
effectively address childhood obesity, it's important to integrate
psychological approaches into clinical management. Cognitive Behavior Therapy
(CBT) is an evidence-based treatment modality for weight loss. Family-based
treatment, incorporating CBT techniques, is considered the gold standard. NICE
guidelines recommend behavioral change techniques, positive parenting skills,
and involving both parents and children for better results. Comorbid conditions
like depression and anxiety may require appropriate medications.
Psychoeducation
involves educating parents and children about the illness, assessment, therapy,
and their roles. Goal setting helps children set achievable therapy goals.
Self-monitoring, is based on CBT technique, permit children to check food
intake, body struggle and weight over time.
Stimulus
control involves changing the environment to promote healthy habits, like going
to parks instead of malls to increase physical activity and reduce junk food
consumption. A behavioral contract is a written document that specifies rewards
for specific behavior changes.
Reinforcement
is when therapists or parents positively reward each behavioral change. Problem
solving teaches children how to solve problems in a positive way. Cognitive
restructuring helps children replace negative thoughts with more positive ones.
Risk factors in treatment of obese child
Children
can be motivated through behavioral techniques like reinforcement and
behavioral contracts. Parental attitudes can be changed through
psychoeducation, making them aware of the health risks associated with obesity.
Environmental restructuring and stimulus control can help address the
obesogenic environment.
Educating
family and friends about their role can enhance social support. To manage food
intake of family and history of family obesity, school authorities can be
helpful for providing support. Healthy cooking competitions and sports can be
managed by them to motivate parents and encourage positive lifestyle changes.
Conclusion
In
conclusion, addressing the causes of childhood obesity requires a multifaceted
approach. Studies have shown that factors such as family eating habits, family
history of obesity, and lack of physical activity can contribute to this issue.
Furthermore, it is important to recognize the psychological issues associated
with childhood obesity. Collaborating with mental health professionals and
pediatricians can lead to a comprehensive
psychosocial assessment, which helps identify underlying psychological
disorders.
Addressing
the psychological aspects of childhood obesity is crucial for effective
intervention. By involving mental health professionals a comprehensive
psychosocial assessment can be conducted to identify underlying psychological
disorders and develop targeted intervention plans. Techniques such as psychoeducation,
goal setting, self-monitoring, and cognitive restructuring can support
children's mental well-being while addressing weight concerns.
Screening
questionnaires like the Child Behavior Checklist can help assess for
internalizing or externalizing disorders. It is important to remember that a
holistic approach, considering both physical and mental health, is essential
for children. Seeking professional help and creating a supportive network can
make a significant impact on addressing the psychological factors contributing
to childhood obesity.
