The American Psychiatric Association joins others in the medical and public health community in calling attention to the mental health impacts of childhood obesity--a burgeoning public health crisis in the U.S.
A study at the University of Medicine and Dentistry of New Jersey found that obese girls ages 13 to 14 are four times more likely to experience low self-esteem than non-obese girls.
The study also reported that obese boys and girls with low self-esteem had higher rates of loneliness, sadness and nervousness. These children were more likely to smoke and drink alcohol compared with obese children with normal self-esteem. Depression, often an outcome of low self-esteem, affects as many as 750,000 teens in the U.S. (Source: Pediatrics, "Childhood Obesity and Self-Esteem," January 2000.)
Untreated depression can be both the cause and effect of obesity. "As a practicing child psychiatrist, I see a clear association between obesity and depression and anxiety disorders among children and teens," notes David Fassler, M.D., an APA Trustee and child and adolescent psychiatrist from Burlington, Vermont.
A recent University of Minnesota study reveals that children who were teased about being overweight were more likely to have poor body image, low self-esteem, and symptoms of depression. The study found that 26 percent of teens who were teased at school and home reported they had considered suicide, and 9 percent had attempted it. Suicide is the third leading cause of death among adolescents. (Source: Archives of Pediatrics and Adolescent Medicine, "Associations of Weight-Based Teasing and Emotional Well-being Among Adolescents," August 2003)
Obese children between the ages of 10 and 13 have an 80 percent chance of being obese adults. Children are considered obese when their weight is at least 10 percent higher than recommended for their age and height. (Source: American Academy of Child and Adolescent Psychiatry, Facts for Families, January 2001.)
Signs and Symptoms of Emotional Distress
According to Dr. David Fassler, parents should be alert to the following signs and symptoms that might indicate an overweight child or teen is experiencing emotional distress:
- Your child seems to have reduced energy or interests and is reluctant to enter into social relationships or other activities;
- Your child seems increasingly sad, lonely, angry or withdrawn;
- Your child has few friends;
- Your child has thoughts of hurting him/herself or others;
- Your child is obsessed with eating and/or food;
- Your child is sleeping too much or not enough; and
- Your child is reluctant to go to school.
How to Help Your Child
It is important for parents to understand the problems and risks for obese children. Dr. Fassler offers these suggestions:
- Help children understand that being overweight can undermine physical and mental health and is more than an appearance issue;
- Talk to children about why they overeat and how they feel about themselves. Identify feelings and situations that cause them to overeat, and discuss coping strategies;
- Criticizing an obese child or trying to humiliate them into losing weight will increase the child's emotional difficulties. The child may become lonelier, more depressed, and less likely to make changes that might help;
- Praise your child's strengths and accomplishments;
- Help children gain control over their weight by discussing and encouraging healthy food choices and exercising regularly with them. Individualize food and exercise plans according to the child's interests and your commitment level;
- Set an example--make healthy eating and exercise a family affair;
- Encourage children to make smart choices and understand the benefits of feeling better and being healthier. Explain the long-term medical impacts of a healthy lifestyle;
- Limit access to high-calorie, high-fat and sugary foods, including soda and juices--especially at home;
- Limit sedentary activities including television and computer time; and
- Do not use food to reward or punish children. Establish a system to reward weight goals and help the child get back on track when they fall off.
The American Psychiatric Association is a national medical specialty society, founded in 1844, whose 35,000 physician members specialize in the diagnosis, treatment and prevention of mental illnesses including substance use disorders. For more information, visit the APA Web site at http://www.psych.org.