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Published in: Indian Journal of Pediatrics 7/2018

01-07-2018 | Review Article

Psychological Aspects of Obesity in Children and Adolescents

Authors: Rajesh Sagar, Tanu Gupta

Published in: Indian Journal of Pediatrics | Issue 7/2018

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Abstract

Childhood obesity is multi factorial health condition, so the simple evaluation of body fat will not be sufficed to manage the global epidemic of childhood obesity. Literature consistently provides evidence for physical health risks associated with childhood obesity; however in recent times, mental health of the obese children has also gained attention of the researchers as well as clinicians. Obese children experience number of psycho-social problems that significantly affect their quality of life and wellbeing. Co-morbid psychosocial and emotional problems of obesity generally act as causal or maintaining factors of obesity and thus significantly affect the treatment outcome. Therefore it becomes imperative for the clinicians/pediatricians to broaden their clinical assessment and include screening of important psycho-social factors within the clinical examination of childhood obesity. This article provides an evidence based comprehensive overview about the psychological factors and psychiatric factors (depression, anxiety, eating disorder, stress, body shape concerns, low self esteem) associated with childhood obesity that can further be utilized in the evaluation and management of this epidemic. The article also elaborates the role of current evidence based psychological approaches such as Cognitive Behavior Therapy (CBT) for management of obesity in children and adolescents. CBT techniques combined with lifestyle intervention and involving parents have been recommended by literature repetitively. However, there are a number of environmental, familial and personal barriers that hinder the whole process of weight loss in children. The article also discusses potential strategies to overcome those barriers.
Literature
1.
go back to reference Shah C, Diwan J, Rao P, Bhabhor M, Gokhle P, Mehta H. Assessment of obesity in school children. Calicutta Med J. 2008;6:e2. Shah C, Diwan J, Rao P, Bhabhor M, Gokhle P, Mehta H. Assessment of obesity in school children. Calicutta Med J. 2008;6:e2.
2.
3.
go back to reference Erickson SJ, Robinson TN, Haydel KF, Killen JD. Are overweight children unhappy?: body mass index, depressive symptoms, and overweight concerns in elementary school children. Arch Pediatr Adolesc Med. 2000;154:931–5.CrossRefPubMed Erickson SJ, Robinson TN, Haydel KF, Killen JD. Are overweight children unhappy?: body mass index, depressive symptoms, and overweight concerns in elementary school children. Arch Pediatr Adolesc Med. 2000;154:931–5.CrossRefPubMed
4.
go back to reference Waring ME, Lapane KL. Overweight in children and adolescents in relation to attention-deficit/hyperactivity disorder: results from a national sample. Pediatrics. 2008;122:e1–6.CrossRefPubMed Waring ME, Lapane KL. Overweight in children and adolescents in relation to attention-deficit/hyperactivity disorder: results from a national sample. Pediatrics. 2008;122:e1–6.CrossRefPubMed
5.
go back to reference Wang F, Veugelers PJ. Self-esteem and cognitive development in the era of the childhood obesity epidemic. Obes Rev. 2008;9:615–23.CrossRefPubMed Wang F, Veugelers PJ. Self-esteem and cognitive development in the era of the childhood obesity epidemic. Obes Rev. 2008;9:615–23.CrossRefPubMed
6.
go back to reference Puhl RM, Latner JD. Stigma, obesity, and the health of the nation's children. Psychol Bull. 2007;133:557.CrossRefPubMed Puhl RM, Latner JD. Stigma, obesity, and the health of the nation's children. Psychol Bull. 2007;133:557.CrossRefPubMed
7.
go back to reference Vaidya V. Psychosocial aspects of obesity. In: Vaidya V, editor. Health and treatment strategies in obesity. Basel, Switzerland: Karger Publishers; 2006. p. 73–85. Vaidya V. Psychosocial aspects of obesity. In: Vaidya V, editor. Health and treatment strategies in obesity. Basel, Switzerland: Karger Publishers; 2006. p. 73–85.
8.
go back to reference Janssen I, Craig WM, Boyce WF, Pickett W. Associations between overweight and obesity with bullying behaviors in school-aged children. Pediatrics. 2004;113:1187–94.CrossRefPubMed Janssen I, Craig WM, Boyce WF, Pickett W. Associations between overweight and obesity with bullying behaviors in school-aged children. Pediatrics. 2004;113:1187–94.CrossRefPubMed
9.
go back to reference Strauss RS, Pollack HA. Social marginalization of overweight children. Arch Pediatr Adolesc Med. 2003;157:746–52.CrossRefPubMed Strauss RS, Pollack HA. Social marginalization of overweight children. Arch Pediatr Adolesc Med. 2003;157:746–52.CrossRefPubMed
10.
go back to reference Goldfield GS, Moore C, Henderson K, Buchholz A, Obeid N, Flament MF. Body dissatisfaction, dietary restraint, depression, and weight status in adolescents. J Sch Health. 2010;80:186–92.CrossRefPubMed Goldfield GS, Moore C, Henderson K, Buchholz A, Obeid N, Flament MF. Body dissatisfaction, dietary restraint, depression, and weight status in adolescents. J Sch Health. 2010;80:186–92.CrossRefPubMed
11.
go back to reference Mond J, Van den Berg P, Boutelle K, Hannan P, Neumark-Sztainer D. Obesity, body dissatisfaction, and emotional well-being in early and late adolescence: findings from the project EAT study. J Adolesc Health. 2011;48:373–8.CrossRefPubMed Mond J, Van den Berg P, Boutelle K, Hannan P, Neumark-Sztainer D. Obesity, body dissatisfaction, and emotional well-being in early and late adolescence: findings from the project EAT study. J Adolesc Health. 2011;48:373–8.CrossRefPubMed
12.
go back to reference Sarkar P, Swain SP, Mukherjee K, Shukla RK. A study of psychological problems in overweight and obese children. Orissa J Psychiatry. 2010;17:25–31. Sarkar P, Swain SP, Mukherjee K, Shukla RK. A study of psychological problems in overweight and obese children. Orissa J Psychiatry. 2010;17:25–31.
13.
go back to reference Kumar DS, Shenoy B, Raju M, Pallakki S. Study on relationship of psychopathology on childhood obesity among school children in south India. Int J Child Health Nutr. 2013;2:34–8. Kumar DS, Shenoy B, Raju M, Pallakki S. Study on relationship of psychopathology on childhood obesity among school children in south India. Int J Child Health Nutr. 2013;2:34–8.
14.
go back to reference Braet C, Mervielde I, Vandereycken W. Psychological aspects of childhood obesity: a controlled study in a clinical and nonclinical sample. J Pediatr Psychol. 1997;22:59–71.CrossRefPubMed Braet C, Mervielde I, Vandereycken W. Psychological aspects of childhood obesity: a controlled study in a clinical and nonclinical sample. J Pediatr Psychol. 1997;22:59–71.CrossRefPubMed
15.
go back to reference Britz B, Siegfried W, Ziegler A, et al. Rates of psychiatric disorders in a clinical study group of adolescents with extreme obesity and in obese adolescents ascertained via a population based study. Int J Obes. 2000;24:1707.CrossRef Britz B, Siegfried W, Ziegler A, et al. Rates of psychiatric disorders in a clinical study group of adolescents with extreme obesity and in obese adolescents ascertained via a population based study. Int J Obes. 2000;24:1707.CrossRef
16.
go back to reference Erermis S, Cetin N, Tamar M, Bukusoglu N, Akdeniz F, Goksen DI. Obesity a risk factor for psychopathology among adolescents? Pediatr Int. 2004;46:296–301.CrossRefPubMed Erermis S, Cetin N, Tamar M, Bukusoglu N, Akdeniz F, Goksen DI. Obesity a risk factor for psychopathology among adolescents? Pediatr Int. 2004;46:296–301.CrossRefPubMed
17.
go back to reference Taner Y, Törel-Ergür A, Bahçivan G, Gürdag M. Psychopathology and its effect on treatment compliance in pediatric obesity patients. Turk J Pediatr. 2009;51:466.PubMed Taner Y, Törel-Ergür A, Bahçivan G, Gürdag M. Psychopathology and its effect on treatment compliance in pediatric obesity patients. Turk J Pediatr. 2009;51:466.PubMed
18.
go back to reference Vila G, Zipper E, Dabbas M, et al. Mental disorders in obese children and adolescents. Psychosom Med. 2004;66:387–94.PubMed Vila G, Zipper E, Dabbas M, et al. Mental disorders in obese children and adolescents. Psychosom Med. 2004;66:387–94.PubMed
19.
go back to reference Isnard P, Michel G, Frelut ML, et al. Binge eating and psychopathology in severely obese adolescents. Int J Eat Disord. 2003;34:235–43.CrossRefPubMed Isnard P, Michel G, Frelut ML, et al. Binge eating and psychopathology in severely obese adolescents. Int J Eat Disord. 2003;34:235–43.CrossRefPubMed
20.
go back to reference Puder JJ, Munsch S. Psychological correlates of childhood obesity. Int J Obes. 2010;34:S37–43.CrossRef Puder JJ, Munsch S. Psychological correlates of childhood obesity. Int J Obes. 2010;34:S37–43.CrossRef
21.
go back to reference Sonneville KR, Calzo JP, Horton NJ, Haines J, Austin SB, Field AE. Body satisfaction, weight gain and binge eating among overweight adolescent girls. Int J Obes. 2012;36:944–9.CrossRef Sonneville KR, Calzo JP, Horton NJ, Haines J, Austin SB, Field AE. Body satisfaction, weight gain and binge eating among overweight adolescent girls. Int J Obes. 2012;36:944–9.CrossRef
22.
go back to reference Agranat-Meged AN, Deitcher C, Goldzweig G, Leibenson L, Stein M, Galili-Weisstub E. Childhood obesity and attention deficit/hyperactivity disorder: a newly described comorbidity in obese hospitalized children. Int J Eat Disord. 2005;37:357–9.CrossRefPubMed Agranat-Meged AN, Deitcher C, Goldzweig G, Leibenson L, Stein M, Galili-Weisstub E. Childhood obesity and attention deficit/hyperactivity disorder: a newly described comorbidity in obese hospitalized children. Int J Eat Disord. 2005;37:357–9.CrossRefPubMed
23.
go back to reference Mustillo S, Worthman C, Erkanli A, Keeler G, Angold A, Costello EJ. Obesity and psychiatric disorder: developmental trajectories. Pediatrics. 2003;111:851–9.CrossRefPubMed Mustillo S, Worthman C, Erkanli A, Keeler G, Angold A, Costello EJ. Obesity and psychiatric disorder: developmental trajectories. Pediatrics. 2003;111:851–9.CrossRefPubMed
25.
go back to reference Anderson SE, Cohen P, Naumova EN, Must A. Association of depression and anxiety disorders with weight change in a prospective community-based study of children followed up into adulthood. Arch Pediatr Adolesc Med. 2006;160:285–91.CrossRefPubMed Anderson SE, Cohen P, Naumova EN, Must A. Association of depression and anxiety disorders with weight change in a prospective community-based study of children followed up into adulthood. Arch Pediatr Adolesc Med. 2006;160:285–91.CrossRefPubMed
26.
go back to reference Phillips BA, Gaudette S, McCracken A, et al. Psychosocial functioning in children and adolescents with extreme obesity. J Clin Psychol Med Settings. 2012;19:277–84.CrossRefPubMed Phillips BA, Gaudette S, McCracken A, et al. Psychosocial functioning in children and adolescents with extreme obesity. J Clin Psychol Med Settings. 2012;19:277–84.CrossRefPubMed
27.
go back to reference Lamertz CM, Jacobi C, Yassouridis A, Arnold K, Henkel AW. Are obese adolescents and young adults at higher risk for mental disorders? A community survey. Obes Res. 2002;10:1152–60.CrossRefPubMed Lamertz CM, Jacobi C, Yassouridis A, Arnold K, Henkel AW. Are obese adolescents and young adults at higher risk for mental disorders? A community survey. Obes Res. 2002;10:1152–60.CrossRefPubMed
28.
go back to reference Wardle J, Cooke L. The impact of obesity on psychological well-being. Best Pract Res Clin Endocrinol Metab. 2005;19:421–40.CrossRefPubMed Wardle J, Cooke L. The impact of obesity on psychological well-being. Best Pract Res Clin Endocrinol Metab. 2005;19:421–40.CrossRefPubMed
29.
go back to reference Young-Hyman D, Schlundt DG, Herman-Wenderoth L, Bozylinski K. Obesity, appearance, and psychosocial adaptation in young African American children. J Pediatr Psychol. 2003;28:463–72.CrossRefPubMed Young-Hyman D, Schlundt DG, Herman-Wenderoth L, Bozylinski K. Obesity, appearance, and psychosocial adaptation in young African American children. J Pediatr Psychol. 2003;28:463–72.CrossRefPubMed
31.
go back to reference Jansen W. Van de Looij-Jansen PM, de Wilde EJ, Brug J. Feeling fat rather than being fat may be associated with psychological well-being in young Dutch adolescents. J Adolesc Health. 2008;42:128–36.CrossRefPubMed Jansen W. Van de Looij-Jansen PM, de Wilde EJ, Brug J. Feeling fat rather than being fat may be associated with psychological well-being in young Dutch adolescents. J Adolesc Health. 2008;42:128–36.CrossRefPubMed
32.
go back to reference Shin NY, Shin MS. Body dissatisfaction, self-esteem, and depression in obese Korean children. J Pediatr. 2008;152:502–6.CrossRefPubMed Shin NY, Shin MS. Body dissatisfaction, self-esteem, and depression in obese Korean children. J Pediatr. 2008;152:502–6.CrossRefPubMed
33.
35.
go back to reference Klesges RC, Haddock CK, Stein RJ, Klesges LM, Eck LH, Hanson CL. Relationship between psychosocial functioning and body fat in preschool children: a longitudinal investigation. J Consult Clin Psychol. 1992;60:793.CrossRefPubMed Klesges RC, Haddock CK, Stein RJ, Klesges LM, Eck LH, Hanson CL. Relationship between psychosocial functioning and body fat in preschool children: a longitudinal investigation. J Consult Clin Psychol. 1992;60:793.CrossRefPubMed
36.
go back to reference Wadden TA, Foster GD, Brownell KD, Finley E. Self-concept in obese and normal-weight children. J Consult Clin Psychol. 1984;52:1104.CrossRefPubMed Wadden TA, Foster GD, Brownell KD, Finley E. Self-concept in obese and normal-weight children. J Consult Clin Psychol. 1984;52:1104.CrossRefPubMed
37.
go back to reference Mendelson BK, White DR. Relation between body-esteem and self-esteem of obese and normal children. Percept Motor Skills. 1982;54:899–905.CrossRefPubMed Mendelson BK, White DR. Relation between body-esteem and self-esteem of obese and normal children. Percept Motor Skills. 1982;54:899–905.CrossRefPubMed
39.
go back to reference Achenbach TM, Edelbrock C. Child Behavior Checklist. Burlington: Department of Psychiatry, University of Vermont; 1991. p. 7. Achenbach TM, Edelbrock C. Child Behavior Checklist. Burlington: Department of Psychiatry, University of Vermont; 1991. p. 7.
40.
go back to reference Achenbach TM. Manual for the youth self-report and 1991 profile. Burlington: Department of Psychiatry, University of Vermont; 1991. Achenbach TM. Manual for the youth self-report and 1991 profile. Burlington: Department of Psychiatry, University of Vermont; 1991.
41.
go back to reference Malhotra S, Varma VK, Verma SK, Malhotra A. Childhood psychopathology meausrement schedule: development and standardization. Indian J Psychiatry. 1988;30:325.PubMedPubMedCentral Malhotra S, Varma VK, Verma SK, Malhotra A. Childhood psychopathology meausrement schedule: development and standardization. Indian J Psychiatry. 1988;30:325.PubMedPubMedCentral
42.
go back to reference Kapur M, Barnabas I, Reddy MV, Rozario J. Developmental psychopathology check list for children (DPCL): a preliminary report. NIMHANS J. 1995;13:1–9. Kapur M, Barnabas I, Reddy MV, Rozario J. Developmental psychopathology check list for children (DPCL): a preliminary report. NIMHANS J. 1995;13:1–9.
43.
go back to reference Kovacs M. Children’s depression inventory. North Tonawanda: Multi-Health System; 1992. Kovacs M. Children’s depression inventory. North Tonawanda: Multi-Health System; 1992.
44.
go back to reference Rosenberg M. Rosenberg self-esteem scale (RSE). Acceptance and commitment therapy. Measures Package. 1965;61:52. Rosenberg M. Rosenberg self-esteem scale (RSE). Acceptance and commitment therapy. Measures Package. 1965;61:52.
45.
go back to reference Evans C, Dolan B. Body shape questionnaire: derivation of shortened “alternate forms”. Int J Eat Disord. 1993;13:315–21.CrossRefPubMed Evans C, Dolan B. Body shape questionnaire: derivation of shortened “alternate forms”. Int J Eat Disord. 1993;13:315–21.CrossRefPubMed
46.
go back to reference Varni JW, Burwinkle TM, Seid M, Skarr D. The PedsQL™* 4.0 as a pediatric population health measure: feasibility, reliability, and validity. Ambul Pediatr. 2003;3:329–41.CrossRefPubMed Varni JW, Burwinkle TM, Seid M, Skarr D. The PedsQL™* 4.0 as a pediatric population health measure: feasibility, reliability, and validity. Ambul Pediatr. 2003;3:329–41.CrossRefPubMed
47.
go back to reference Fossati A, Barratt ES, Acquarini E, Di Ceglie A. Psychometric properties of an adolescent version of the Barratt impulsiveness Scale-11 for a sample of Italian high school students. Percept Motor Skills. 2002;95:621–35.CrossRefPubMed Fossati A, Barratt ES, Acquarini E, Di Ceglie A. Psychometric properties of an adolescent version of the Barratt impulsiveness Scale-11 for a sample of Italian high school students. Percept Motor Skills. 2002;95:621–35.CrossRefPubMed
48.
go back to reference Singh P, Solanki RK, Bhatnagar PS. BIS-11A-Hindi version: a preliminary study of impulsivity in rural and urban Indian adolescents. Indian J Psychiatry. 2008;50:96.CrossRefPubMedPubMedCentral Singh P, Solanki RK, Bhatnagar PS. BIS-11A-Hindi version: a preliminary study of impulsivity in rural and urban Indian adolescents. Indian J Psychiatry. 2008;50:96.CrossRefPubMedPubMedCentral
49.
go back to reference Strauss ES, Sherman EM, Spreen O. A compendium of neuropsychological tests: administration, norms, and commentary. Oxford: Oxford University Press; 2006. Strauss ES, Sherman EM, Spreen O. A compendium of neuropsychological tests: administration, norms, and commentary. Oxford: Oxford University Press; 2006.
50.
go back to reference Oude Luttikhuis H, Baur L, Jansen H, et al. Summary of ‘interventions for treating obesity in children’. Evidence-Based Child Health: A Cochrane Review J. 2009;4:1730–3.CrossRef Oude Luttikhuis H, Baur L, Jansen H, et al. Summary of ‘interventions for treating obesity in children’. Evidence-Based Child Health: A Cochrane Review J. 2009;4:1730–3.CrossRef
51.
go back to reference Morgan F, Weightman A, Whitehead S. Managing overweight and obesity among children and young people: lifestyle weight management services. NICE guidance. UK: Support Unit for Research Evidence, Cardiff University; 2012. Morgan F, Weightman A, Whitehead S. Managing overweight and obesity among children and young people: lifestyle weight management services. NICE guidance. UK: Support Unit for Research Evidence, Cardiff University; 2012.
52.
go back to reference Spear BA, Barlow SE, Ervin C, et al. Recommendations for treatment of child and adolescent overweight and obesity. Pediatrics. 2007;120:S254–88.CrossRefPubMed Spear BA, Barlow SE, Ervin C, et al. Recommendations for treatment of child and adolescent overweight and obesity. Pediatrics. 2007;120:S254–88.CrossRefPubMed
53.
go back to reference Gupta T, Jain V, Ammini AC. Obesity. In: Mehta M, Sagar R, editors. A practical approach to cognitive behaviour therapy for adolescents. India: Springer; 2015. p. 375–93. Gupta T, Jain V, Ammini AC. Obesity. In: Mehta M, Sagar R, editors. A practical approach to cognitive behaviour therapy for adolescents. India: Springer; 2015. p. 375–93.
Metadata
Title
Psychological Aspects of Obesity in Children and Adolescents
Authors
Rajesh Sagar
Tanu Gupta
Publication date
01-07-2018
Publisher
Springer India
Published in
Indian Journal of Pediatrics / Issue 7/2018
Print ISSN: 0019-5456
Electronic ISSN: 0973-7693
DOI
https://doi.org/10.1007/s12098-017-2539-2

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