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The psychosocial concerns that accompany (being) overweight are ubiquitous. Poor self-image and social isolation are the rule, especially in severely overweight individuals. In younger children obesity may isolate them from opportunities to participate in sports and other physical activities, thus producing a vicious cycle of inactivity and overeating. Low self esteem may manifest in adolescence as depression, eating disorders (including binge eating and bulimia nervosa), and poor performance in school. This effect has been magnified in girls, especially in Hispanics and whites.”

– Dr. Marcie B. Schneider, M. D & Susan R. Brill, M.D. (2005, p. 159)

In addition to the psychological benefits lost through lack of exercise, being overweight or obese increases the probability of psychological and behavioral disorders in children. This occurs for a number of reasons:

  1. These kids face added stressors in the form of teasing, bullying, dieting, or general stigma.

  1. They are more isolated from peers and have fewer social supports.

  1. Since body physical activity and proper nutrition help to reduce stress and regulate neurotrasmitters in the brain, the lack of physical exercise and unhealthy eating habits typically observed among overweight children means more stress and a greater propensity towards negative moods.

  1. Overweight individuals simply don’t feel as good about themselves, not just because of social stigmas, but because they don’t feel as attractive, can’t do as much as other kids, and often feel guilt/frustration about their inability to control their weight.

  1. Body image plays a prominent role in a child’s overall psychology, and weight along with physical activity levels factor heavily into body image. As neuroscientist Lise Eliot writes, “Exercise is also important for maintaining a positive body image, which turns out to be the biggest risk factor for depression in adolescent girls.” (Eliot, 2010)

  1. They face more frustration in terms of achieving their goals, For example, an overweight child is likely to find it harder to secure a boyfriend / girlfriend, have an influential effect on others, or otherwise attain what they desire in life.

Overweight children ultimately face the turmoil of dieting, which as anyone with a weight problem knows can take a psychological toll of its own. Addictions come in all forms, and food can be an addiction just like other things. It becomes a source of comfort. So when a child becomes overweight, they can face a guilt complex for overeating and then the psychological toll on the other side that comes with trying to get one’s weight problems under control. There can also be a severe psychological toll taken by the fear of medical problems. One 9-year-old girl reports that she regularly worries about having a heart attack. (Painter, 8-4-08) Another obese 12-year-old is in the same position, after his brother had a heart attack at age 26. (Kotz, 2009)

All in all, this leads to an ongoing assault on a child’s self-esteem and psychological health. One meta-analysis of 71 different studies found that excess body weight diminishes self-esteem, with a larger affect on girls and women. (Miller & Downey, 1999) Low self-esteem, in turn, leads to many other problems. Marcie B. Schneider, M.D., and Susan R. Brill, M.D., report that research “has documented reduced self-esteem in cohorts of obese children from ages 9 to 10 years to 13 to 14 years and significantly higher rates of sadness and loneliness and of smoking and alcohol use in those whose self-esteem declined.” (2005, p. 159)

In other words, it creates the chronic conditions we’re most worried about when it comes to abuse and neglect. This psychological onslaught takes its toll. Overweight kids are 2-3 times more likely to have suicidal thoughts than their healthy weight Peers. (Puhl et al., 2007)

The stigma attached to children who are overweight or obese

Overweight children and adults face discrimination on a regular basis. (Shkolnikova, 5-21-08) One study found that overweight kids are stigmatized by their peers as early as age three, and often even face bias from parents and teachers. The sum of this, the researchers found, gives overweight children a quality of life that is comparable to kids who have cancer. (Puhl et al., 2007) In a newspaper interview, lead author Rebecca Puhl states that “these kids are facing stigma from everywhere they look in society, whether it’s media, school or at home.” (Christofferson, 7-13-07)

Antifat attitudes can be documented in children as young as 3-years-old, who view chubby children in drawings as undesirable playmates, viewing them as meaner and as possessing more negative characteristics. (Cramer & Steinwert, 1998) Six- and 7-year-old boys say they would rather look at a muscular silhouette and consistently assigned unfavorable attributes (such as sloppy or sneaky) to silhouettes featuring endomorphic (overweight) body types. Overweight boys in this age group were also found to be less-accepted and least-liked by their peers. (Staffieri, 1967) The same pattern was found in a sample of 7- to 11-year-old girls. (Staffieri, 1972)

Lerner and Gellert (1969) found that 86% of kindergarten children expressed a consistent aversion to “chubbiness” when shown photographs of children. Another study asked children to pick which child they would like to get to know as a friend among a page that depicted outlines of children with selected attributes – one healthy child, one obese, and 4 with various handicaps, such as a child in a wheelchair or one with a facial disfigurement. It was found that “the obese child was reliably ranked last, even lower than children with gross physical disabilities.” (Latner & Stunkard, 2003) Whereas 74.9% of kids picked the healthy child for their first or second choice, 7 in 10 kids ranked the obese child as either last or second to last among their choice of friends. Even children who were themselves overweight showed this same aversion towards the obese outline, and girls tended to have slightly more disfavorable perceptions than boys.

Other research has found that the number of negative responses to open-ended questions about obese children increases with age, suggesting a steady rise in the stigmatization of obesity as kids grow. (Sigelman, Miller & Whitworth, 1986) The consequences of this stigma persist through adolescence and into adulthood (Latner & Stunkard, 2003), and may explain the lower self-esteem, greater sense of shame and humiliation, and greater perceived teasing that overweight children display. (Pierce & Wardle,1997)

Obesity & bullying

Not surprisingly, research shows that overweight children are far more likely to be bullied than normal weight peers, regardless of all other factors. (Hellmich, 5-3-2010) Obese teens twelve- to sixteen-years of age are more often the victims of repeated group aggression, or “mobbing.” (Lagerspetz et al., 1982) This increased bullying results in more depression, anxiety and loneliness than their peers. (Hellmich, 5-3-2010)

Social and behavioral problems in overweight children

Stigmatization has a tendency to come full circle, and so overweight kids are more prone to social problems. Because they don’t experience as many positive social interactions as their peers do, they are both less experienced when it comes to dealing with others and are more ambivalent about social relationships in general. When rejected or teased, they may withdraw further or lash out in return.

Trudeau and Shephard (2008) reported that obese 3rd grade girls (8-years-old) exhibited more displaced behaviors like arguing and fighting, as well as more depressive symptoms like loneliness and sadness (which also make a child less attractive to peers).

Children who are overweight or obese will face more discrimination throughout life, even from people who aren’t openly aware of it. In a clever study, Eugene Caraso of the University of Chicago and colleagues arranged people to pick partners for a mock trivia game where they would be paired together. Researchers prepared phony profiles of two potential partners that described each person’s education, IQ and previous trivia game experience. A photograph of either a thin or an overweight person was attached to each profile. Each subject judged 24 such pairings altogether, each with new attributes, under the premise that they would be paired with their choices for a trivia game. Results showed that participants were willing to sacrifice 12 IQ points in a trivia partner to have one who was thin versus overweight. It revealed a subconscious bias that people weren’t even aware they had. (Carpenter, 2009b)

There is a tendency for obese adolescents to be less often accepted into high-ranking colleges than their nonobese peers, despite equal qualifications. (Canning & Mayer, 1966) Once in college, female obese students also receive less financial support from their parents than their nonobese peers receive, even when parents have similar income, family size, and number of children. (Crandall, 1991)

As you might expect, this trend continues in the workplace, where large women earn less than slim ones. (USA Today, 9-22-2010) While hidden prejudices are no doubt to blame, there also may be more at play here than overt bias. Kirkcaldy, Shephard & Siefen (2002) note that “in the adult world, some companies seek out people who are involved in endurance sports because they tend to be employees who have outstanding performances on the job. (Baun, Bernacki & Tsai, 1986) And indeed, studies find that obese individuals as a whole tend to miss more work and are slightly less productive on the job when compared to normal weight workers, cumulatively costing employers around $11.7 billion a year. (Hammond & Levine, 2010)

A Family Affair

Children aren’t just affected by their own weight issues. They can be adversely affected by those of their family members as well. There was once a little girl in our care who was adopted from China. She was adopted into a single parent home, and her mother was what would be medically labeled as morbidly obese. She was a very kind, caring mother, and did a wonderful job raising Shirley. But she had a weight issue, and unfortunately, this affected the girl. Both in Preschool and at elementary school, the other kids would tease Shirley about how obese her mother was. Shirley was a normal, healthy weight child herself, but this still stung her quite a bit. She loved her adopted mother, and it hurt when other kids made fun of her, or even just made an errant comment about how large she was. She became extremely sensitive about it. It hurt so much that Shirley broke down in tears on numerous occasions, and Shirley’s mother asked us to try and watch for kids saying stuff about her, because it was devastating Shirley. We did our best, but kids will be kids, and it’s difficult to put a wrap on such things.

Granted, this involved some manufactured social pain; Shirley was buying into the false ideas of her friends. But it was also implicit. Having a parent you’re so close to and love so much put down or made fun of also causes an automatic hurt. It was something she felt without having to add anything to the situation. Hopefully Shirley, who by now is a teenager (gosh I feel so old), has learned how to work through it. But for those who might be quick to dismiss such hurt as the normal pains of childhood, Shirley’s reaction, a negative 3-4 reaction, exceeded the negative reaction caused by most legitimate molestations. (Children can survive both; by the way, our intent is not to make children out to be fragile flowers but to show the hypocrisy in worrying about one issue and dismissing the other.) This teasing caused Shirley very deep and real social injury. If such episodes were to continue, and Shirley should remain getting as upset over it, it could cause the same sort of problems seen in chronic abuse. It’s something that, with Shirley sobbing because of what other kids were saying, might have to be dealt with through some sort of cognitive therapy, helping her to dismiss their taunting. Just as ‘guilt by association’ can cause a sexually abused child to feel hurt when someone tells a joke about the subject, this teasing can cause a child hurt by association that feels just as bad. If it gets severe enough, it could potentially lead to a subconscious disgust of the parent and drive a wedge in their relationship.

This isn’t the only way in which children are affected by a family member’s obesity. They can also be fearful over a parents weight problems, particularly when that person is suffering from health problems due to their weight. This can result in added stress as the child worries on a regular basis about that parent having a heart attack or dying. Even without specific health problems, this can be a worry to children whose parents are obese based on the number of media reports on the dangers of obesity. Obesity causes mobility problems, and so this can also adversely affect a child who wants to run around and play with that parent, and isn’t able to interact with them in the way they need. Unhealthy lifestyles truly are a family affair.

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