What’s eating teens today?

Image used for representational purpose only

Childhood and adolescent obesity is growing at alarming rates. And it can wreak havoc on a teen’s mind as well

The global prevalence of childhood obesity is increasing at an alarming rate with the World Health Organisation rating childhood obesity as among the more serious public health concerns. Globally, in 2016, over 340 million children and adolescents between the ages of 2-17 were considered overweight or obese. In Australia 1 in 4 or 25% of all children between the ages of 2-17 years are now considered overweight or obese (triple the number since 1980).

Obesity in childhood and into adolescence can result in several psychological issues. These issues are particularly prevalent in the teenage years given the unique social atmosphere this age group faces. There are several psychological effects of childhood and adolescent obesity that parents need to be aware of as well.

One issue that appears as a result of obesity is a dip in self-esteem. Children and teens can feel quite alone and self-conscious as they are very aware of how others see and perceive them. A lot of these perceptions hinge on superficial attributes such as clothes, facial attractiveness, and weight and this could make overweight kids feel out of place compared to their “slimmer” peers. Research has shown that overweight or obese children suffer from low levels of self-esteem and this can make them unhappy with themselves not just about their appearance but also socially.

Low self-esteem tends to lead to higher levels of depression. This is particularly prevalent in children during the middle and high school years. Depression in overweight and obese children is exasperated in when they fixate on how other people react to them. Unfortunately, research has also shown that overweight children tend to elicit more negative reactions compared to average weight peers. It is important to note that a child’s psychological wellbeing rests to a large degree on positive social interactions with peers and the lack of this can lead to higher levels of depression in this age group.

Lower self-esteem and depression can also lead to more behavioural problems in this age group. Indeed, research has shown that parents of overweight and obese children tend to report more behavioural issues compared to parents of average weight children. These issues can be more “internalised” whereby issues such as anger are directed inward leading to higher depression, anxiety, and eating issues. The problems can also be “externalised” whereby issues such as aggression, defiance, and back talk can become a concern. The internalising and externalising of issues can also have a negative impact on the child’s school and social performance. Psychologists are trained in working with anxiety, depression, and self-esteem issues and teaching children healthier, more effective ways to cope.

Anorexia nervosa is a serious mental illness, a life threatening eating disorder, and has the highest rate of mortality of any mental illness. Anorexia nervosa commonly emerges during adolescence and affects not only young women but also men and women of all ages including children. When a person with anorexia nervosa restricts their eating, it is not a lifestyle choice but a sign of a complex condition with serious effects for both physical and mental health. In Australia over 30,000 people suffer from anorexia nervosa. Recognising the signs early and getting help can reduce the impact and help with a full recovery.

Both men and women can develop anorexia but display it in different ways. Women tend to engage in severe dietary restriction and excessive and compulsive exercise. Men on the other hand in order to get a toned body use steroid and compulsively exercise. Models, gymnasts, jockeys and dancers are at an increased risk of an eating disorder like anorexia. It is important to note that anorexia nervosa is characterised by an unhealthy preoccupation with food and weight and an intense fear of gaining weight.

The reason someone develops anorexia nervosa differ and can range personality traits such as perfectionism, obsessive compulsive tendencies to exposure to trauma.

The symptoms of anorexia can be divided into three categories. The physical symptoms include unexplained weight loss, development of bloating, constipation and food intolerance, loss of periods (in women) and failure to begin a menstrual cycle (in girls), loss of libido, heart problems etc. Psychological symptoms include intense fear of gaining weight or ongoing behaviour that does not enable weight gain, obsessive concern and rules about dieting, body shape and weight, anxiety and irritability around meal times, low self-esteem, along with perfectionism, distorted body image, and low self-worth.

There are two types of anorexia nervosa. One type emphasises the restriction of food consumption, while the other type includes either excessive food consumption (binge eating) followed by purging, or purging after the consumption of normal portions, or small amounts of food. Purging may be self-induced vomiting, or misuse of laxatives, diuretics or enemas.

The long-term consequences of anorexia nervosa can be detrimental. Extreme weight loss and restricted eating can lead to weakened bones, slow growth, infertility, problems with concentration and thinking and decision making.

Research is continuing into which treatment for anorexia nervosa might be most effective. Common approaches such as family-based treatment and cognitive behaviour therapy are the most effective.

National Eating Disorders Collaboration is a good source of information and help, if you think you or your child is suffering from eating disorder. Or see your paediatrician before it is too late. Early detection and interventions are crucial to recovery.

Dr Raj Khillan is Consultant Paediatrician, Western Specialist Care Centre; and Dr Malini Singh is a psychologist at Change for Life


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