The social and psychological issues of childhood obesity are perhaps even more intrusive on the child's life than the physical. Childhood is a critical time for the development of self-esteem, thus the psychological issues faced by an overweight child places even more urgency on the prevention of the problem.
Obesity is "one of the most stigmatizing and least socially acceptable conditions in childhood." (Schwimmer, Jeffrey B., MD ET AL,: Health-related quality of life of severely obese children and adolescents," The Journal of American Medicine, 2003, p. 1818). An historic study showed that normal weight children rank obese children as the least desirable friends. Obese individuals were described as lazy, dirty, dumb and deceitful. These descriptions were made by children as young as six years old (Must, Aviva, Ph.D., "Effects of obesity on morbidity in children and adolescents," Nutrition in Clinical Care, p. 9).
One study relates that the quality of life of an obese child can be directly compared to the quality of life of a child undergoing cancer treatment. They feel excluded from a variety of activities and have lower levels of self worth and self esteem. They are teased and withdraw from their peers. The physical limitations and inability to keep up with normal activities may lead to a vicious cycle of additional weight gain. Studies have also shown that obese children miss four times more school than healthy weight children, which could lead to decreased school performance (Schwimmer, p. 1814).
Depression and Oppositional Defiant Disorder (ODD) have also been linked to childhood obesity (Mustillo, Sarah, Ph.D., "Obesity and psychiatric disorder: developmental trajectories," Pediatrics, 2003, p. 854). ODD is manifested by a pattern of uncooperative and defiant behavior toward authority that can interfere with day-to-day functioning (www.aacap.org)
The effects of obesity effects have a lasting impact on an individual's life in childhood, through adolescence and into adulthood. Obese adolescents have lower education attainment, earn less money and have higher rates of poverty. Discrimination because of obesity has been documented toward adolescents in apartment rentals, employment opportunities and college admissions (Must, p. 9). Finding success as an adult is an enormous challenge, but especially daunting when faced with the physical, emotional and discriminatory effects brought on by obesity
Americans in general are much too sedentary. Children should have at least thirty minutes per day of exercise outside of school time (Hu,Frank B., M.D., Ph.D., "Television watching and other sedentary behaviors in relation to risk of obesity and type 2 diabetes mellitus in women," The Journal of American Medicine, 2003, p. 1790). Television, computers, and video games consume more and more of outside playtime. Television watching is the predominant sedentary behavior in children, second only to sleeping (Kaur, Haroshena, M.D., MPH, "Duration of television watching is associated with body mass index," The Journal of Pediatrics, 2003, p. 506).
Watching television is more strongly associated with obesity than other sedentary behaviors. This is because (1) watching television reduces energy expenditure by limiting time that children spend doing physical activities, (2) watching television leads to increased energy intake because it tends to lead to snacking - especially with the inundation of junk food enticements, and (3) watching television has even less energy expenditure associated with it than other sedentary behaviors such as reading and writing. (Hu, p. 1790).
Increased time spent in front of the television can result in a net gain of 350 calories per day (combined loss of potential physical activity with snacking) that over a week would result in a 0.7 pound gain in body weight per week. (Epstein, Leonard H., Ph.D., "Effects of manipulating sedentary behavior on physical activity and food intake," The Journal of Pediatrics, 2002, 140, p. 334). These findings suggest that even in healthy, non-obese children, sedentary behavior can drastically increase caloric consumption while decreasing energy expenditure.
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