Obesity has been associated with increased risk of poor mental health in children and adolescents in the United States. Youth who are considered obese may have difficulty with sleep issues, sedentary habits, and dysregulated food consumption. These same symptoms are common in youth who experience depression.
Children and adolescents who are obese may also be the target of bullying from peers. According to research from the American Academy of Pediatrics, weight-based bullying is one of the most frequent forms of reported peer harassment. Evidence has documented increased vulnerability to depression, anxiety, substance use, low self-esteem, and poor body image among youth who are teased or bullied about their weight.
As primary care providers it is important to consider mental health and behavioral interventions when addressing obesity in the pediatric office. The American Academy of Pediatrics makes the following recommendations for pediatric providers:
- Use appropriate, sensitive, and non-stigmatizing language when discussing weight with children, adolescents, and their families. Discuss weight in a “matter of fact” manner using language that focuses on health rather than weight or appearance.
- Provide patient-centered, empathic frameworks such as motivational interviewing to illicit positive changes with children and their families. Also, using family-centered communication and family-based interventions takes focus off the patient.
- Encourage long-term changes in behaviors that are related to obesity risk rather than relying on diets and exercise prescriptions, which may only result in short-term success.
- Screen patients for comorbid mental health conditions, including weight-based bullying, poor self-esteem, depression, and anxiety.
*** DATA SOURCES AND REFERENCES ***
Centers for Disease Control and Prevention: Childhood Obesity Facts https://www.cdc.gov/obesity/data/childhood.html
Tevie, J., Fadia, T.S. (2015). Association between mental health and comorbid obesity and hypertension among children and adolescents in the US. Eur Child Adolesc Psychiatry. 24:497–502; DOI 10.1007/s00787-014-0598-8.
The State of Obesity: Better Policies for a Healthier America 2019 by Trust for Americas Health
Pont, S.J., Puhl, R., Cook, S., Slusser, W. (2017). Stigma experienced by children and adolescents with obesity. Pediatrics: 140 (6) e20173034; DOI: https://doi.org/10.1542/peds.2017-3034