The Pandemic Obesity Spike and its Mental Health Implications

Obesity prevalence among children and adolescents was already on the rise pre-pandemic, however a new analysis by the Center for Disease Control found that rates accelerated during the pandemic with an increase in obesity rates from 19% to about 22%. The rise in obesity is especially prevalent among preschool and school-aged children due to widespread decreases in physical activity and changes in diet that occurred during school closings and remote learning (Lange et al., 2021). To address the long-term impacts of this recent obesity spike in children and adolescents it’s important to consider the association with poor mental health. Youth who are considered obese may have difficulty with sleep issues, sedentary habits such as increased use of screen time, and dysregulated food consumption. These same symptoms are common in youth who experience depression. Additionally, weight-based bullying is one of the most frequent forms of reported peer harassment. Children who have been bullied about their weight have increased vulnerability to depression, anxiety, substance use, low self-esteem, and poor body image (Pont, 2017).

Primary care providers will likely be identifying and treating more and more young people who are struggling with obesity along with co-occurring mental health difficulties. The American Academy of Pediatrics offers the following guidance for pediatric providers:

• Screen and treat patients for comorbid mental health conditions, including weight-based bullying, poor self-esteem, depression, trauma and anxiety.
• 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. Research shows that adolescents struggling with obesity prefer words such as “weight” and “body mass index” rather than “obese” or “big.”
• Provide patient-centered, empathic frameworks such as motivational interviewing to illicit positive changes with children and their families.
• Using family-centered communication and family-based interventions takes the focus off the patient who may already be experiencing weight-based stigma.
• 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.