1
|
Beltrán-Garrayo L, Solar M, Blanco M, Graell M, Sepúlveda AR. Examining associations between obesity and mental health disorders from childhood to adolescence: A case-control prospective study. Psychiatry Res 2023; 326:115296. [PMID: 37331070 DOI: 10.1016/j.psychres.2023.115296] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 05/26/2023] [Accepted: 06/06/2023] [Indexed: 06/20/2023]
Abstract
Childhood obesity and mental disorders often co-exist. To date, most of the studies are cross-sectional, involve the assessment of a specific disorder, and rely on self-report questionnaires. This study aimed to provide a comprehensive psychological assessment to examine the concurrent and prospective association between childhood obesity and mental health problems. We compared 34 children with obesity with 37 children with normal weight at baseline, and at a five-year follow-up, to examine the development of mental health disorders from childhood (8-12 years) to adolescence (13-18 years). Both assessments included a clinical interview and self-reported measures of psychosocial and family markers. Findings showed that the obesity group had a higher prevalence of mental disorders, and psychological comorbidity increased in five years. Prospectively, childhood obesity was associated with a psychological diagnosis in adolescence. Moreover, the obesity group displayed higher severity of symptoms at both times. Finally, body esteem contributed to predicting mental health disorders in adolescence regardless of weight status, while eating symptomatology was a specific marker for the obesity group. Therefore, in the management of childhood obesity is suggested to address also psychosocial variables such as weight-related teasing and body esteem, to prevent the onset or development of mental health problems.
Collapse
Affiliation(s)
- Lucia Beltrán-Garrayo
- Department of Biological and Health Psychology, Faculty of Psychology, Autonomous University of Madrid, Madrid, Spain.
| | - María Solar
- Research & Development Department, Hogrefe TEA Ediciones, Madrid, Spain
| | - Miriam Blanco
- Department of Biological and Health Psychology, Faculty of Psychology, Autonomous University of Madrid, Madrid, Spain
| | - Montserrat Graell
- Department of Child and Adolescent Psychiatry and Psychology, University Hospital Niño Jesús, Madrid, Spain
| | - Ana Rosa Sepúlveda
- Department of Biological and Health Psychology, Faculty of Psychology, Autonomous University of Madrid, Madrid, Spain
| |
Collapse
|
2
|
Halberg SE, Visek AJ, Blake EF, Essel KD, Sacheck J, Sylvetsky AC. SODA MAPS: A Framework for Understanding Caffeinated Sugary Drink Consumption Among Children. Front Nutr 2021; 8:640531. [PMID: 33777993 PMCID: PMC7988216 DOI: 10.3389/fnut.2021.640531] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 02/16/2021] [Indexed: 12/15/2022] Open
Abstract
Excess sugary drink (SD) consumption is associated with childhood obesity and development of cardiometabolic disease. In addition to having high added sugar content, many SDs also contain caffeine, which may further encourage excess SD consumption among children. The objective of this study was to develop a conceptual framework of children's caffeinated SD consumption using group concept mapping, an applied social research multimethodology that collectively harnesses qualitative and quantitative data from participants to generate a visual representation of their ideas and input. Children, 8–14 years old, who reported consuming ≥12 ounces of caffeinated SDs (e.g., sodas, sweet teas) per day were recruited throughout Washington, D.C. and invited to participate. Concept mapping included three participant-driven activities: (1) brainstorming (n = 51), during which children reported reasons for their SD consumption, from which 58 unique reasons were identified; (2) sorting (n = 70), during which children sorted each of the reported reasons into categories and named each category; and (3) rating (n = 74), during which children rated the influence of each reason on their own caffeinated SD consumption. Similarity matrices, multidimensional scaling, and hierarchical cluster analysis were used to generate concept maps (hereafter “SODA MAPS”), which display the 58 reasons organized within eight overarching clusters. Among these eight clusters, Taste and Feel, Something to Do, and Energy were rated as particularly influential. Children's caffeinated SD consumption is encouraged not only by the palatable taste and reported preferences for these beverages (e.g., Taste and Feel), but also by psychological (e.g., Mood and Focus), biological (e.g., Energy), social (e.g., Something to Do) and environmental reasons (e.g., Nothing Better Available). Thus, the SODA MAPS can inform the development of tailored, multi-level SD reduction interventions that incorporate strategies to address important and currently overlooked reasons for caffeinated SD consumption among children.
Collapse
Affiliation(s)
- Sabrina E Halberg
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, The George Washington University, Washington, DC, United States
| | - Amanda J Visek
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, The George Washington University, Washington, DC, United States
| | - Emily F Blake
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, The George Washington University, Washington, DC, United States.,Department of Kinesiology, School of Public Health, University of Maryland, College Park, MD, United States
| | - Kofi D Essel
- School of Medicine and Health Sciences, The George Washington University, Washington, DC, United States.,Division of General and Community Pediatrics, Children's National Hospital, Washington, DC, United States
| | - Jennifer Sacheck
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, The George Washington University, Washington, DC, United States
| | - Allison C Sylvetsky
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, The George Washington University, Washington, DC, United States
| |
Collapse
|
3
|
Carsley S, Pope E, Tu K, Parkin PC, Toulany A, Birken CS. Association between Weight Status and Mental Health Service Utilization in Children and Adolescents. JOURNAL OF THE CANADIAN ACADEMY OF CHILD AND ADOLESCENT PSYCHIATRY = JOURNAL DE L'ACADEMIE CANADIENNE DE PSYCHIATRIE DE L'ENFANT ET DE L'ADOLESCENT 2020; 29:229-240. [PMID: 33184567 PMCID: PMC7595256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Accepted: 05/01/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Previous literature reports inconsistent associations between obesity and mental health. The objective of this study was to determine the association between weight status and mental health service utilization in Ontario children and youth. METHODS A cross-sectional study of children 0 to 18 years, identified using primary care electronic medical records from the EMRPC database in Ontario, Canada was conducted. Height and weight data were extracted to calculate BMI and linked to administrative data on mental health related outpatient visits, emergency department visits, and hospitalizations. Multivariable logistic regression models were performed. RESULTS A total of 50,565 children were included. Overall, 2.2% were underweight, 70.4% had a normal weight, 18.3% were overweight, 6.9% had obesity and 2.2% had severe obesity. 28.2% of all children had at least one mental health visit. Multivariable analyses showed children with overweight, obesity, and severe obesity were 1.11 (95% CI 1.05-1.17), 1.18 (95% CI 1.08-1.27) and 1.39 (95% CI 1.22-1.59) times more likely to have an outpatient mental health visit compared to children with normal weight. CONCLUSION Increased weight status was associated with mental health related outpatient visits and emergency department visits. This study may inform policy makers' planning of mental health resources for children with obesity and severe obesity.
Collapse
Affiliation(s)
- Sarah Carsley
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario
- ICES, Toronto, Ontario
| | - Eliza Pope
- Faculty of Medicine, University of Toronto, Toronto, Ontario
| | - Karen Tu
- Department of Family and Community Medicine, University of Toronto, Toronto, Ontario
- Toronto Western Hospital Family Health Team, University Health Network, Toronto, Ontario
| | - Patricia C Parkin
- Peter Gilgan Centre for Research and Learning, Child Health Evaluative Sciences, the Hospital for Sick Children; Pediatric Outcomes Research Team (PORT), Division of Paediatric Medicine, the Hospital for Sick Children, Toronto, Ontario
- Department of Pediatric Medicine, University of Toronto, Toronto, Ontario
| | - Alene Toulany
- ICES, Toronto, Ontario
- Department of Pediatric Medicine, University of Toronto, Toronto, Ontario
| | - Catherine S Birken
- Peter Gilgan Centre for Research and Learning, Child Health Evaluative Sciences, the Hospital for Sick Children; Pediatric Outcomes Research Team (PORT), Division of Paediatric Medicine, the Hospital for Sick Children, Toronto, Ontario
- Department of Pediatric Medicine, University of Toronto, Toronto, Ontario
| |
Collapse
|
4
|
Vanden Brink H, Pacheco LS, Bahnfleth CL, Green E, Johnson LM, Sanderson K, Demaio AR, Farpour-Lambert N, Ells LJ, Hill AJ. Psychological interventions delivered as a single component intervention for children and adolescents with overweight or obesity aged 6 to 17 years. Hippokratia 2020. [DOI: 10.1002/14651858.cd013688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
| | - Lorena S Pacheco
- Department of Nutrition; Harvard T.H. Chan School of Public Health; Boston MA USA
| | | | - Erin Green
- Division of Nutritional Sciences; Cornell University; Ithaca NY USA
| | - Lynn M Johnson
- Cornell Statistical Consulting Unit; Cornell University; Ithaca NY USA
| | | | - Alessandro R Demaio
- Melbourne School of Population and Global Health; University of Melbourne; Melbourne Australia
- Center for a Livable Future; Johns Hopkins Bloomberg School of Public Health; Baltimore USA
| | | | - Louisa J Ells
- School of Clinical and Applied Sciences; Leeds Beckett University; Leeds UK
| | - Andrew J Hill
- Division of Psychological and Social Medicine; University of Leeds; Leeds UK
| |
Collapse
|
5
|
Attention-deficit Hyperactivity Disorder Symptoms and Conduct Problems in Children and Adolescents with Obesity. MEDICAL BULLETIN OF SISLI ETFAL HOSPITAL 2020; 53:300-305. [PMID: 32377100 PMCID: PMC7192264 DOI: 10.14744/semb.2019.09475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Accepted: 05/20/2019] [Indexed: 11/20/2022]
Abstract
Objectives Recent studies focus on the potential factors that increase the potantial risks of obesity in children and adolescents. According to research for the past years, one of the factors that increases the risk of obesity may be attention- deficit hyperactivity disorder (ADHD). We hypothesized that overweight/obese children and adolescents that apply to pediatric endocrinology for treatment would be at higher risk for ADHD symptoms. Methods In this cross-sectional study, the sample consisted of 55 children and adolescents aged between 6-14 years with body mass index greater than 95th percentile and 37 nonobese control group. Sociodemographic form, Strengths and Difficulties Questionnaire and The Turgay Diagnostic and Statistical Manuel of Mental Disorders Based Child and Adolescent Behavior Disorders Screening and Rating Scale has been used. Results The rates of inattentive subtype, hyperactivity/impulsivity subtype, and the combined type in the subject group were 10.9%, 3.6% and 7.3%, respectively. The rates of inattentive subtype, hyperactivity/impulsivity subtype were 5.4%, 2.7%, respectively, in the nonobese group. In terms of SDQ scores, peer problems subscale scores were significantly higher in the subject group than the control group (5.13±1.24 vs 4.32±1.18, p=0.003). According to the binary regression analysis, having peer problems was found to be significantly related to being obese (Exp B (OR): 3.3, p=0.04). Conclusion Our findings show that obese children and adolescents have higher rates of ADHD symptoms and problems in peer relations. Underestimation of ADHD might be a risk factor for treatment failure in obesity since ADHD symptoms cause a lack of motivation and compliance.
Collapse
|
6
|
Overweight and obesity in preschool aged children and risk of mental health service utilization. Int J Obes (Lond) 2018; 43:1325-1333. [PMID: 30546134 DOI: 10.1038/s41366-018-0280-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Revised: 10/16/2018] [Accepted: 11/04/2018] [Indexed: 01/29/2023]
Abstract
OBJECTIVE To determine if overweight or obesity in preschool-age children is associated with mental health service utilization in later childhood. SUBJECTS Overall, 10,522 children 2 to <5 years, with no previous history of mental health service utilization, were identified from primary care electronic medical records (EMRs) across Ontario, Canada. METHODS This was a retrospective longitudinal cohort study. Height and weight data were extracted and body mass index z-scores (zBMI) were calculated using the World Health Organization Growth Standards. Mental health service utilization, between ages 5 and <19, was defined using administrative billing codes for mental health outpatient visits, emergency department visits, and hospitalizations. A multivariable Cox proportional hazards model was performed. RESULTS In total, 74.9% of children were healthy weight (zBMI between -2 and ≤1), 18.8% of children were at risk of overweight (zBMI between 1 and ≤2), 4.9% were overweight (zBMI > 2 and ≤3), and 1.5% had obesity (zBMI > 3). The median follow-up time was 2.2 years (IQR 1.0-4.2). The overall incidence rate of mental health service use was 44.5 events per 1000 person-years. The hazard ratio for girls with obesity was 2.73 (95% CI 1.62-4.60; p < 0.001) compared to girls with healthy weight. Compared to boys with healthy weight, boys 'at risk of overweight' and overweight were 1.22 (95% CI 1.03-1.44; p = 0.02) and 1.43 (95% CI 1.09-1.87; p = 0.01) times at higher risk of an incident mental health visit. CONCLUSION Our study shows an association between weight status in preschool school aged children and higher incidence of mental health service use in later childhood. This relationship was strongest in girls. Future research is needed to understand this relationship by mental health diagnosis, sex, and age.
Collapse
|
7
|
Fox CK, Kaizer AM, Ryder JR, Rudser KD, Kelly AS, Kumar S, Gross AC. Cardiometabolic risk factors in treatment-seeking youth versus population youth with obesity. Obes Sci Pract 2018; 4:207-215. [PMID: 29951211 PMCID: PMC6009991 DOI: 10.1002/osp4.166] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Revised: 02/20/2018] [Accepted: 02/22/2018] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Although obesity affects approximately one in five youths, only a fraction is treated in pediatric weight management clinics. Characteristics distinguishing youth with obesity who seek weight management treatment from those who do not are largely unknown. Yet identification of specific health characteristics which differentiate treatment-seeking from non-treatment seeking youth with obesity may shed light on underlying motivations for pursuing treatment. OBJECTIVES Compare the cardiometabolic profiles of an obesity treatment-seeking sample of youth to a population-based sample of youth with obesity, while controlling for body mass index (BMI). METHODS This cross-sectional study included participants, ages 12-17 years, with obesity from the Pediatric Obesity and Weight Evaluation Registry (POWER) and National Health and Nutrition Examination Survey, representing the treatment-seeking and population samples, respectively. Mean differences were calculated for systolic and diastolic blood pressure percentiles, total cholesterol, low-density and high-density lipoprotein-cholesterol, triglycerides, fasting glucose, glycated hemoglobin and alanine aminotransferase, while adjusting for age, sex, race/ethnicity, insurance status, and multiple of the 95th BMI percentile. RESULTS The POWER and National Health and Nutrition Examination Survey cohorts included 1,823 and 617 participants, respectively. The POWER cohort had higher systolic blood pressure percentile (mean difference 17.4, 95% confidence interval [14.6, 20.1], p < 0.001), diastolic blood pressure percentile (21.8 [19, 24.5], p < 0.001), triglycerides (42.3 [28, 56.5], p < 0.001) and alanine aminotransferase (7.5 [5.1, 9.8], p < 0.001) and lower fasting glucose (-6.9 [-8.2, -5.6], p < 0.001) and high-density lipoprotein-cholesterol (-2.3 [-3.8, -0.9], p < 0.002). There were no differences in total cholesterol or low-density lipoprotein-cholesterol or clinical differences in glycated hemoglobin. CONCLUSION For a given BMI, obesity treatment-seeking youth are more adversely affected by cardiometabolic risk factors than the general population of youth with obesity. This suggests that treatment-seeking youth may represent a distinct group that is at particularly high risk for the development of future cardiometabolic disease.
Collapse
Affiliation(s)
- C. K. Fox
- Department of PediatricsUniversity of MinnesotaMinneapolisUSA
| | - A. M. Kaizer
- Department of BiostatisticsUniversity of MinnesotaMinneapolisUSA
| | - J. R. Ryder
- Department of PediatricsUniversity of MinnesotaMinneapolisUSA
| | - K. D. Rudser
- Department of BiostatisticsUniversity of MinnesotaMinneapolisUSA
| | - A. S. Kelly
- Department of PediatricsUniversity of MinnesotaMinneapolisUSA
| | | | - A. C. Gross
- Department of PediatricsUniversity of MinnesotaMinneapolisUSA
| | | |
Collapse
|
8
|
Kebbe M, Damanhoury S, Browne N, Dyson MP, McHugh TLF, Ball GDC. Barriers to and enablers of healthy lifestyle behaviours in adolescents with obesity: a scoping review and stakeholder consultation. Obes Rev 2017; 18:1439-1453. [PMID: 28925065 DOI: 10.1111/obr.12602] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Revised: 07/14/2017] [Accepted: 07/29/2017] [Indexed: 11/29/2022]
Abstract
Healthy lifestyle behaviours are key to successful weight management, but have proven to be challenging to attain for adolescents with obesity. The purpose of our scoping review was to (i) describe barriers and enablers that adolescents with obesity encounter for healthy nutrition, physical activity, sedentary behaviour and sleep habits and (ii) identify gaps in the literature. We adhered to established methodology for scoping reviews. Six databases were searched (1980-June 2016) for original articles published in English or French that focused on lifestyle behaviours of 13- to 17-year-olds in paediatric weight management. Following screening and data extraction, findings of selected articles were synthesized thematically using a social ecological framework. Stakeholder consultation (n = 20) with adolescents with obesity and health professionals was completed to enhance methodological rigour. Our search yielded 17 articles for inclusion, including 546 unique participants. Barriers to healthy nutrition and physical activity were more consistently related to individual-level and interpersonal-level factors; enablers tended to be linked with interpersonal-level factors. Knowledge gaps identified related to sedentary behaviour and sleep as well as environmental and policy levels of influence. Our review revealed that some barriers and enablers were unique to adolescents with obesity, which were either within or beyond their control. These findings highlight the importance of multilevel interventions to enable healthy lifestyle behaviours for weight management.
Collapse
Affiliation(s)
- M Kebbe
- Department of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Canada
| | - S Damanhoury
- Department of Agricultural, Food and Nutritional Science, Faculty of Agricultural, Life and Environmental Sciences, University of Alberta, Edmonton, Canada
| | - N Browne
- Department of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Canada
| | - M P Dyson
- Department of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Canada
| | - T-L F McHugh
- Faculty of Physical Education and Recreation, University of Alberta, Edmonton, Canada
| | - G D C Ball
- Department of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Canada
| |
Collapse
|
9
|
Mühlig Y, Scherag A, Bickenbach A, Giesen U, Holl R, Holle R, Kiess W, Lennerz B, Brintrup DL, Moss A, Neef M, Ose C, Reinehr T, Teuner CM, Wiegand S, Wolters B, Wabitsch M, Hebebrand J. A Structured, Manual-Based Low-Level Intervention vs. Treatment as Usual Evaluated in a Randomized Controlled Trial for Adolescents with Extreme Obesity - the STEREO Trial. Obes Facts 2017; 10:341-352. [PMID: 28787738 PMCID: PMC5644941 DOI: 10.1159/000475717] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Accepted: 04/03/2017] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND To compare efficacy and safety of a manual-based low-level psychological intervention with treatment as usual (weight loss treatment). METHODS A two-armed randomized controlled trial without blinding and computer-based stratified block randomization included adolescents and young adults (14.0-24.9 years) with a BMI ≥ 30 kg/m2 at five German university hospitals. Primary outcomes were adherence (participation rate ≥ 5/6 sessions) and quality of life (DISABKIDS-37) 6 months after randomization. Secondary outcomes included depression, self-esteem, and perceived stress scores. RESULTS Of 397 screened adolescents, 119 (mean BMI 40.4 ± 7.0 kg/m2, 49.6% female) were randomized to the manual-based low-level intervention (n = 59) or treatment as usual (n = 60). We observed no group difference for adherence (absolute risk reduction 0.4%, 95% CI -14.7% to 15.5%; p = 1.0) or health-related quality of life (score difference 8.1, 95% CI -2.1 to 18.3; p = 0.11). Among all secondary outcomes, we detected explorative evidence for an effect on the DISABKIDS-37 'social exclusion' subscale (score difference 15.5; 95% CI 1.6-29.4; p = 0.03). 18/19 adverse events occurred in 26 participants, none were classified as serious. CONCLUSION Adherence to a coping-oriented intervention was comparable to weight loss treatment, although it was weak in both interventions. Psychological interventions may help to overcome social isolation; further confirmation is required.
Collapse
Affiliation(s)
- Yvonne Mühlig
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - André Scherag
- Research Group Clinical Epidemiology, Integrated Research and Treatment Center, Center for Sepsis Control and Care (CSCC), Jena University Hospital, Jena, Germany
| | - Annika Bickenbach
- Ambulatory Obesity Center, Charité - University Hospital Berlin, Berlin, Germany
| | - Ulrike Giesen
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Reinhard Holl
- Institute for Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - Rolf Holle
- Institute of Health Economics and Health Care Management, Helmholtz Zentrum München - German Research Center for Environmental Health, Munich, Germany
| | - Wieland Kiess
- Hospital for Children and Adolescents, Department of Women and Child Health, University of Leipzig, Leipzig, Germany
| | - Belinda Lennerz
- Division of Pediatric Endocrinology and Diabetes, Interdisciplinary Obesity Unit, Department of Pediatrics and Adolescent Medicine, University of Ulm, Ulm, Germany
| | - Diana Lütke Brintrup
- Institute for Medical Informatics, Biometry and Epidemiology and Center for Clinical Trials Essen (ZKSE), University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Anja Moss
- Division of Pediatric Endocrinology and Diabetes, Interdisciplinary Obesity Unit, Department of Pediatrics and Adolescent Medicine, University of Ulm, Ulm, Germany
| | - Madlen Neef
- Hospital for Children and Adolescents, Department of Women and Child Health, University of Leipzig, Leipzig, Germany
| | - Claudia Ose
- Institute for Medical Informatics, Biometry and Epidemiology and Center for Clinical Trials Essen (ZKSE), University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Thomas Reinehr
- Vestische Childrens Hospital Datteln, University Witten/Herdecke, Datteln, Germany
| | - Christina M. Teuner
- Institute of Health Economics and Health Care Management, Helmholtz Zentrum München - German Research Center for Environmental Health, Munich, Germany
| | - Susanna Wiegand
- Ambulatory Obesity Center, Charité - University Hospital Berlin, Berlin, Germany
| | - Barbara Wolters
- Vestische Childrens Hospital Datteln, University Witten/Herdecke, Datteln, Germany
| | - Martin Wabitsch
- Division of Pediatric Endocrinology and Diabetes, Interdisciplinary Obesity Unit, Department of Pediatrics and Adolescent Medicine, University of Ulm, Ulm, Germany
| | - Johannes Hebebrand
- Institute for Medical Informatics, Biometry and Epidemiology and Center for Clinical Trials Essen (ZKSE), University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| |
Collapse
|
10
|
Abstract
Objective This study aimed to analyse the psychological conditions and behaviour of a group of Chinese children and adolescents with obesity, and to develop an intervention for these young patients. Methods A group of 72 patients aged from 4 to 15 years were recruited from an obesity clinic. Patients, or the parents of children younger than 12 years, filled out a series of self-report questionnaires, and the responses were recorded and analysed. Results The 72 children and adolescents with obesity had a mean age of 9.14 ± 2.18 years. The body mass index-z scores of children with obesity showed a significant positive correlation with the level of impulsive behaviour, motivational impulses, and cognitive instability (inattention). Children with obesity quickly responded with extreme emotions, and these responses were positively correlated with the degree of obesity (slight, intermediate, or severe obesity). Conclusion Children and adolescents being treated for obesity have many underlying psychological problems, including emotional instability and impulsivity, and are prone to extreme emotional-psychological problems. These difficulties are positively correlated with the degree of obesity. Therefore, clinical treatment of these problems requires not only use of medication, improved nutrition, and healthy exercise, but also addressing underlying psychologic problems.
Collapse
Affiliation(s)
- Liya Pan
- Department of Clinical Nutrition, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Xiaxi Li
- Department of Clinical Nutrition, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yi Feng
- Department of Clinical Nutrition, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Li Hong
- Department of Clinical Nutrition, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| |
Collapse
|
11
|
Fox C, Gross A, Rudser K, Foy AM, Kelly AS. Depression, Anxiety, and Severity of Obesity in Adolescents: Is Emotional Eating the Link? Clin Pediatr (Phila) 2016; 55:1120-5. [PMID: 26581357 PMCID: PMC5958895 DOI: 10.1177/0009922815615825] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
The purposes of this study were to characterize the impact of depression and anxiety on the severity of obesity among youth seeking weight management treatment and to determine the extent to which emotional eating mediates the relationship between depression and/or anxiety and degree of obesity. This cross-sectional, retrospective chart review of 102 adolescent patients from a weight management clinic analyzed demographics, body mass index, depression (Patient Health Questionnaire-9), and anxiety (Generalized Anxiety Disorder Scale-7) screens and the Child Eating Behavior Questionnaire, Emotional Over-Eating subscale. After adjusting for demographics and emotional eating, the odds of having severe obesity versus obesity were 3.5 times higher for patients with depression compared with those without (odds ratio [OR] = 3.5; 95% CI = 1.1, 11.3; P = .038) and nearly 5 times higher for those with anxiety (OR = 4.9; CI = 1.2, 20.9; P = .030). Emotional eating, however, was not a mediator between depression/anxiety and degree of adiposity.
Collapse
Affiliation(s)
- Claudia Fox
- University of Minnesota, Department of Pediatrics, University of Minnesota Masonic Children’s Hospital, 2450 Riverside Avenue, 6 floor east building, Minneapolis, MN 55454
| | - Amy Gross
- University of Minnesota, Department of Pediatrics
| | - Kyle Rudser
- University of Minnesota, School of Public Health, Division of Biostatistics, Clinical and Translational Science Institute
| | | | - Aaron S. Kelly
- University of Minnesota, Departments of Pediatrics and Medicine
| |
Collapse
|
12
|
Faber A, Dubé L. Parental attachment insecurity predicts child and adult high-caloric food consumption. J Health Psychol 2016; 20:511-24. [PMID: 25903239 DOI: 10.1177/1359105315573437] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Eating habits are established early and are difficult to change once formed. This study investigated the role of caregiver-child attachment quality and its associations with high-caloric food consumption in a sample of middle socio-economic status children and adults, respectively. Survey data were collected from an online questionnaire administered separately to 213 (143 girls) children and 216 parents (adult sample; 180 women). Two studies showed that an insecure parental attachment, whether actual (Study 1; children) or recalled (Study 2; adults), significantly and positively predicted high-caloric food consumption in both samples. The present findings highlight the importance of parental attachment and its association with unhealthy eating patterns in children and adults.
Collapse
|
13
|
Psychological and physiological correlates of childhood obesity in Taiwan. Sci Rep 2015; 5:17439. [PMID: 26612264 PMCID: PMC4661724 DOI: 10.1038/srep17439] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2015] [Accepted: 10/29/2015] [Indexed: 11/08/2022] Open
Abstract
Evidence of associations between psychopathology and obesity in childhood remains inconsistent, and most studies have been conducted in Western countries. This study investigated psychological and physiological correlates of obesity in a community sample of children in Taiwan. In total, 302 children (157 overweight/obese and 145 healthy-weight children) were selected from first- and fourth-grade schoolchildren in eight elementary schools in 2009. These children participated in a comprehensive health examination, including a physical examination, blood sample analysis, and questionnaire administration. We found that regarding physiological characteristics, compared with the healthy-weight children, the overweight/obese children had significantly higher values for body fat estimated using the bioelectrical impedance method (p < 0.001), systolic blood pressure (p < 0.001), and diastolic blood pressure (p = 0.001); lower values for high-density lipoprotein (p < 0.001); and worse values for glutamic-pyruvic transaminase (p < 0.001), triglycerides (p < 0.001), and fasting blood glucose (p = 0.049). In logistic models adjusted for parental and child traits and physiological characteristics, children’s overweight/obesity was significantly associated with lower self-concept (odds ratio [OR] = 0.96, 95% confidence interval [CI] = 0.93–0.99) and less disruptive behavior (OR = 0.96, 95% CI = 0.92–0.99). Less disruptive behavior and the lack of a higher prevalence of anxiety and depression in childhood obesity appear to be a unique pattern in Taiwan that warrants further investigation.
Collapse
|
14
|
Eisenberg ME, Carlson-McGuire A, Gollust SE, Neumark-Sztainer D. A content analysis of weight stigmatization in popular television programming for adolescents. Int J Eat Disord 2015; 48:759-66. [PMID: 25139262 PMCID: PMC4765318 DOI: 10.1002/eat.22348] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2014] [Revised: 07/20/2014] [Accepted: 07/24/2014] [Indexed: 11/07/2022]
Abstract
OBJECTIVE This study provides updated information regarding the prevalence and characteristics of weight stigma in popular adolescent television programming, using a sample of favorite shows named by diverse adolescents. METHOD Participants in a large, population-based study of Minnesota adolescents (N = 2,793, mean age = 14.4) listed their top three favorite television shows. A coding instrument was developed to analyze randomly selected episodes from the most popular 10 programs. Weight-stigmatizing incidents were compared across television show characteristics and characters' gender and weight status. RESULTS Half (50%) of the 30 episodes analyzed contained at least one weight-stigmatizing incident. Both youth- and adult-targeted shows contained weight-stigmatizing comments, but the percent of these comments was much higher for youth-targeted (55.6%) than general audience-targeted shows (8.3%). Male characters were more likely than females to engage in (72.7% vs. 27.3%), and be the targets of, weight stigma (63.6% vs. 36.4%), and there was no difference in the amount of weight stigmatizing directed at average weight females compared to overweight females. Targets of these instances showed a negative response in only about one-third of cases, but audience laughter followed 40.9% of cases. DISCUSSION The portrayal of weight stigmatization on popular television shows-including targeting women of average weight-sends signals to adolescents about the wide acceptability of this behavior and the expected response, which may be harmful. Prevention of weight stigmatization should take a multi-faceted approach and include the media. Future research should explore the impact that weight-related stigma in television content has on viewers.
Collapse
Affiliation(s)
- Marla E. Eisenberg
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota,Division of General Pediatrics and Adolescent Health, Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota,Correspondence to: Marla E. Eisenberg, Division of General Pediatrics and Adolescent Health, Department of Pediatrics, University of Minnesota, 717 Delaware St. SE, Minneapolis, MN 55414.
| | - Ashley Carlson-McGuire
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota
| | - Sarah E. Gollust
- Division of Health Policy and Management, University of Minnesota School of Public Health, Minneapolis, Minnesota
| | - Dianne Neumark-Sztainer
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota
| |
Collapse
|
15
|
Föcker M, Bühren K, Timmesfeld N, Dempfle A, Knoll S, Schwarte R, Egberts KM, Pfeiffer E, Fleischhaker C, Wewetzer C, Hebebrand J, Herpertz-Dahlmann B. The relationship between premorbid body weight and weight at referral, at discharge and at 1-year follow-up in anorexia nervosa. Eur Child Adolesc Psychiatry 2015; 24:537-44. [PMID: 25159090 DOI: 10.1007/s00787-014-0605-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2013] [Accepted: 08/18/2014] [Indexed: 11/30/2022]
Abstract
Body mass index (BMI) is one of the most important outcome predictors in patients with anorexia nervosa (AN). A low premorbid BMI percentile calculated by the patients recalled premorbid weight and the height at first admission has been found to predict the BMI at first inpatient admission. In this study, we sought to confirm this relationship. We additionally analyze the relationship between premorbid BMI percentile and BMI percentile at discharge from the first inpatient treatment and at 1-year follow-up or alternatively if applicable upon readmission within this time period. We included 161 female patients aged 11-18 years of the multisite ANDI-trial with a DSM-IV diagnosis of AN. We used a multivariate statistical model including the independent variables age, duration of illness, duration of treatment, BMI at admission and BMI percentile at discharge. The relationship between premorbid BMI percentile and BMI at admission was solidly confirmed. In addition to premorbid BMI percentile, BMI at admission and age were significant predictors of BMI percentile at discharge. BMI percentile at discharge significantly predicted BMI percentile at 1-year follow-up. An additional analysis that merely included variables available upon referral revealed that premorbid BMI percentile predicts the 1-year follow-up BMI percentile. Further studies are required to identify the underlying biological mechanisms and to address the respective treatment strategies for AN patients with a low or high premorbid BMI percentile.
Collapse
Affiliation(s)
- Manuel Föcker
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Essen, University of Duisburg-Essen, Wickenburgstr. 21, 45147, Essen, Germany,
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
16
|
Bell R, Arnold E, Golden S, Langdon S, Anderson A, Bryant A. Perceptions and psychosocial correlates of bullying among Lumbee Indian youth. AMERICAN INDIAN AND ALASKA NATIVE MENTAL HEALTH RESEARCH 2015; 21:1-17. [PMID: 24788918 DOI: 10.5820/aian.2101.2014.1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Although bullying has been linked to suicide among youth, little is known about bullying in American Indians, a population at high risk for suicide. Qualitative data from focus groups with Lumbee Indian youth (N = 31, 16 males, 15 females, 12-17 years of age) and in-depth interviews with gatekeepers in the Lumbee community revealed that bullying is common, and is perceived to contribute to depression and suicide. Youth expressed powerlessness to overcome bullying. Survey data (N = 79, 32 males, 47 females, 11-18 years of age) showed that bullied youth (11.5%) had lower self-esteem and higher levels of depressive symptoms. Interventions are needed to address this behavior that contributes to poor psychosocial health in Lumbee youth.
Collapse
|
17
|
Abstract
Type 2 diabetes (T2D) in youth is a relatively novel condition facing paediatric health care providers. Few experimental trials exist to guide clinical management in this population. Supporting and prescribing modifiable lifestyle behaviours is cornerstone in the management of T2D in adults. Clinical trials in obese adolescents suggest that intensive lifestyle interventions that include both dietary changes and increased physical activity elicit clinically meaningful reductions in weight and improve cardiovascular risk profiles. Observational studies in youth with T2D suggest that better diet quality and increased physical activity are associated with better metabolic control; however, the limited experimental data available does not support these observations. Trials evaluating lifestyle monotherapy for the treatment of hyperglycaemia in youth with T2D do not exist, and the only study evaluating combined lifestyle and pharmacologic therapy did not show additional benefit over pharmacologic treatment with metformin alone. Physiological and psychosocial differences between youth and adults with T2D likely contribute to the differences in the effectiveness of lifestyle therapy for improving glycaemic control. The current review describes these topics in detail and provides recommendations for paediatric health care providers for the promotion of lifestyle therapy for the management of hyperglycaemia and cardiovascular risk factors for youth with T2DM.
Collapse
Affiliation(s)
- Jonathan McGavock
- Department of Pediatrics and Child Health, Faculty of Medicine, Manitoba Institute of Child Health, University of Manitoba, 511 JBRC 715 McDermot ave., Winnipeg, MB, R3E 3P4, Canada,
| | | | | |
Collapse
|
18
|
Mühlig Y, Wabitsch M, Moss A, Hebebrand J. Weight loss in children and adolescents. DEUTSCHES ARZTEBLATT INTERNATIONAL 2014; 111:818-24. [PMID: 25512008 PMCID: PMC4269075 DOI: 10.3238/arztebl.2014.0818] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2014] [Revised: 09/10/2014] [Accepted: 09/10/2014] [Indexed: 11/27/2022]
Abstract
BACKGROUND 15% of children and adolescents in Germany are overweight, including 6.3% who are affected by obesity. The efficacy of conservative weight-loss treatments has been demonstrated, but there has not yet been a detailed analysis of their efficacy in terms of the amount of weight loss that can be expected. We re-evaluated the available evidence on this question, with particular attention to the methodological quality of clinical trials, in order to derive information that might be a useful guide for treatment. METHODS We conducted a systematic literature search of Medline for the period May 2008 (final inclusion date for a 2009 Cochrane Review) to December 2013. The identified studies were analyzed qualitatively. RESULTS 48 randomized controlled clinical trials with a total of 5025 participants met the predefined inclusion criteria for this analysis. In the ones that met predefined criteria for methodological quality, conservative weight-loss treatments led to weight loss in amounts ranging from 0.05 to 0.42 BMI z score (standard deviation score of the body mass index) over a period of 12-24 months. Information on trial dropout rates was available for 41 of the 48 trials; the dropout rate was 10% or higher in 27 of these (66% ), and 25% or higher in 9 (22% ). CONCLUSION The available evidence consistently shows that only a modest degree of weight loss can be expected from conservative treatment. Families seeking treatment should be informed of this fact. Future research should focus on determining predictive factors for therapeutic benefit, and on the evaluation of additional types of psychological intervention to promote coping with obesity.
Collapse
Affiliation(s)
- Yvonne Mühlig
- Department of Child and Adolescent Psychiatry, LVR-Klinikum Essen, University of Duisburg-Essen
| | - Martin Wabitsch
- Department of Pediatrics and Adolescent Medicine, Division of Pediatric Endocrinology, Diabetes and Obesity Unit, University of Ulm
| | - Anja Moss
- Department of Pediatrics and Adolescent Medicine, Division of Pediatric Endocrinology, Diabetes and Obesity Unit, University of Ulm
| | - Johannes Hebebrand
- Department of Child and Adolescent Psychiatry, LVR-Klinikum Essen, University of Duisburg-Essen
| |
Collapse
|
19
|
Abstract
Obesity among children, adolescents and adults has emerged as one of the most serious public health concerns in the 21st century. The worldwide prevalence of childhood obesity has increased remarkably over the past 3 decades. The growing prevalence of childhood obesity has also led to appearance of obesity-related comorbid disease entities at an early age. Childhood obesity can adversely affect nearly every organ system and often causes serious consequences, including hypertension, dyslipidemia, insulin resistance, dysglycemia, fatty liver disease and psychosocial complications. It is also a major contributor to increasing healthcare expenditures. For all these reasons, it is important to prevent childhood obesity as well as to identify overweight and obese children at an early stage so they can begin treatment and attain and maintain a healthy weight. At present, pharmacotherapy options for treatment of pediatric obesity are very limited. Therefore, establishing a comprehensive management program that emphasizes appropriate nutrition, exercise and behavioral modification is crucial. The physician's role should expand beyond the clinical setting to the community to serve as a role model and to advocate for prevention and early treatment of obesity.
Collapse
Affiliation(s)
- Neslihan Koyuncuoğlu Güngör
- Louisiana State University Health Sciences Center-Shreveport, Department of Pediatric Endocrinology, Shreveport, LA, USA
,* Address for Correspondence: Louisiana State University Health Sciences Center-Shreveport, Department of Pediatric Endocrinology, Shreveport, LA, USA GSM: +1 312 6756070 E-mail:
| |
Collapse
|
20
|
Maggio ABR, Saunders Gasser C, Gal-Duding C, Beghetti M, Martin XE, Farpour-Lambert NJ, Chamay-Weber C. BMI changes in children and adolescents attending a specialized childhood obesity center: a cohort study. BMC Pediatr 2013; 13:216. [PMID: 24369093 PMCID: PMC3877963 DOI: 10.1186/1471-2431-13-216] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2013] [Accepted: 12/14/2013] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Multidisciplinary group therapies for obese children and adolescents are effective but difficult to implement. There is a crucial need to evaluate simpler management programs that target the obese child and his family. This study aimed to determine changes in body mass indexes (BMI) after individual family-based obesity intervention with a pediatrician in a specialized obesity center for child and adolescent. METHODS This cohort study included 283 patients (3.3 to 17.1 years, mean 10.7 ± 2.9) attending the Pediatric Obesity Care Program of the Geneva University Hospitals. Medical history and development of anthropometric were assessed in consultations. Pediatricians used an integrative approach that included cognitive behavioral techniques (psycho-education, behavioral awareness, behavioral changes by small objectives and stimulus control) and motivational interviewing. Forty five children were also addressed to a psychologist. RESULTS Mean follow-up duration was 11.4 ± 9.8 months. The decrease in BMI z-score (mean: -0.18 ± 0.40; p < .001) was significant for 49.5% of them. It was dependent of age, BMI at baseline (better in youngest and higher BMI) and the total number of visits (p = .025). Additional psychological intervention was associated with reduced BMI z-score in children aged 8 to 11 years (p = .048). CONCLUSIONS Individual family obesity intervention induces a significant weight reduction in half of the children and adolescents, especially in the youngest and severely obese. This study emphasizes the need to encourage trained pediatricians to provide individual follow up to these children and their family. Our study also confirms the beneficial effect of a psychological intervention in selected cases.
Collapse
Affiliation(s)
- Albane B R Maggio
- Pediatric sport medicine and obesity care program, Division of pediatric specialties, Department of Child and Adolescent, University Hospitals of Geneva and University of Geneva, 6, rue Willy-Donzé, 1211, Geneva 14, Switzerland.
| | | | | | | | | | | | | |
Collapse
|
21
|
Smith SM, Sumar B, Dixon KA. Musculoskeletal pain in overweight and obese children. Int J Obes (Lond) 2013; 38:11-5. [PMID: 24077005 PMCID: PMC3884137 DOI: 10.1038/ijo.2013.187] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2012] [Revised: 09/11/2013] [Accepted: 09/21/2013] [Indexed: 01/06/2023]
Abstract
This review seeks to provide a current overview of musculoskeletal pain in overweight and obese children. Databases searched were Academic Search Complete, CINAHL, Medline, Proquest Health and Medical Complete, Scopus, Google Scholar, SPORTDiscuss and Trove for studies published between 1 January 2000 and 30 December 2012. We used a broad definition of children within a 3- to 18-year age range. The search strategy included the following terms: obesity, morbid obesity, overweight, pain, musculoskeletal pain, child, adolescent, chronic pain, back pain, lower back pain, knee pain, hip pain, foot pain and pelvic pain. Two authors independently assessed each record, and any disagreement was resolved by the third author. Data were analysed using a narrative thematic approach owing to the heterogeneity of reported outcome measures. Ninety-seven records were initially identified using a variety of terms associated with children, obesity and musculoskeletal pain. Ten studies were included for thematic analysis when predetermined inclusion criteria were applied. Bone deformity and dysfunction, pain reporting and the impact of children being overweight or obese on physical activity, exercise and quality of life were the three themes identified from the literature. Chronic pain, obesity and a reduction in physical functioning and activity may contribute to a cycle of weight gain that affects a child's quality of life. Future studies are required to examine the sequela of overweight and obese children experiencing chronic musculoskeletal pain.
Collapse
Affiliation(s)
- S M Smith
- 1] Family and Community Health Research Group, School of Nursing and Midwifery, University of Western Sydney, Campbelltown, NSW, Australia [2] Centre for Pharmacology and Therapeutics, Imperial College, Chelsea and Westminster Campus, London, UK
| | - B Sumar
- Family and Community Health Research Group, School of Nursing and Midwifery, University of Western Sydney, Campbelltown, NSW, Australia
| | - K A Dixon
- Family and Community Health Research Group, School of Nursing and Midwifery, University of Western Sydney, Campbelltown, NSW, Australia
| |
Collapse
|
22
|
Giel KE, Zipfel S, Schweizer R, Braun R, Ranke MB, Binder G, Ehehalt S. Eating disorder pathology in adolescents participating in a lifestyle intervention for obesity: associations with weight change, general psychopathology and health-related quality of life. Obes Facts 2013; 6:307-16. [PMID: 23941969 PMCID: PMC5644671 DOI: 10.1159/000354534] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2013] [Accepted: 03/13/2013] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE The aim of this study was to identify the prevalence of eating disorder symptoms in obese adolescents participating in a lifestyle intervention for weight loss and to investigate possible relationships with weight change, general psychopathology, and health-related quality of life (HRQOL). METHOD At the beginning and after completion of a 6-month lifestyle intervention, 41 participants (20 females; age: 13.7 ± 1.4 years) reported on core symptoms of eating disorders (SCOFF), self-esteem (Rosenberg Self-Esteem Scale, RSES), and HRQOL (Questionnaire for Measuring Health-Related Quality of Life in Children and Adolescents, KINDL), while parents filled in a questionnaire assessing their children's internalizing and externalizing behavioral problems (Child Behavior Checklist, CBCL). RESULTS Compared to age-matched normative samples, patients showed increased behavior problems and an impaired HRQOL. 43% of the patients were screened positive for an eating disorder pathology, and this subgroup showed an increased psychopathological burden compared to patients that were screened negative. The lifestyle intervention resulted in a significant weight loss which was unaffected by the presence of an eating disorder pathology. The screening rate for eating disorders remained stable after the intervention. CONCLUSION The large overlap, mutual interaction, and high burden of eating and weight problems in children and adolescents underpin the need for an integrated view in both prevention and treatment approaches in pediatric obesity.
Collapse
Affiliation(s)
- Katrin E Giel
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tübingen, Tübingen, Germany.
| | | | | | | | | | | | | |
Collapse
|
23
|
Jacobson D, Melnyk BM. A primary care healthy choices intervention program for overweight and obese school-age children and their parents. J Pediatr Health Care 2012; 26:126-38. [PMID: 22360932 DOI: 10.1016/j.pedhc.2010.07.004] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2010] [Revised: 06/28/2010] [Accepted: 07/10/2010] [Indexed: 11/29/2022]
Abstract
INTRODUCTION The escalating crisis of childhood overweight and obesity creates an urgent demand for evidence-based interventions that can be used by primary care providers. Therefore, the purpose of this study was to test the feasibility, acceptability, and preliminary efficacy of a theory-based Healthy Choices Intervention (HCI) Program with fifteen 9-12 year old overweight and obese children and their parents in a primary care setting. METHODS A 1-group, 7-week pre-/posttest study design was used. Outcome measures included: body mass index (BMI) percentile, physical activity and nutrition knowledge, beliefs, choices and behaviors, anxiety, depression, self-concept, and social competence. RESULTS Children and parents found the HCI to be useful and informative. Positive effects of the HCI for the children included decreased BMI percentile, increased knowledge, beliefs, choices and behaviors, and self-control. Positive effects of the intervention for the parents included increased knowledge, beliefs, behaviors, and decreased anxiety. DISCUSSION This study provides evidence to support the feasibility, acceptability, and preliminary effects of the HCI with overweight and obese school-age children and their parents within a primary care setting.
Collapse
Affiliation(s)
- Diana Jacobson
- Arizona State University College of Nursing and Health Innovation, Phoenix, AZ 85004, USA.
| | | |
Collapse
|
24
|
Examining the relationship between attention-deficit/hyperactivity disorder and overweight in children and adolescents. Eur Child Adolesc Psychiatry 2012; 21:39-49. [PMID: 22120761 DOI: 10.1007/s00787-011-0230-0] [Citation(s) in RCA: 90] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2011] [Accepted: 11/11/2011] [Indexed: 10/15/2022]
Abstract
Although a higher prevalence of overweight/obesity was reported in clinical samples of patients with Attention-Deficit/Hyperactivity Disorder (ADHD), an association between overweight and ADHD has yet not been established in the general population in childhood. As both disorders are common and significantly affect psychosocial functioning, we investigated the prevalence of ADHD in overweight/obese youth and vice versa. In a cross-sectional nationally representative and community based survey 2,863 parents and their children aged 11-17 years rated symptoms on the Diagnostic and Statistical Manual of Mental Disorders-based German ADHD Rating scale. Weight and height were assessed by professionals. Body mass index was categorized according to national age and sex specific reference values. Overall, 4.2% of the respondents met criteria for ADHD. The prevalence of ADHD was significantly higher for overweight/obese (7%) than for normal weight (3.5%) and underweight (4.9%) children. In a logistic regression analysis controlling for age, gender, and socio-economic status, overweight/obese children were twice as likely to have an ADHD diagnosis (OR = 2.0). Vice versa, adjusting for all covariates, children with ADHD had an OR of 1.9 for overweight/obesity status. For all weight-status groups, children with ADHD more frequently reported eating problems as compared to their non-clinical counterparts. Overweight/obese respondents with ADHD displayed the highest level of health services utilization. A clinician should be aware of the significant risk for a child with ADHD to become overweight and for an overweight child to have ADHD. Longitudinal studies are needed to better understand the mechanisms underlying the association between ADHD and overweight/obesity.
Collapse
|
25
|
Abstract
Pediatric obesity is a major health problem and has reached epidemiological proportions today. The present paper reviews major psychological issues in pediatric obesity from a developmental perspective. Research and literature has shown that a number of developmental, family, maternal and child factors are responsible in the genesis of pediatric obesity. Family food habits, early developmental lifestyle of the child, parenting, early family relationships and harmony all contribute towards the growth and development of a child. The present review focuses on the role of developmental psychological factors in the pathogenesis of pediatric obesity and highlights the developmental factors that must be kept in mind when evaluating a case of pediatric obesity.
Collapse
Affiliation(s)
- Gurvinder Kalra
- Department of Psychiatry, L.T.M. Medical College and L.T.M.G. Hospital, Sion, Mumbai, Maharashtra, India
| | | | | | | |
Collapse
|
26
|
Albayrak O, Wölfle SM, Hebebrand J. Does food addiction exist? A phenomenological discussion based on the psychiatric classification of substance-related disorders and addiction. Obes Facts 2012; 5:165-79. [PMID: 22647300 DOI: 10.1159/000338310] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2011] [Accepted: 12/31/2011] [Indexed: 01/26/2023] Open
Abstract
The relationship between overeating, substance abuse and (behavioral) addiction is controversial. Medically established forms of addiction so far pertain to substance use disorders only. But the preliminary Diagnostic and Statistical Manual for Mental Disorders V (DSM V) suggests replacing the previous category 'Substance-Related Disorders' with 'Addiction and Related Disorders', thus for the first time allowing the diagnosis of behavioral addictions. In the past psychiatrists and psychologists have been reluctant to systematically delineate and classify the term behavioral addiction. However, there is a broad overlap between chemical and behavioral addiction including phenomenological, therapeutic, genetic, and neurobiological aspects. It is of interest to point out that the hormone leptin in itself has a pronounced effect on the reward system, thus suggesting an indirect link between overeating and 'chemical' addiction. Thus, leptin-deficient individuals could be classified as fulfilling criteria for food addiction. In our overview we first review psychological findings in chemical (substance-based) and subsequently in behavioral addiction to analyze the overlap. We discuss the diagnostic validity of food addiction, which in theory can be chemically and/or behaviorally based.
Collapse
Affiliation(s)
- Ozgür Albayrak
- Department of Child and Adolescent Psychiatry, LVR-Klinikum Essen, University of Duisburg-Essen, Essen, Germany
| | | | | |
Collapse
|
27
|
Abstract
Psychological complications associated with pediatric obesity include low self-esteem, depression, body dissatisfaction, loss-of-control eating, unhealthy and extreme weight control behaviors, impaired social relationships, obesity stigma, and decreased health-related quality of life. Bioecological models offer a framework for understanding the interaction between pediatric obesity and psychological complications and illustrate system-level approaches for prevention and intervention. As the medical setting is often the first point of contact for families, pediatricians are instrumental in the identification and referral of children with psychological complications. Motivational interviewing, patient talking points, brief screening measures, and referral resources are important tools in this process.
Collapse
Affiliation(s)
- Jillon S Vander Wal
- Department of Psychology, Saint Louis University, 221 North Grand Boulevard, St Louis, MO 63103, USA.
| | | |
Collapse
|
28
|
Jacobson D, Melnyk BM. Psychosocial correlates of healthy beliefs, choices, and behaviors in overweight and obese school-age children: a primary care healthy choices intervention pilot study. J Pediatr Nurs 2011; 26:456-64. [PMID: 21930032 DOI: 10.1016/j.pedn.2011.07.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2010] [Revised: 06/28/2011] [Accepted: 07/05/2011] [Indexed: 10/17/2022]
Abstract
The relationships among weight, mental health, social competence, healthy lifestyle beliefs, choices, and behaviors in overweight and obese school-age children (9 to 12 years) who were participating in a pilot Healthy Choices Intervention Program were examined using a descriptive correlational design. Results indicated that the children's weight negatively correlated with the children's self-concept, social skills, and, most importantly, healthy lifestyle choices. Their healthy lifestyle beliefs demonstrated positive correlations with their intentions to choose a healthy lifestyle. The children's healthy lifestyle beliefs and choices also were associated with increased cooperation and empathy behaviors. A positive self-concept was associated with decreased anxiety and depressive symptomology. These data support the need for health care providers to understand the psychological and social issues that overweight and obese school-age children experience. Cognitive behavior skills building techniques, such as those in the Healthy Choices Intervention Program, may promote healthy lifestyle choices and behaviors.
Collapse
Affiliation(s)
- Diana Jacobson
- Arizona State University College of Nursing and Health Innovation, Phoenix, AZ, USA.
| | | |
Collapse
|
29
|
Incledon E, Wake M, Hay M. Psychological predictors of adiposity: Systematic review of longitudinal studies. ACTA ACUST UNITED AC 2011; 6:e1-11. [DOI: 10.3109/17477166.2010.549491] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
30
|
Ling FCM, Masters RSW, Yu CCW, McManus AM. Central adiposity and the propensity for rehearsal in children. Diabetes Metab Syndr Obes 2011; 4:225-8. [PMID: 21760739 PMCID: PMC3131803 DOI: 10.2147/dmso.s22227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2011] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND There is increasing evidence that continuous activation of the hypothalamic-pituitary adrenal axis and the central sympathetic nervous system contributes to the pathogenesis of central adiposity via increased psychological stress. The purpose of this study was to examine the link between central adiposity and the propensity for Chinese children to rehearse emotionally upsetting events, a dimension of psychological stress. Additionally, gender differences in this relationship were explored. METHODS Waist circumference, which is a marker of central adiposity and associated risks of developing cardiovascular disease, was measured and the propensity for rehearsal was assessed twice over two consecutive years in Hong Kong Chinese children (n = 194, aged 7-9 years), using a psychometric tool. RESULTS Children with waist circumference indicative of a risk of cardiovascular disease displayed higher rehearsal scores than children categorized as "not at risk", as did boys compared with girls. Our results suggest that central adiposity and the propensity for rehearsal of emotionally upsetting events may be linked in Chinese children. CONCLUSION Future prospective studies examining the direction of causality between central adiposity and rehearsal can potentially have valuable clinical implications.
Collapse
Affiliation(s)
| | | | | | - Alison M McManus
- Correspondence: Alison M McManus, Institute of Human Performance, University of Hong Kong, Patrick Manson Building, 7 Sassoon Road, Pokfulam, Hong Kong, Tel +852 2589 0582, Fax +852 2855 1712, Email
| |
Collapse
|
31
|
Knutson JF, Taber SM, Murray AJ, Valles NL, Koeppl G. The role of care neglect and supervisory neglect in childhood obesity in a disadvantaged sample. J Pediatr Psychol 2010; 35:523-32. [PMID: 19996153 PMCID: PMC2910942 DOI: 10.1093/jpepsy/jsp115] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2009] [Revised: 10/23/2009] [Accepted: 10/29/2009] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Assess the roles of care neglect and supervisory neglect, and the moderating influence of child age on childhood obesity. Study Design Child BMI, parental care neglect, and supervisory neglect were assessed in an ethnically diverse sample of 571 young children from two Midwestern States. Hierarchical linear regression was used to assess the influence of both forms of neglect and the moderating role of age. RESULTS Fifteen percent of the children were overweight and 16.3% were obese. Care neglect significantly correlated with child BMI for younger but not older children, while supervisory neglect significantly correlated with child BMI for older but not younger children. CONCLUSIONS The impact of two types of neglect on obesity varied across age, highlighting the importance of differentiating between types of neglectful parenting when addressing the high rate of childhood obesity in disadvantaged children.
Collapse
|
32
|
Nasreddine L, Mehio-Sibai A, Mrayati M, Adra N, Hwalla N. Adolescent obesity in Syria: prevalence and associated factors. Child Care Health Dev 2010; 36:404-13. [PMID: 19961497 DOI: 10.1111/j.1365-2214.2009.01042.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Abstract Background Data on the prevalence of overweight and obesity in Eastern Mediterranean countries remain scarce, particularly for children and adolescents. The objective of this study is to estimate the prevalence of obesity and examine associated factors and covariates amongst school adolescents in Syria. Methods A cross-sectional survey of a representative sample of 776 adolescents (386 males and 390 females), aged 15-18 years, was conducted in six randomly chosen secondary schools in Damascus, the capital city of Syria. Anthropometric measurements and dietary assessment data were collected using standard methods and techniques. Overweight and obesity were defined according to World Health Organization 2007 child growth standards. Results The prevalence rates of overweight and obesity were estimated at 18.9 and 8.6%, respectively. Carbohydrate and saturated fatty acid intakes were significantly higher amongst overweight and obese (250.66 and 32.82 g/day, respectively) as compared with normal weight adolescents (218.12 and 26.10 g/day, respectively). Regression analysis showed that the likelihood of obesity was significantly greater amongst adolescent boys than girls (OR = 2.30, P < 0.05) and amongst subjects reporting family history of obesity (OR = 2.98, P < 0.05). The odds of obesity increased consistently with increasing educational attainment of both parents and was higher (OR = 1.63) amongst adolescents reporting lower crowding index than their counterparts. Conclusion Our findings of a positive association between obesity and socio-economic status measured by parental education and crowding index call for intervention strategies for the promotion of healthy dietary practices not only amongst school adolescents but also parents, targeting families as the unit of intervention. Further studies are needed to examine nutritional habits and food choices amongst families of different socio-economic strata.
Collapse
Affiliation(s)
- L Nasreddine
- Department of Nutrition and Food Science, American University of Beirut, Lebanon
| | | | | | | | | |
Collapse
|
33
|
|