Children Living With Obesity
Authors: Elizabeth Coleman, MSN, CRNP, CPNP-PC, Nursing Instructor & Loretta T. Lee, PhD, CRNP, FNP-BC, CNE, Associate Professor and Department Vice Chair Family, Community & Health Systems at the UAB School of Nursing, University of Alabama at Birmingham
Ms. Coleman is pictured below.
Children living with obesity can suffer health complications later in life, such as hyperlipidemia, hypertension, and diabetes (Grossman et al., 2017). Obesity is also linked to mental health conditions in the adolescent population. Some researchers report a bidirectional relationship between obesity and mental health conditions (Chao et al., 2019). Chao and colleagues 2019 and Gow et al. (2019) have found associations between decreased self-esteem, obesity, and increased depressive symptoms in adolescents. Moreover, Eisenberg et al. (2019) found a correlation between teased adolescents living with obesity and lower self-esteem and depressive symptoms.
The associated co-morbidities, present and in the future of youths living with obesity, indicate a need to intervene with robust interventions to improve the quality of life among under-resourced children. An intervention for obesity is Cognitive Behavioral Therapy (CBT). Several studies using a CBT-based program improved healthy lifestyle behaviors and mental health conditions associated with obesity (Hoying et al., 2016; Melnyk, 2020; Melnyk et al., 2015). Melnyk et al. found a decrease in the proportion of overweight and obese and decreased depression symptoms in adolescents after implementing a CBT-based program (2015). These findings were supported by a systematic review of treatments for adolescents living with overweight and obesity (Militello et al., 2018). Reported studies in this systematic review revealed that components of CBT, such as cognitive restructuring, behavioral techniques, problem-solving, coping, and relaxation techniques were effective strategies for reducing mental health concerns among those living with obesity. Also, parental involvement has been reported to improve weight outcomes (Militello et al., 2018).
A significant concern among the adolescent population is stress-eating. A mindfulness-based intervention can help to prevent worsening stress-eating in adolescents with an increased risk for weight gain (Bernstein et al., 2021). A systematic review explored the benefits of mindfulness as an intervention for children and adolescents living with obesity. The authors report that studies included in the systematic review revealed that mindfulness or stress management helped to reduce obesity (Paltoglou et al., 2021). Hence, mindfulness can be essential in decreasing obesity in the adolescent population.
Improving access to healthy foods for children is essential in schools and the community. Equally important is targeted nutritional eating education for children and providing youths with engaging physical activity. Structural and societal influences that create racial disparities must be eliminated to provide safe spaces for all children to exercise outdoors and access convenient options for securing affordable and healthy foods — especially fresh fruits and vegetables.
Notwithstanding the effective therapies and strategies mentioned above, pharmacological treatment is often needed in conjunction with other interventions to manage obesity (Xu & Xue, 2016). Obesity is a chronic condition that affects many children and adolescents in the U.S, particularly those from minority and under-resourced populations. To improve the quality of life and decrease morbidity among under-resourced youths, obesity must be addressed with early interventions. These interventions should include proven effective interventions such as behavioral modification, pharmacological therapy, improved health education, and attention to poorly built environments found disproportionately in high-poverty areas.
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