Fat in the Head: The Physical and Psychological Consequences of Childhood Obesity - Research Paper Example

Fat in the Head: The Physical and Psychological Consequences of Childhood Obesity From a very young age, I remember hearing about weight. Peoplewere categorized into two groups: those who were thin versus those who were fat. As an individual who, for a very long time, belonged to the latter category, I vividly recall the physical limitations of being clinically obese. There were a myriad of things I could not do as a result of my prodigious size. I could not swing on the monkey bars because my arms could not support me; I could not participate in track because my legs and lungs would burn after running a short distance; and I could not go on all the rides due to the size of the seat, or perhaps the size of my own seat, when our school went to the local amusement park on a field trip. Consequently, the students started to exclude me from activities, abuse me with their cruel remarks, and ignore my very existence. Looking back now, I realized that hating myself did not result from being a chubby child; it was steadily nurtured by society’s institutionalized abhorrence of ‘fatness’ which not only permitted, but encouraged, a systematic attack on my personhood (Dietz; 1998; Goodman & Whitaker, 2002). Although there are very serious health complications that arise from obesity, the psychological effects caused by being an overweight child tends to follow an individual into adulthood, frequently caused by a downward shame cycle of social ostracism, depression, self-destructive behaviour, and further weight gain (Deichsel, personal anecdote, November 13, 2010). Before delving into the physical and psychological consequences of obesity, a definition of what constitutes obesity is necessary to begin the discussion. The Centers for Disease Control and Prevention (CDC) argue that there is a spectrum of body size, from extremely thin to extremely obese; consequently, it is important to recognize that, due to this spectrum, ranges of a healthy body mass index (BMI – body fat content based on an evaluation of mass divided by height) exist. At present, there are no studies that show that a person at a height of 180 centimeters (cms) should be exactly 160 pounds (lbs); yet, the range of healthy and unhealthy BMI levels are useful guides to ascertain an individual’s proximity to obesity. According to the CDC (2010), “an adult who has a BMI between 25 and 29.9 is considered overweight; [and] an adult who has a BMI of 30 or higher is considered obese.” Therefore, according to this statistic, an average adult person with a height of 5 ft 9 inches (5’9) should be between 125 and 168 lbs. Those who exceed to top end of the range, as well as those who are below the low end of the range, are at risk for experiencing health complications that become more exaggerated as the individual moves father away from the spectrum. Although the BMI range is easy to comprehend for adults, how does measuring weight change when taking growing children into account? The CDC suggests that the focus on childhood obesity has arisen from the fear that obesity in childhood is a primary predictor of obesity in adulthood,1 which raises further questions about the ability of health care institutions and federal funding to deal with the elevated needs of a fatter population.2 According to the National Health and Nutrition Examination Survey (NHANES), the obesity level for children ages 2 to 19 years was 17% in 2008, with a shocking 15% increase in obesity for children ages 6 to 11. In 1976, it was estimated that approximately 6.5% of children in the same age range were considered obese; whereas obesity was estimated at 19.6% in 2000. It is also a fair assumption that this statistic has continued to grow in the past decade. Obesity in children is calculated differently than for adults, in that it is determined by a BMI-for-age-percentile range: “overweight is defined as a BMI at or above the 85th percentile and lower than the 95th percentile”; whereas “obesity is defined as a BMI at or above the 95th percentile for children of the same age and sex” (CDC, 2010). Faced with the reality that children are getting fatter and fatter, health care practitioners, educators, policy makers, and every-day citizens are trying to figure out the factors responsible for contributing to this epidemic of mass proportions. In assessing the issue, three central factors contributing to childhood obesity emerge: genetic factors which discuss “that certain genetic characteristics may increase an individual’s susceptibility to excess body weight”; behavioral factors which addresses eating habits and levels of physical activity; and environmental factors which take media (advertisements) and food industry influence into account (CDC, 2010). Although genetics plays a large part in the discussion on obesity, a close analysis of being genetically predisposed to obesity will not be discussed in this paper due to length constraints; however, it is imperative to conduct further studies on this issue so as to reverse the damaging assumption that people become obese through a myriad of personal character flaws, such as laziness and gluttony. The CDC (2010) states that behavior factors contributing to obesity include energy intake, physical activity, and sedentary behavior. Energy intake involves what is being eaten, when is it being eaten, and in what quantity is it being eaten. To decrease calorie intake, physical activity is essential for both physical and psychological well being. Children who are involved in regular physical activities in childhood often participate in physical activities in adulthood; however, on the flip side, children who have a highly sedentary lifestyle frequently carry this behavior over into adulthood leads to adult obesity. In the discussion on obesity, behavior factors are the easiest to quantify and the easiest to blame; if we are simply looking at obesity from a behavioral perspective, the individual comes to bear full responsibility for his/her condition, which is a completely unfair, and thoroughly damaging, assumption. The reality is that environmental factors, most notably the food industry, which is heavily controlled and regulated by big business and government, and the media, which manipulates consumers through catchy advertisements, are as responsible for this crisis. In the widely acclaimed documentary, Food. Inc., director Robert Kenner delves into the highly secretive world of food production and distribution. Through countless interviews with farmers, representatives of large food distribution companies (Perdue, Tyson, Monsanto), and policy makers, Kenner presents the audience with the shocking fact that soda and hamburgers are cheaper to purchase than broccoli and apples because of the way in which farm subsidies are distributed by government to farmers. In addition, he also argues that the emphasis on growing foods “faster, fatter, bigger, and cheaper,” pumping our food full of hormones which adversely affect our bodies. Finally, the question of childhood obesity is also inextricably linked with race and social class because lower income people who cannot afford the head of broccoli are opting for the hamburger. Another environmental factor that is contributing to the obesity epidemic is the media. In the television broadcast, How to Get Fat Without Really Trying (2003), news journalist Peter Jennings discusses the acute impact that advertising has on children. Food companies spend millions of dollars on catchy ads that are entirely directed at selling their products to children through adorable cartoon mascots and catchy jingles. Many other countries wonder why obesity is so poignant in the U.S. but, rather than pointing the finger at the individual, it is essential to point the finger at government and industry, especially in regards to child obesity. Unlike responsible governments in countries like Australia and Spain who have made advertising illegal to children under a certain age (usually 8 or 10), there are no such rules that exist in the US (Summa, 2003). As a result, kids are being inundated endlessly with enticing commercials, after which they beg and whine until the parent gives in and buys the product (to stop the fighting or to avoid feeling shame during a temper tantrum). Ironically, the food companies that spend top dollars for advertisement indoctrination are the first ones to place blame on parents for not protecting their children against the companies’ very own products (Summa, 2003). They are also not the ones who have to deal with the physical and emotional consequences of eating a processed, junk-food diet. Countless health journals abound with entries discussing the detrimental health effects of the obesity epidemic. Obesity in childhood makes children more susceptible to asthma, sleep apnea, high blood pressure, higher LDL cholesterol, and heart abnormalities (Reilly et. al., 2003). This drastic increase in Body Mass Index (BMI) among children ages 6 to 11 has left health practitioners reeling and, as argued by de Onis, Blossner, and Borghi (2010), this ever-increasing figure brings with it massive implications on the future state of health care expenses. Wang and Dietz’s study on the economic burden of obesity, completed in 2002, illuminates how the fear of an overburdened health care system was already a major concern at the turn of the century, indicating that, in 2001, “the hospital costs associated with obesity may have risen to more than $127 million per year.” Therefore, in response to the astronomical increase in health care costs, it is imperative to discuss the psychological factors contributing to the transition of childhood obesity into adult obesity. Goodman and Whitaker (2002) argue the following: “the social stigmatization associated with obesity is believed to engender chronic embarrassment, shame, and guilt, all of which may lead to affective disorders.” Numerous studies conducted on obese 9 and 10 year old children show that, at that age, the seeds of self loathing have already been planted and, by the age of 13 and 14, most obese students have significantly lower self esteem than their average weight peers (Reilly et. al., 2003; Strauss, 2000; Goodman & Whitaker, 2002). These feelings of self-loathing are frequently accompanied by heightened levels of depression, anxiety, loneliness, and isolation and, in an attempt to fit into a social group as something other than the “fat kid”, these children are more likely to exhibit behavioural problems and are more willing to engage in high risk behaviours, such as using tobacco, consuming alcohol, and engaging in sex at an earlier age (Strauss, 2000). In regards to the psychological effects of obesity on childhood, the most pervasive is depression, which is the catalyst for such other issues as withdrawal, poor participating in school and social circles, anti-social or violent behavioral problems, and a willingness to participate in destructive or criminal activities. Dr. Dolgoff (2009) argues that all children, regardless of their level of self-confidence, “get a sense of their own identity by monitoring how others perceive them…. [therefore], since our culture looks down on the overweight, overweight kids tend to develop a low sense of self-esteem.” Depending on the level of social rejection and the subsequent levels of depression experience by the child, the child frequently comes to see him/herself as inferior to others, and unworthy of many things, such as love, success, and pride. If this self-hatred is not dealt with early in a child’s life, the damages will inevitably follow him/her into adulthood, causing a spiral of shame, insecurity, depression, and destructive behaviors that will affect their personal and public lives. The ill effects of obesity are magnified by social reaction to fatness. As we are inundated with magazine advertisements, television commercial, and movies filled with painfully thin models that are perceived as the epitome of beauty, our understanding of beauty changes. What was acceptable 50 years ago is deemed too fat now. The psychological effects of obesity are further complicated by the social discrimination against obesity that is embedded within our society. Rather than looking at the extenuating circumstances behind a person’s weight, society is quick to brandish that person as a lazy, unmotivated, glutinous sloth who deserves to be socially attacked, demeaned, and ostracized. Furthermore, the intensity of this attack increases as the individual moves from childhood to adolescence; “overweight teens are often teased, ridiculed and shunned,” but the perpetrators of this attack are rarely punished because ‘making fun of the fat kid’ has become normalized, accepted, and even encouraged. (Dolgoff, 2009). Yet, this discrimination further intensifies as the adolescent enters adulthood. Unlike the attack experienced in adolescence, which is overt and easy to locate, the attack on obese adults is more subtle. Upon entering the workforce, the obese individual experiences institutionalized discrimination, or sizism as it has been referred to; “studies show that overweight individuals are less likely to be hired for a job than normal-weight individuals. Wages of the overweight, particularly overweight women, are much lower than wages of normal-weight workers” (Dolgoff, 2009). In addition, obese individuals are also frequently refused health insurance, which is ironic because the person suffering from obesity is the same person who has an elevated risk of sleep apnea, asthma, diabetes, and heart conditions. In addition to discrimination in the workforce, the obese individual (child and adult) is frequently the victim of social attacks in public places, especially on public transportation. On buses and subways, entrance and exit doors and seat sizes often pose a real challenge to obese individuals, not only in practical terms, but also in terms of creating shame over their heightened visibility as a person who simply cannot “fit” into the seat and into society. “Discrimination against the obese is so rampant that normal-weight individuals will often let an obese person know that he or she is taking up more space that he or she should” (Dolgoff, 2009). After several of these experiences, the obese individual begins to internalize this discrimination and see themselves as worthless. Therefore, as “early adolescence is a crucial time for the formation of self-worth in … children,” it is essential to take a closer and more critical look at the psychological consequences of obesity to not only remedy the obesity epidemic, but to also curtail additional delinquencies that may arise from feelings of exclusion and shame (Strauss, 2000). In conclusion, the question of child obesity must take into account the external factors that are contributing significantly to this problem. Simply asserting that personal responsibility is the central factor behind obesity is ignorant. It is being wielded as a useful tool by the food industry and government to hurl blame on the individual or, in the case of children, on the parents. The reality is that there are three central factors at play – genetics, behavior, and environment. Although one cannot alter genetics, the other two can be changed in order to save a generation of people from a lower quality of life, and to save the taxpayer from an elevated fiscal responsibility (through taxes) to deal with this crisis. It is imperative that we, as citizens, begin investigating the role of industry, government policy, and advertising in the discussion on childhood obesity because, if we do not take a closer look soon, the already staggering statistics on obesity in both children and adults will continue to increase. References CDC. (2001, September 20). Overweight and Obesity. Retrieved from http://www.cdc.gov/obesity/index.html de Onis, M., Blossner, M., & Borghi, E. (2010). Global prevalence and trends of overweight and obesity among pre school children. The American Journal of Clinical Nutrition, 92, 1257-1264. Dietz, W.H. (1998). Health consequences of obesity in youth: childhood predictors of adult disease. Pediatrics, 101(3), 518–525. Dolgoff, J. (2009). The devastating psychological effects of child obesity. Retrieved from http://drweigh.com/blog/2009/04/17/the-devastating-psychological-effects- of-child-obesity/ Goodman, E., & Whitaker, R.C. (2002). A prospective study of the role of depression in the development and persistence of adolescent obesity. Pediatrics, 110(3), 497- 504. Kenner, R. (Director). (2008) Food, Inc. [Motion Picture]. United States: River Road Entertainment. Reilly, J.J., Metheven. E., McDowell, Z.C., Hacking, B., Alexander, D., Stewart, L., & Kelnar, C.J.H. (2003). Health consequences of obesity. Archives of Disease in Childhood, 88(9), 748-752. Serdula, M.K., Ivery, D., Coates, R.J., Freedman, D.S. Williamson, & Byers, T. (1993) Do obese children become obese adults? A review of the literature.  Preventative Medicine 22: 167–177. Strauss, R. S. (2000). Childhood obesity and self esteem. Pediatrics, 105(1), 15. Summa, K. (Producer). (2003). Special: Peter Jennings reporting – how to get fat without really trying: 12/8/03. [Television Broadcast]. New York: ABC. Wang, G., & Dietz, W.H. (2002). Economic burden of obesity in youths aged 6 to 17 years: 1979 – 1999. Pediatrics, 109(5), 81. Whitaker, R.C., Wright, J.A., Pepe, M.S., Seidel, K.D., & Dietz, W.H. (1997). Predicting obesity in young adulthood from childhood and parental obesity. New England Journal of Medicine. 37(13): 869–873. http://www.cdc.gov/obesity/index.html (CDC obesity - homepage intro) Read More