PII: S0882-5963(05)00051-5

Abstract

AS A PEDIATRIC nurse practitioner–student, I was drawn to an article published December 2004 in your journal entitled “Overweight in Children: Definitions, Measurements, Confounding Factors, and Health Consequences” (Harrell et al., 2004Harrell L.R. Hardy J.S. Bell R.A. Overweight in children: Definitions, measurements, confounding factors, and health consequences.Journal of Pediatric Nursing. 2004; 19: 376-384Abstract Full Text Full Text PDF PubMed Scopus (38) Google Scholar). I found it to be a very poignant discussion of the epidemic known as childhood obesity. It brought up several valid points with regard to the health consequences of this population. I felt that it described most of the maladies faced by overweight children quite well. I did, however, feel that this article only skimmed the surface of the social and psychological issues concerning obese children. Their social and psychological health should play as important a role as their physical well-being. The importance of their psychological health should not be overlooked. Prinstein et al., 2002Prinstein M.J. Pearce M.J. Boergers J. Adolescent obesity, overt and relational peer victimization, and romantic relationships.Obesity Research. 2002; 10: 386-393Crossref PubMed Scopus (241) Google Scholar found that perhaps equally as damaging as the negative health effects are the negative social and psychological ramifications of childhood obesity. Psychological problems associated with childhood obesity include negative self-esteem, withdrawal from interaction with peers, depression, anxiety, and the feeling of chronic rejection (Williams & Deckelbaum, 2001Williams C.L. Deckelbaum R.J. Childhood obesity: The health issue.Obesity Research. 2001; 9: 239-243Crossref Scopus (544) Google Scholar). According to the National Institutes of Health's website (http://www.nih.gov/news/WordonHealth/jun2002/childhoodobesity.htm), “Perhaps more devastating to an overweight child than the health problems is the social discrimination. Children who are teased a lot can develop low self-esteem and depression” (Torgan, 2002Torgan C. Childhood obesity on the rise.2002http://www.nih.gov/news/WordonHealth/jun2002/childhoodobesity.htmGoogle Scholar). The results of a study based on Canadian records from the 2001/2002 World Health Organization Health Behavior in School-Aged Children Survey state that “Overweight and obese school-aged children are more likely to be the victims and perpetrators of bullying behavior than their normal-weight peers” and that “The social and psychological ramifications induced by the bully-victimization process may hinder the social development of overweight and obese youth” (Pickett et al., 2004Pickett W. Janssen I. Craig W.M. Boyce W.F. Associations between overweight and obesity with bullying behaviors in school-aged children.Pediatrics. 2004; 113: 1187-1194Crossref PubMed Scopus (636) Google Scholar). In my clinical experience, both as an undergraduate and graduate student, I have seen firsthand the demoralizing effects that bullying and teasing have on overweight children. These children suffer from many forms of abuse because of their weight. They say that they have been teased, called names, physically threatened, and sexually harassed because they are overweight. Because of this abuse, these children say that they experience feelings of sadness and loneliness. Some of these children state that they feel an increased desire to eat more when sad or lonely. “Issues of stigma and stereotype among peers are particularly relevant during childhood and adolescence because the formation of adaptive social relationships is especially important during these developmental periods” (Prinstein et al., 2002Prinstein M.J. Pearce M.J. Boergers J. Adolescent obesity, overt and relational peer victimization, and romantic relationships.Obesity Research. 2002; 10: 386-393Crossref PubMed Scopus (241) Google Scholar). Because adolescents rely on their peers for the development and maintenance of their self-image, self-acceptance, and sense of belonging, the rejection that obese children and teens experience from their peers can have devastating effects on their social and psychological health. “The prevalence of social problems among obese youth is quite high, and these social problems are predictive of both short-term and long-term psychological outcomes” (Pickett et al., 2004Pickett W. Janssen I. Craig W.M. Boyce W.F. Associations between overweight and obesity with bullying behaviors in school-aged children.Pediatrics. 2004; 113: 1187-1194Crossref PubMed Scopus (636) Google Scholar). It is therefore imperative that healthcare providers look at the overall picture with regard to these children. Their social and psychological health should be considered as important as their physical health. Obesity in children and adolescents is a serious issue with many health and social consequences that often continue into adulthood (Liverman et al., 2005Liverman C.T. Kraak V.I. Koplan J.P. Preventing childhood obesity: Health in the balance: Executive summary.Journal of the American Dietetic Association. 2005; 105: 131-138PubMed Google Scholar). The prevention, treatment, and long-term care of childhood obesity are serious challenges facing healthcare professionals. The surgeon general suggests, “Overweight children need support, acceptance, and encouragement. The focus needs to be on the child's health and his or her positive qualities, not on their weight. Realize that an appropriate goal for many overweight children is to maintain their current weight while growing normally in height” (The United States Department of Health & Human Services, 2005The United States Department of Health & Human Services, (n.d.). The surgeon general's call to action to prevent and decrease overweight and obesity. Retrieved February 14, 2005, from http://www.surgeongeneral.gov/topics/obesity/calltoaction/fact_adolescents.htm.Google Scholar). Healthcare professionals play a significant role in preventing and fighting childhood obesity. Time is of the essence regarding this most important issue; the physical, psychological, and social health of our nation's children is in the balance. Overweight in Children: Definitions, Measurements, Confounding Factors, and Health ConsequencesJournal of Pediatric Nursing: Nursing Care of Children and FamiliesVol. 19Issue 6PreviewThe epidemic of childhood overweight continues to grow at staggering rates, increasing nearly four-fold between 1963 and 2000. Children that are overweight are more apt to be overweight adults and are more likely to suffer adverse health consequences associated with excess weight. Nurses have a unique presence in the healthcare environment to assess children for overweight, provide parent/child nutritional education, and conduct obesity-related research. This article provides an overview of the current body of literature surrounding the definition and measurement of overweight and the morbidity association with childhood overweight. Full-Text PDF