Psychological mechanisms underlying overweight and obesity during adolescence. Triads study from the EDUDORA2 project.

Abstract

Strategies for prevention and treatment of obesity in adolescents are too often limited to lifestyle modifications and dietary counseling. EDUDORA 2 (Education therapeutique et preventive face au Diabete et a l’Obesite a Risque chez l’Adulte et l’Adolescent) project focused on going beyond this dyadic and biological vision. 12 Triads were recruited in regions of Belgium, Luxembourg and France, each including an overweight or obese adolescent, the attending healthcare professional and a family member. Each subject of the triad was interviewed individually using the “life story” technique. Psychosocial factors influencing the degree of adherence to the prescribed treatment were assessed by speech thematic analysis. The most common strategy inside a triad remained focused on symptoms limiting the change of life style or diet. More complex and generally ignored underlying psychological mechanisms were highlighted: interaction with peers was a factor of awareness and strength for change, while food compensation difficulties, body image and devalued self-esteem were inhibitory factors for weight management. Psychological behavior affecting adolescence with respect to body ratio as well as projection of the mother’s experience with her own weight further strengthened these factors. Having a global view of obesity is also essential, at least when integrated in real life situations and in the psychological development during adolescence. Therapeutic Patient Education appears as a real opportunity provided professionals are properly trained.