Overweight Youngsters Research Articles

The Reflection of Exercise on the New Generation

Introduction: Our health, tonus and overall well-being are in a constant relationship with a number of factors. One of the most important ones being, as evolution set it - physical activity. Unfortunately, in recent years the nature of our day-to-day life has changed for the worse as sedentary life has taken the place of the active one, even for the youngest. This tendency has led to an unheard of amount of overweight youngsters and such with an impaired metabolism. Materials and Methods: To get to the bottom of this worldwide problem, we prepared and conducted a survey. The answers we received showed us the parents` views of what an increased amount of activity correlates to in their children`s physical and mental health. The survey was aimed towards the parents of children between 7 and 12 years of age. In it, we asked a number of questions which cover the parent`s view on exercise, the connection with their child and their willingness to discipline them towards a healthy lifestyle. Results: The results showed that there is a substantial number of children that have little to no physical activity, but fortunately the tendency is for parents to be willing to make the first step towards a healthier, more active lifestyle. Conclusion: Sedentary life leads to an increasingly overweight and unhealthy society. Children should be guided towards an active way of living by their parents not only with words but with an example. New and upcoming sports are a good way to stimulate the children`s attention towards exercise and with that to lead to a healthier society.

Prevalence of elevated 1-h plasma glucose and its associations in obese youth

We found that in obese youth, plasma glucose above 155mg/dl (8.6mmol/l) at 60min of an OGTT, a predictor of type 2 diabetes (T2D) in adults, was present in 12% with normal glucose tolerance and 57% with impaired glucose tolerance. Performance of elevated 1-h glucose in predicting T2D in overweight youngsters should be tested.

Attentional distraction during exercise in overweight and normal-weight boys.

The purpose of this study was to investigate the effect of attentional distraction on field running distance and activity intensity during an exercise session in normal-weight and overweight youngsters and to investigate potential mediators. Fifty-three 12–14 yr-old boys participated twice in a 12-min running test and a 20-min exercise session, once with attentional distraction (by listerning to music) and once without distraction (counterbalanced randomised controlled design). At the end of the endurance test running distance was recorded. During the exercise session activity intensity was assessed by accelerometers. After each experiment, rate of perceived exertion (RPE) was estimated and seven questions were asked about how participants experienced the experiment. Both overweight and normal-weight boys ran further during the running test with music (p < 0.05) and this effect was mediated by a decrease in feelings of annoyance. During the exercise session with music, both overweight and normal-weight boys exercised less at low and high intensity and more at moderate and very high intensity (p < 0.01) and this effect was mediated by a decrease in RPE. We can conclude that attentional distraction has a positive effect on running distance on a field endurance test and on activity intensity during an exercise session through different mechanisms in both overweight and normal-weight boys.

Combating adolescent obesity: an integrated physiological and psychological perspective.

Purpose of reviewOptimizing the approach to combat childhood obesity, we emphasize the importance of combining both biological and psychological knowledge. In such an approach, strength exercises might be an important aspect in the treatment and prevention of childhood obesity.Recent findingsRecent evidence indicates plausible effects of the role of resistance exercise in combating the negative health effects of childhood obesity. When looking at body composition, overweight youngsters do not only have a higher fat mass, but also a higher muscle mass compared with their normal-weight counterparts. With that, they are also stronger and better in exercises wherein the focus is on absolute strength, making them – under the right circumstances – more motivated to engage in resistance exercise and ultimately maintain a physically active lifestyle.SummaryMore and more children are obese, and obese children become obese adults. One reason that overweight youngsters are not physically active is that they are outperformed by normal-weight youngsters, and one reason they are overweight is because they are not physically active. To combat childhood obesity, strength exercise might be a solution to break the vicious cycle.

When Parents Focus on Weight, Kids’ Eating Disorder Risk Rises

Back to table of contents Previous article Next article Clinical and Research NewsFull AccessWhen Parents Focus on Weight, Kids’ Eating Disorder Risk RisesJoan Arehart-TreichelJoan Arehart-TreichelSearch for more papers by this authorPublished Online:8 Aug 2013https://doi.org/10.1176/appi.pn.2013.8b3AbstractParents need to be careful in discussing weight issues with their children in light of findings suggesting that such discussions can increase the risk of developing an eating disorder.Jaimie Duplass/Shutterstock At a workshop concerned with binge eating last year, Chevese Turner, the founder and chief executive officer of the Binge Eating Disorder Association, said that when she was little, her mother had anorexia nervosa and talked a lot about dieting. Both factors encouraged Turner to start binge eating, she believes (Psychiatric News, June 1, 2012).Now a new study reinforces Turner’s assumption. It has found a link between parents’ discussion of weight with their adolescents and the adolescents engaging in unhealthy eating behaviors such as dieting, laxative use, and binge eating.The study, headed by Jerica Berge, Ph.D., an assistant professor of family medicine and community health at the University of Minnesota, was published online June 24 in JAMA Pediatrics.Berge and her colleagues first surveyed approximately 2,400 adolescents from 20 public middle schools and high schools in the Minneapolis/St. Paul area to determine whether they were overweight and whether they engaged in unhealthy eating behaviors. The adolescents came from diverse racial and ethnic backgrounds and were mostly from low, low-middle, and middle socioeconomic backgrounds.The researchers then surveyed about 3,500 parents of the adolescents—50 percent of the adolescents had both parents surveyed—to learn whether the parents discussed weight or healthful eating with their youngsters and to see if there were any associations between parental conversations on these topics and adolescents engaging in unhealthy eating behaviors.They found that such a relationship did exist.For example, adolescents who were not overweight and whose mothers talked about healthful eating were significantly less likely to diet than were nonoverweight adolescents whose mothers talked about weight (27 percent versus 35 percent).Similarly, overweight adolescents whose mothers talked about healthful eating were significantly less likely to diet than were overweight youngsters whose mothers talked about weight (40 percent versus 53 percent).When their fathers talked about weight, nonoverweight adolescents were significantly more likely to diet than when their fathers did not discuss weight (33 percent versus 22 percent). The findings were comparable for overweight youngsters. When their fathers talked about weight, 64 percent dieted, whereas when fathers talked about healthy eating, only 49 percent did.As for the prevalence of binge eating, it was significantly lower among nonoverweight adolescents whose mothers didn’t discuss weight than among nonoverweight adolescents whose mothers did discuss it (4 percent versus 8 percent). Similar findings emerged for overweight adolescents. The prevalence of binge eating was 9 percent in youngsters whose mothers didn’t discuss weight, but 13 percent in youngsters whose mothers did.“These findings suggest that parents should avoid conversations that focus on weight or losing weight and instead engage in conversations that focus on healthful eating, without reference to weight issues,” Berge and her team concluded. “This approach may be particularly important for parents of overweight or obese adolescents.”Psychiatrists can also “use the results of this study to guide their conversations with parents and adolescents about eating behaviors,” Berge suggested in an interview with Psychiatric News.“I think these are important findings,” Michael Devlin, M.D., codirector of eating disorders research at the New York State Psychiatric Institute, told Psychiatric News. “They support the idea that despite our concerns about obesity and its comorbidities, the most useful health-promotion messages relate to lifestyle and not weight and that weight-related messaging—particularly messages that evoke shame or contribute to stigma—can be counterproductive. The next step would be to examine this cohort, or some similar cohort, over time to examine the longer-term ‘hard outcomes’ of medical risk factors, such as blood pressure, insulin sensitivity, blood lipids, and others, and the quality of life in groups exposed to weight versus lifestyle-related messages.”The study was funded by the National Institutes of Health. ■An abstract of “Parent Conversations About Healthful Eating and Weight” is posted at http://archpedi.jamanetwork.com/article.aspx?articleid=1700514. ISSUES NewArchived

A review of the psychological and familial perspectives of childhood obesity.

Childhood obesity is on the rise in both industrialized and developing countries. The investigation of the psychosocial aspects of childhood obesity has been the focus of long- standing theoretical and empirical endeavor. Overweight in children and adolescents is associated with a host of psychological and social problems such as reduced school and social performance, less favorable quality of life, societal victimization and peer teasing, lower self-and body-esteem, and neuropsychological dysfunctioning. Whereas community samples of obese youngsters usually do not show elevated psychopathology, clinically-referred overweight children show elevated depression, anxiety, behavior problems, attention deficit hyperactivity disorder and disordered eating. Parents’ perceptions of their child’s overweight highly influence the well-being of obese children and the way in which they perceive themselves.The present review paper aims to broaden the scope of knowledge of clinicians about several important psychosocial and familial dimensions of childhood obesity: the psychosocial functioning, self and body esteem and psychopathology of overweight youngsters, the influence of children’s perceptions of overweight, including those of the obese children themselves on their well being, and the influence of parental attitudes about weight and eating on the psychological condition of the obese child.

Psychiatric assessment of Children with constitutional obesity

Objectives To determine the psychiatric disorders that accompany pediatric obesity and to compare boys and girls in terms of the presence of these disorders. Methods This is a descriptive cross-sectional outpatient study. The study sample included 52 overweight youngsters (26 girls and 26 boys) who presented to the endocrinology clinic in Abo-elrish pediatric hospital with increased body weight. The endocrinal profile revealed no abnormality and it was established as constitutional obesity. The following tools were applied: the Anxiety Scale for Children, the Depression Scale for Children, and the Self-Concept Scale and Behavioral Checklist for Children. Weight and height were measured and the adjusted BMI was calculated. Results Eight (15.4%) of the children were depressed, 16 (30.8%) were moderately anxious, and 10 (19.2%) were highly anxious. Twenty-four (46.2%) of the children had a low self-concept and 28 (53.8%) had a positive self-concept. The entire sample of children had an eating disorder. Comparative results of boys and girls showed that all girls were in the primary stage, whereas the boys were distributed throughout the stages of education. Four (15.4%) boys and girls were depressed. Half of the boys were not anxious, 10 (38.5%) of the other half were moderately anxious, and four (15.4%) of them were highly anxious. Six (23.1%) of the girls had moderate anxiety and another six (23.1%) were highly anxious. Sixteen (61.5%) of the girls had a low self-concept, whereas only eight (30.8%) of the boys had a low self-concept with a statistical significance (P=0.050). Eight (30.8%) boys and girls had a withdrawal problem. Eight (30.8%) boys had anxiety/depression and only four (15.4%) girls had anxiety/depression. Conclusion Low self-concept and eating disorders compensated for the absence of other psychiatric comorbidities, especially depression and anxiety.

59 – The long-term outcome of eating pathology in overweight youngsters following weight-loss treatment

59 – The long-term outcome of eating pathology in overweight youngsters following weight-loss treatment

Environmental risk factors and metabolic syndrome components in overweight youngsters

Introduction. The environmental risk factors such as food intake and physival activity, are determinants in the etiology of metabolic syndrome in overweight adolescents.Objective. To explore the association between environmental risk factors and components presence of metabolic syndrome in overweight youngsters in Medellín.Materials and methods. Adolescents between the ages of 10 and 18 were selected for a cross sectional study. Body composition by anthropometry, blood pressure, lipid profile, glucose, insulin, food intake and physical activity level were assessed in the study population.Results. The prevalence for metabolic syndrome components of hypertriglyceridemia was 40.9%; hypertension, 20.9%; low HDLc, 15.6%; high waist circumference, 4.0%, and hyperglycemia, 0.9%; the overall prevalence of metabolic syndrome was 3.1%. There was a statistical difference (p&lt;0.005) between the consumption of calories, simple and total carbohydrates and the presence of the components; no association was found between the level of physical activity and the presence of components (p&gt;0.05). The logistic regression model showed a higher probability of having at least one component if the youngster was male (p=0.022), with a higher BMI (Body Mass Index) (p=0.019) and was located in the fourth simple carbohydrates consumption quartile (p=0.036). Conclusions. Environmental risk factors associated with components of metabolic syndrome were the increased consumption of calories, simple and complex carbohydrates, all directly related to the BMI. In contrast, the level of physical activity, family history and personal risk factors showed no association. The metabolic syndrome only occurred in youngsters with obesity.

Environmental risk factors and metabolic syndrome components in overweight youngsters

The environmental risk factors such as food intake and physival activity, are determinants in the etiology of metabolic syndrome in overweight adolescents. To explore the association between environmental risk factors and components presence of metabolic syndrome in overweight youngsters in Medellín. Adolescents between the ages of 10 and 18 were selected for a cross sectional study. Body composition by anthropometry, blood pressure, lipid profile, glucose, insulin, food intake and physical activity level were assessed in the study population. The prevalence for metabolic syndrome components of hypertriglyceridemia was 40.9%; hypertension, 20.9%; low HDLc, 15.6%; high waist circumference, 4.0%, and hyperglycemia, 0.9%; the overall prevalence of metabolic syndrome was 3.1%. There was a statistical difference (p<0.005) between the consumption of calories, simple and total carbohydrates and the presence of the components; no association was found between the level of physical activity and the presence of components (p>0.05). The logistic regression model showed a higher probability of having at least one component if the youngster was male (p=0.022), with a higher BMI (Body Mass Index)(p=0.019) and was located in the fourth simple carbohydrates consumption quartile (p=0.036). Environmental risk factors associated with components of metabolic syndrome were the increased consumption of calories, simple and complex carbohydrates, all directly related to the BMI. In contrast, the level of physical activity, family history and personal risk factors showed no association. The metabolic syndrome only occurred in youngsters with obesity.

Screening for eating pathology in the pediatric field

To develop normative data for the children's version of the eating disorder examination questionnaire (ChEDE-Q) for adolescents of different weight status and sexes, and to investigate the usefulness of the ChEDE-Q in overweight youngsters by making a comparison with the ChEDE. The subjects were 1 291 adolescents from 12 to 18 years old (429 of them were overweight). The ChEDE-Q and data on height and weight were carried out for all youngsters. For the validity study, 235 overweight subjects were invited to participate in a clinical interview (ChEDE). Each of the subscales of the ChEDE-Q was significantly correlated with the corresponding subscale of the ChEDE and no significant difference was found between the interview and questionnaire with regard to the overall proportion of youngsters who reported binge eating and excessive exercising and those who did not. The results demonstrate the importance of taking into account sex and weight status when interpreting ChEDE-Q test results. Furthermore, a comparison with the ChEDE indicates that the ChEDE-Q may serve as a reliable instrument for the screening of binge eating episodes among overweight youngsters.

Psychometric Quality of the Dutch Version of the Children's Eating Attitude Test in a Community Sample and a Sample of Overweight Youngsters

Introduction. Disturbed eating attitudes may be important precursors of pathological eating patterns and, therefore need to be researched adequately. The Children's Eating Attitude Test (ChEAT) is indicated for detecting at-risk attitudes and concerns in youngsters. Method. The present study was designed to provide a preliminary psychometric evaluation of the Dutch version of the ChEAT, by examining reliability and validity in a sample of 166 youngsters. Results. Generally the ChEAT seems to be a reliable instrument. Concurrent validity was demonstrated by positive correlations with measures assessing pathological eating behaviour and with related psychological problems. The discriminant validity was good. Based on ChEAT scores we can distinguish overweight youngsters from the community sample and “dieters” from “non dieters”. Divergent validity and factor structure show still shortcomings. Discussion. The Dutch version of the ChEAT seems to be a promising screening- and research instrument. Future prospective research could focus on a cut-off score for identifying at-risk youngsters.

Long‐term outcome of pediatric eating pathology and predictors for the onset of loss of control over eating following weight‐loss treatment

To investigate the stability of eating pathology over a 6-year period and predictors for the onset of loss of control (LC) over eating among overweight youngsters having undergone weight-loss treatment. Structured clinical interviews and self-report questionnaires were administered to a sample of 56 overweight youngsters (M age = 13 years) who were at the start of weight-loss treatment in 2000 and again 6 years later. Mean levels of eating concerns, drive for thinness, bulimic symptoms, and body dissatisfaction decreased over the 6-year period. Dietary restraint, weight, and shape concerns were stable over time. Also, in 50% of those reporting objective binge eating at baseline, binge-eating episodes remained stable. Youngsters characterized by symptoms of depression in early adolescence were at a higher risk for developing new episodes of LC 6 years later. Neither concerns about eating, shape, and weight nor dietary restraint independently predicted LC. Six years after following structured weight-loss treatment, some eating pathology variables still remain stable. Especially youngsters who already report LC at young ages appear to develop a more stable pattern of disordered eating behavior.

Relations of dietary restraint and depressive symptomatology to loss of control over eating in overweight youngsters

This study investigated the dietary restraint and depression pathway to loss of control over eating among a sample of overweight youngsters based on the assumptions of the extended cognitive behavioural theory for bulimia nervosa. The children's version of the eating disorder examination interview and the children's depression inventory were administered to 350 overweight youngsters (with a mean age of 13.30 years old). Structural equation modelling indicated that the over-evaluation of eating, weight and shape was significantly associated with dietary restraint, which in turn was significantly associated with loss of control over eating. Evidence was also found for a direct pathway between depressive symptoms and loss of control over eating. It can be concluded that in general, the main components to maintain the bulimic cycle in eating disordered patients operate in a similar way to maintain loss of control over eating in overweight youngsters.

Weight Status of Children and Adolescents in a Telepsychiatry Clinic

The prevalence of overweight and obesity is approximately 32% among children and adolescents in the United States. Comorbid conditions associated with pediatric overweight and obesity include psychiatric conditions. The purpose of this study was to determine the prevalence of overweight and obesity among children and adolescents presenting for consultation from rural communities to the UC Davis Telemedicine Program (UCDTP), as well as to collect preliminary data to design an integrated disease management program for children and adolescents with obesity and mental illness. Patients aged 21 and under seen for psychiatric consultation at the UCDTP between 2004 and 2006 were included. Retrospective medical record review was conducted to determine the major psychiatric diagnoses, height, weight, body-mass index, and weight status (underweight/at risk for underweight, normal weight, overweight, or obese) for each patient. Of the 230 patients referred, a total of 121 patients had both height and weight values documented. Three patients were underweight; 51 were normal weight; 28 were overweight; 39 were obese. The most common psychiatric diagnoses in the 121 patients were attention deficit/hyperactivity disorder (ADHD; n = 40), bipolar disorder (n = 36), and depression (n = 31). The most common psychiatric diagnoses in patients with available weight and height data who were overweight and obese were bipolar disorder (n = 20), depression (n = 18), and ADHD (n = 17). Approximately 55% of child and adolescent patients seen for telepsychiatry consultation whose charts documented height and weight measurements were overweight or obese. Psychiatric diagnoses in overweight youngsters need to be researched further to determine whether the weight change is primary or secondary to mood and/or to treatments, such as medication. At such a high rate of comorbidity, monitoring the weight status of young psychiatric patients in this population is indicated.

Defusing the child obesity time bomb

Rotherham is investing in an innovative programme of weight management camps for overweight youngsters.

Attachment and weight and shape concerns in inpatient overweight youngsters

Objective: The aim of this study was to investigate the associations between weight and shape concerns and attachment towards mother and father in inpatient obese youngsters. Method: In a sample of 39 inpatient obese youngsters weight and shape concerns were measured with the Children's Version of the Eating Disorder Examination and attachment was measured using the Relationship Questionnaire. Results: Pearson correlation analyses demonstrated that attachment towards mother was linked with both weight and shape concerns, whereas attachment towards father was uniquely linked with weight concerns. Conclusion: This study demonstrated an association between attachment and weight and shape concerns in inpatient obese youngsters. This suggests that relationships with attachment figures should be taken into account when these youngsters require treatment for eating disorder symptoms.

Dysfunctional schemas and eating pathology in overweight youth: A case–control study

This study aimed to investigate in overweight adolescents the association of dysfunctional schemas (negative basic beliefs about the self and one's relationships with others) on one hand and eating disorder (ED) symptoms and depression on the other hand. Participants were 32 overweight adolescents experiencing loss of control over eating (LC) and 32 overweight youngsters experiencing no loss of control over eating (NoLC), matched on referral status, age, gender, and degree of overweight. Adolescents were interviewed with the Eating Disorder Examination-Child version and completed the Young Schema Questionnaire and the Children's Depression Inventory. The LC group displayed a greater severity of dysfunctional schemas than the NoLC group. Maladaptive schemas were related to ED cognitions, dietary restraint attitudes, and depressive symptoms. In overweight youngsters, ED symptoms are associated with dysfunctional thinking patterns and negative affect.

Psychiatric disorders and symptom severity in referred versus non-referred overweight children and adolescents

This study aimed firstly to investigate whether youngsters referred for overweight treatment differ from non-referred overweight youngsters on the prevalence of psychiatric disorders and psychological symptoms. Secondly, the potentially moderating role of age, gender, socio-economic status and degree of overweight in the association of referral status and mental disorder in overweight youth was explored. Participants were 155 overweight youngsters enrolled in an obesity treatment programme (mean age = 13.76; mean BMI = 33.99) and 73 non-referred overweight youngsters (mean age = 13.74; mean BMI = 27.35). The Structured Clinical Interview for DSM-IV-Childhood version and the Child version of the Eating Disorder Examination were administered and participants filled out the Children's Depression Inventory, the Spence Children's Anxiety Scale and the Youth Self Report. Parents were asked to complete the Child Behavior Checklist. In the referred group 37.50% and in the non-referred group 23.29% of the participants met criteria for at least one mental disorder. In both groups, anxiety disorders were most prominent. Overall, a higher prevalence of mental disorders was found in the referred group. Referred youth displayed significantly more 'full blown' eating disorders and binge eating than non-referred youngsters and exhibited a significantly greater severity of self- and parent-reported internalizing symptoms. Referral was also associated with a significantly higher degree of overweight and significantly lower SES. After controlling for these pre-existing differences in degree of overweight and SES, only the greater severity of parent-reported internalizing symptoms in referred youth remained significant. Older age was generally predictive for the presence of mental disorders and in the non-referred group SES was positively associated with psychiatric disorder. A substantial proportion of overweight youngsters suffer from mental disorders. Referral status and age are associated with the presence of psychopathology. However, differences between referred and non-referred youngsters are not as pronounced as expected on the basis of earlier research in the field.

Differences in Eating Style between Overweight and Normal-Weight Youngsters

Differences in eating styles between overweight and normal-weight youngsters were investigated with a child version of the Dutch Eating Behavior Questionnaire (DEBQ). Subjects were children (n=1458; M: 10.1; SD=1.3) and adolescents (n=1016; M: 14.9; SD=1.5). Overweight adolescent girls scored high on emotional eating while overweight adolescent boys displayed more external eating. In overweight children, already 10.5 per cent displayed emotional eating and 38.4 per cent reported external eating. All overweight youngsters reported restrained attitudes. Eating styles were positively associated with indicators of eating pathology. The results suggest the use of appropriate norms that take into account the child's age, gender and overweight status.