FACTS ON FILE HEALTH REFERENCE CENTER



FACTS ON FILE HEALTH REFERENCE CENTER

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Adolescent Obesity

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[pic]From: The Encyclopedia of Obesity and Eating Disorders, Third Edition.

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During the early years of adolescence, as their bodies are undergoing dramatic physical growth and biological change, some individuals become plump and may think of themselves as "too fat." But once the growth stops and the biological change is completed, the weight of most will naturally level off until they regain slimmer proportions.

For some, adolescent obesity is a temporary condition. For others, it is the beginning of a lifetime of obesity compounded with severe emotional and personality problems, since experiences during adolescence play such an important role in psychological development.

Just as other segments of America's population are becoming increasingly obese, there is a growing national health problem of true obesity among young people. According to the U.S. Centers for Disease Control and Prevention (CDC), the percent of adolescents (ages 12–19) who are overweight is 16 percent (1999–2000), an increase of 11 percent since 1976–80. An additional 14.9 percent of adolescents are at risk for overweight. And a 2002 National Center for Health Statistics study found nearly 6 million American children ages six to 17 years to be severely overweight—triple the prevalence of the 1960s.

Some obese adolescents are simply continuing a history of childhood obesity, becoming even heavier during puberty. Some have not been overweight until adolescence. Others go from extreme thinness to obesity during these years.

This period of rapid growth is usually accompanied by an increase in appetite, especially for high-calorie foods, and some adolescent obesity is caused by an apparent inability to restrict food intake. While some adolescents burn off these extra calories in vigorous physical activities, others appear unwilling to exercise. They choose instead to treat their fatness as a "disability," refusing to join in normally active and boisterous adolescent games and activities. Frequently, this refusal to participate derives from feelings of inferiority and shame brought on by taunting and name-calling by their peers. Further exacerbating their difficulty may be parents and teachers who lecture them about their unhealthy weight and social nonparticipation. It soon becomes easy for them to blame all their failures or disappointments on their obesity.

Such feelings, demoralizing at any age but devastating during adolescence, can have serious long-term consequences. Thus, adolescent obesity may often contribute to lifelong behavioral and psychological problems.

When obese adolescents do not receive—or accept—help, whether in losing weight or dealing positively and maturely with their weight and emotional problems, they usually withdraw even further from social life. They frequently then turn to food for solace, causing them to put on even more weight.

Obesity in adolescence is also frequently blamed for problems with sexual adjustment. Although being fat can prevent a person from being considered "attractive" in our weight-conscious society, Hilde Bruch cautioned that "it is not the weight excess itself but the attitude toward it, or more correctly toward oneself, that interferes with any personal relationships, most of all in the sexual area." Studies of adolescent obesity have described frequent cases of provocativeness and uncontrolled sexual behavior, even to the point of promiscuity.

Adolescents with severe personality problems who are desperately unhappy about being fat are especially easy prey for fad diets and novelties. The promise and dream of changing a boring, uneventful life to one of exciting activity and romance make the advertised products appear magical.

Members of the American Society of Bariatric Physicians have reported little success in treating younger children for obesity, but they have had increased success with adolescents at about the age of puberty. Emerging interest in the opposite sex and a developing maturity level contribute to the motivation to follow eating restrictions.

Because the adolescent body undergoes so many energy-requiring physical changes, "average" calorie requirement tables are of little use for obese adolescents dieting to lose weight. Following typical calorie requirement tables is likely to result in an unhealthy low calorie intake. Diets are particularly difficult for boys around the age of 15, when their calorie intake may increase five times or more. Adolescent dieting can also be stressful socially because so much of teenage social life revolves around eating. Well-meaning but nagging parents may add to this stress, especially given adolescents' growing independence. Experts suggest that, for this reason, parents may be most helpful in supportive roles.

According to the American Obesity Association, surgical procedures such as gastric bypass have been performed successfully on adolescents; however, surgery for adolescents is usually considered only when severe medical conditions are present that can improve with the surgery.

Barlow adds, "An adolescent who has continued rapid weight gain during organized attempts at weight management has obviously not succeeded, but this failure may reflect an eating or emotional disorder that requires psychological treatment, not surgery."

Writing in Diabetes and Primary Care (March 22, 2004), Dr. John J. Reilly of the University of Glasgow, says, "There is still a widespread belief among adolescents, their parents and healthcare professionals that obesity is a relatively minor health problem, or even a largely cosmetic problem with no significant health impact. In fact, there is a rapidly accumulating body of evidence that obesity in adolescents will have major health consequences in the short term (for the adolescent) and the longer term (for the adult who was an obese adolescent)."

Baur and O'Connor add, "The current epidemic (of child and adolescent obesity) is due to massive environmental change over the past few decades leading to a rise in sedentary pursuits, a decrease in physical activity and increased energy intake. Effective management requires a family-focused, developmentally sensitive, behavioral management approach that addresses, for example, eating habits, incidental activity and television viewing."

[pic][pic]Further Information

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Barlow, Sarah E. "Bariatric Surgery in Adolescents: For Treatment Failures or Health Care System Failures?" Pediatrics 114, no. 1 (July 2004): 252–253.

Baur, L. A., and J. O'Connor. "Special Considerations in Childhood and Adolescent Obesity." Clinics in Dermatology 22, no. 4 (July/August 2004): 338–344.

Bruch, Hilde. "Obesity in Adolescence." In Eating Disorders: Obesity, Anorexia Nervosa, and the Person Within. New York: Basic Books, 1973.

Burch, Gwen Weber, and Paul H. Pearson. "Anorexia, Bulimia, and Obesity in Adolescence: The Sociocultural Perspective." In Eating Disorders: Effective Care and Treatment, edited by Félix E. F. Larocca. St. Louis: Ishiyaku EuroAmerica, 1986.

Collipp, Platon J., ed. Childhood Obesity. New York: Warner Books, 1986.

Noonan, S. S. "Children and Obesity: Flunking the Fat Test." New Jersey Medicine 94, no. 6 (June 1997): 49–51.

[pic]Citation Information

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Record Citation: Cassell, Dana K., and David H. Gleaves. "adolescent obesity." The Encyclopedia of Obesity and Eating Disorders, Third Edition. New York: Facts On File, Inc., 2006. Health Reference Center. Facts On File, Inc. EOED0012&SingleRecord=True (accessed May 6, 2009).

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