Childhood obesity

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Overview

What is childhood obesity?

Childhood obesity is a serious health issue affecting children and adolescents who are well above the average weight range for their age, gender, and height.1 In Australia, the number of obese children has greatly increased over the past 30 years with current figures showing that one in four Australian children aged between 5 and 17 years are considered to be overweight or obese.2

Childhood obesity raises the risk for a range of health problems, such as high blood pressure, type I and type II diabetes and heart problems, and is associated with depression and low self-esteem.3-6 Obese children are also more likely to be obese in adolescence and adulthood compared to children of a healthy weight increasing the risk for long term health concerns.7 Treating obesity in childhood is therefore very important to help improve a child’s quality of life. A range of treatment strategies are available to help children to have a healthy diet, be active, and achieve and maintain a healthy weight.

What causes childhood obesity?

In children, as in adults, obesity typically occurs when the amount of energy children get from eating and drinking is greater than the energy they use in everyday physical activity. As a result, diet and physical activity play an important role. In particular, a diet high in fat and sugar and low levels of physical activity are considered to be the most common causes of childhood obesity.8-10

Apart from diet and physical activity, there are a range of other factors that can increase a child’s risk of becoming overweight or obese. These include:

  • Genetic factors: A family history of obesity and certain genetic syndromes can cause children to gain weight more easily, placing them at a higher risk of developing obesity.9
  • Hormonal factors: Changes in the levels or activity of certain chemicals in the brain (e.g., leptin and insulin) can increase a child’s weight status.9
  • Maternal factors: Obesity before and during pregnancycan increase the risk of the child being overweight.11, 12 Postnatal factors, such as breastfeeding for less than six months and early introduction of solids can also increase a child’s risk of obesity.9, 12, 13
  • Family factors: A range of family factors including unhealthy family dietary habits, parental modelling, and parenting style can influence a child’s food consumption and weight status.14-16
  • Psychological factors: A child’s weight status can also be influenced by the child’s mental health. Unhealthy eating behaviours, such as emotional eating, have been associated with a range of psychological factors in obese children including, depression, anxiety, and low self-esteem.17, 18

Evidence-based psychological approaches and strategies

Healthy lifestyle habits, including a balanced diet and daily physical activity, play an important role in the treatment of obesity. A range of health professionals can work together to help children and families achieve a healthy lifestyle in a safe and effective way. A general practitioner (GP) or paediatrician, a psychologist, a dietitian, and an exercise physiologist or physiotherapist might be part of a treatment team. As part of this team, a psychologist can use a range of psychological strategies to help support children and their families make the healthy lifestyle changes required for weight loss.

Family-based behavioural treatment (FBT)

Family-based behavioural treatment (FBT) has been found to be one of the most effective psychological treatments of childhood obesity.19-25 FBT helps children achieve weight loss by using a range of behavioural strategies. These strategies include:

  • Goal Setting: Goal setting techniques help children and their parents develop clear, focused and relevant goals to work towards, for example, walking to school three days a week or making sure to eat a healthy breakfast each morning.21, 26, 27
  • Self-monitoring: Self-monitoring involves recording specific behaviours, such as daily food intake and physical activity, and charting a child’s progress towards previously developed goals.19, 21, 26
  • Stimulus control: Stimulus control involves changing aspects of a child’s environment to help encourage or stop particular behaviours. For example, to help promote healthy eating in their children, parents might stop buying processed snacks and instead store a bowl of fresh fruit on the kitchen table.19, 21, 26
  • Reinforcement: Rewarding a child with praise or a special prize (e.g., a sticker for a reward chart) for achieving a goal or performing a desired behaviour can increase motivation and encourage the child to repeat the behaviour.19, 21, 26
  • Modelling: Children are more likely to eat and drink healthily and be active if they see their parents modelling those same behaviours. Making a healthy diet and physical activity a part of daily life is therefore important for the whole family, not just the child.21

Parenting skills training

Given that parents and caregivers play an essential role in the treatment of childhood obesity, parenting skills training might also be provided as part of the treatment program. Parenting skills training helps parents understand their role in their child’s diet and activity levels and provides them with useful strategies to encourage healthy behaviours in their children.16

How a psychologist can help

Through discussion with the child and the family, and the possible use of questionnaires, the psychologist develops an understanding of the child’s and family’s concerns and develops a treatment plan with them. The psychologist can then work with the child and family to help them achieve their treatment goals.

Other professionals who might be involved

The involvement of a general practitioner (GP) or paediatrician might be suggested as they are best placed to assess and address any underlying medical issues or co-occurring health concerns. Referrals might also be made to a dietitian to help establish a safe and balanced diet, and to an exercise physiologist or physiotherapist to develop safe and effective goals around increased activity.

When to seek professional help

If weight-related problems are affecting a child’s health, school life, activities, or relationships, psychological assistance should be considered. The APS Find a Psychologist service can be used to locate a psychologist in your local area: call 1800 333 497 or visit www.findapsychologist.org.au. A GP can also organise a referral to a registered psychologist.

More information

The Australian Psychological Society

Australia’s largest professional association for psychologists

www.psychology.org.au

Australian Dietary Guidelines

Advice about the amount and kinds of foods that children and adolescents should eat for health and wellbeing

http://www.eatforhealth.gov.au/

Australian Physical Activity and Sedentary Behaviour Guidelines

Advice about how much physical activity children need and ideas for how to encourage them to become more physically active

http://www.health.gov.au/internet/main/publishing.nsf/content/health-pubhlth-strateg-phys-act-guidelines

Raising Children Network

General information on childhood obesity and tips on how to help children adopt a healthy lifestyle

http://raisingchildren.net.au/articles/childhood_obesity.html

Further Reading

Altman, M., & Wilfley, D. E. (2015). Evidence update on the treatment of overweight and obesity in children and adolescents. Journal of Clinical Child And Adolescent Psychology, 44(4), 521-537. http://dx.doi.org/10.1080/15374416.2014.963854

National Health and Medical Research Council. (2013). Clinical practice guidelines for the management of overweight and obesity in adults, adolescents and children in Australia. Melbourne: Author

Skelton, J. A., Irby, M. B., Grzywacz, J. G., & Miller, G. (2011). Etiologies of obesity in children: Nature and nurture. Pediatric Clinics of North America, 58(6), 1333-1354. http://dx.doi.org/10.1016/j.pcl.2011.09.006

  • Contributor(s)
    APS Member Resources Team
    Members of the APS College of Health Psychologists
  • Publish date
    02 Jul 2015
  • References
    View

References

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  2. ABS. (2013). Australian Health Survey: Updated results, 2011-12.  Retrieved 23 February, 2015, from http://www.abs.gov.au/ausstats/abs@.nsf/Latestproducts/33C64022ABB5ECD5CA257B8200179437?opendocument
  3. Harriger, J. A., & Thompson, J. K. (2012). Psychological consequences of obesity: Weight bias and body image in overweight and obese youth. International Review of Psychiatry, 24(3), 247-253. doi: http://dx.doi.org/10.3109/09540261.2012.678817
  4. Pulgarón, E. R. (2013). Childhood obesity: A review of increased risk for physical and psychological comorbidities. Clinical Therapeutics, 35(1), A18-A32. doi: http://dx.doi.org/10.1016/j.clinthera.2012.12.014
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  10. Spruijt-Metz, D. (2011). Etiology, treatment, and prevention of obesity in childhood and adolescence: A decade in review. Journal of Research on Adolescence, 21(1), 129-152. doi: http://dx.doi.org/10.1111/j.1532-7795.2010.00719.x
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  13. Yan, J., Liu, L., Zhu, Y., Huang, G., & Wang, P. P. (2014). The association between breastfeeding and childhood obesity: A meta-analysis. BMC Public Health, 14, 1267-1267. doi: http://dx.doi.org/10.1186/1471-2458-14-1267
  14. Kral, T. V. E., & Rauh, E. M. (2010). Eating behaviors of children in the context of their family environment. Physiology & Behavior, 100(5), 567-573. doi: http://dx.doi.org/10.1016/j.physbeh.2010.04.031
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  19. Altman, M., & Wilfley, D. E. (2015). Evidence update on the treatment of overweight and obesity in children and adolescents. Journal of Clinical Child and Adolescent Psychology, 44(4), 521-537. doi: http://dx.doi.org/10.1080/15374416.2014.963854
  20. Bogle, V., & Sykes, C. (2011). Psychological interventions in the treatment of childhood obesity: What we know and need to find out. Journal of Health Psychology, 16(7), 997-1014. doi: http://dx.doi.org/10.1177/1359105310397626
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  22. National Health and Medical Research Council. (2013). Clinical practice guidelines for the management of overweight and obesity in adults, adolescents and children in Australia.  Melbourne: Author.
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  25. Oude Luttikhuis, H., Baur, L., Jansen, H., Shrewsbury, V. A., O'Malley, C., Stolk, R. P., & Summerbell, C. D. (2009). Interventions for treating obesity in children. The Cochrane Database of Systematic Reviews, 21(1). doi: http://dx.doi.org/10.1002/14651858.CD001872.pub2
  26. Faith, M. S., Van Horn, L., Appel, L. J., Burke, L. E., Carson, J. A., Franch, H. A., . . . Wylie-Rosett, J. (2012). Evaluating parents and adult caregivers as "agents of change" for treating obese children: Evidence for parent behavior change strategies and research gaps: A scientific statement from the American Heart Association. Circulation, 125(9), 1186-1207. doi: http://dx.doi.org/10.1161/CIR.0b013e31824607ee
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