Obesity Plus Low Self-Esteem May Lead to Risky Behavior in Teens
Jan. 14, 2000 (Atlanta) -- Obese boys and girls have significantly lower
self-esteem than their nonobese peers at age 14, according to a report in the
January issue of Pediatrics. The researchers also found that obese
adolescents with esteem difficulties are more likely to engage in such risky
behaviors as smoking and drinking alcohol. Doctors say effective weight control
should focus on lifestyle issues rather than strict diets and calorie
Researchers collected data from over 1,500 white, black, and Hispanic
children at age 10 and followed them for four years. Self-esteem was measured
using a standard psychological tool, body mass was calculated from height and
weight, and tobacco/alcohol use was reported via questionnaire.
The data showed that self-esteem was not significantly different between
obese and nonobese children at 10 years of age. But by age 14, significantly
lower self-esteem was observed among obese boys and girls of all races. But the
effect of obesity on self-esteem in white and Hispanic girls was significantly
greater than it was in black girls. In all of the teens, low self-esteem was
associated with feelings of sadness, loneliness, and nervousness. Additionally,
the obese children were more likely to use tobacco and alcohol.
The chief investigator says the findings have implications for psychological
well-being. "Our findings and [those of] others indicate that early
adolescence is a critical time for obese children," says Richard Strauss,
MD, director of the Childhood Weight Control Program and assistant professor of
pediatrics at the University of Medicine and Dentistry of New Jersey.
"Because this is when they're developing their sense of
"The focus should be on healthy food choices and eating right rather
than strict calorie counts," says Strauss. "Increasing physical
activity and watching less television is equally important. Also, this and
other research suggest that teen-age girls smoke cigarettes to control their
weight. That's why an expert committee has recommended that smoking cessation
be an integral part of childhood obesity treatment."
Psychiatrists say parents who enforce strict diets may actually be
contributing to a poor self-image. "Enforcing a strict diet informs
children that parents are in charge," says Robert Begtrup, MD, a child
psychiatrist and associate clinical professor of psychiatry at Vanderbilt
University in Nashville. "This denies children a sense of control and
reinforces their low self-esteem. It's also probably too soon to panic about
obesity in early adolescence. At 14, kids still have a lot of growing to
do." Begtrup tells WebMD that allowing adolescents to guide obesity
treatment is a good approach.
"Parents should make an appointment with the pediatrician and let their
child take charge during the visit. That way, a safe and effective plan of
treatment can be developed that the child buys into," says Begtrup, who was
not involved in the study "Parents also need to look in the cupboards and
make adjustments in order to support their child's efforts."
"Our findings demonstrate an association between childhood obesity and
low self-esteem, but a true causal relationship is only speculative," says
Strauss. "Depression, weight gain, and home environment are additional
factors in need of study. Investigation in these areas may help identify
interventions to improve self-concept."
- Obese teens have significantly lower self-esteem at age 14, compared to
- Effective weight control programs should focus on eating healthy foods and
increasing physical activity, not counting calories.
- Parents of obese children should allow them to guide their own