Overweight Children: Depression Eating

See how children's weight and depression eating are linked and how parents can help.

From the WebMD Archives

If you know what to look for, you can probably spot the signs of depression and eating-related issues. Your daughter, who used to run to the playground after school, now prefers to sit in front of the television with her hand in a bowl of potato chips. Your son, a former soccer player, gorges on soda and cheese curls before burrowing into his room behind a closed door, playing video games until suppertime.

Or maybe friends don't call as they used to, and your child seems to go around the house with worried, downcast eyes. Yet when you ask if something's wrong, you get a monotonous, "I'm fine."

If a scene like this seems familiar, it may be time to take action. Overeating can be a symptom of depression. And being overweight can cause child depression if weight leads to feelings of loneliness, isolation, or poor self-esteem. But parents can help break the chain. Here's how to recognize the signs of child depression in overweight children and what you can do to help.

The Depression-Eating Link in Children

Nearly one in three American children is overweight or obese, more than triple the number in 1980. Reports of childhood depression have also increased, and the two problems are often related. The connection between them is not always obvious, but experts say that parents need to pay attention if their children's unhealthy eating habits seem tied to sadder moods or depression.

"The relationship between obesity and depression goes in many different directions," psychiatrist Myrna Weissman, MD, tells WebMD. In a study Weissman and her colleagues at Columbia University published in 2001, depressed children were more likely than other kids to become obese adults. "It's very easy in our culture to get overweight," Weissman says. "And if you are depressed, you may eat to compensate."

Feelings of emptiness -- caused by depression or weight -- can make children want to fill up on carbohydrates and chocolates. These stimulate the release of chemicals that can make them feel better.

Sometimes, physical ailments such as anemia and thyroid conditions can cause depression. And some depression medications can cause weight gain.

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Common Ground Between Depression and Obesity

While it can be more difficult to diagnose child depression than depression in adults, a survey of more than 1,500 9- to 10-year-olds found that 20% of those who were obese often felt sad, compared to only 8% of their healthy-weight peers.

Depression and obesity have many shared symptoms, including sleep problems, sedentary behavior, and unhealthy attitudes toward eating.

A 2006 study of 400 depressed teenagers showed that, on average, it took them longer to get to sleep than other teens. Obese children also have sleep issues. They are more likely to suffer from sleep apnea -- a serious condition marked by lapses in breathing during sleep. And they're more likely to feel sleepy during the day. That can be harmful because sleepiness can make you hungry, so poor sleep can aggravate both depression and obesity.

Being overweight also can lead to self-esteem problems that lead to depression, says Eileen Stone, a child and adolescent psychologist at Sanford Health in Fargo, N.D. "I see children at a young age who are concerned about their weight and size and are being picked on," Stone says. "Those ideas about self-esteem get to you pretty young, and you can grow up with them."

Inactivity or listlessness, typical characteristics of depression, also lead to weight gain. The more time children spend "vegging out" in front of the TV or computer screen, instead of being up and active, the fewer calories they burn. In addition to limiting opportunities for healthy exercise, too much screen time reduces contact with other children or parents.

Trading out some screen time to make more time to be physically active can provide an instant boost and, over the long haul, may help lift depression. Studies have shown physical activity to be among depression treatments that can help break the vicious cycle of depression, inactivity, and weight gain.

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5 Tips for Parenting Overweight and Depressed Children

The risks of poor sleep, inactivity, and depression eating are clear. But what can parents do about it? Experts offer these tips:

  1. Remember that kids deserve love regardless of their size.
    "We encourage parents to give unconditional love," Stone says. "From there, the job is to provide a healthy atmosphere -- healthy food choices, activity, and positive social interactions."
  2. Set a good example.
    Parents can be more effective by setting good examples with their own healthy eating than by simply encouraging kids to diet or prohibiting certain foods. "You should help them find healthier choices," Stone tells WebMD. "Don’t restrict everything. That doesn’t work."
    One way to avoid having to say "no" when your child goes for the cookie jar is to limit buying unhealthful food in the first place. Not bringing tempting food home keeps you from having to prohibit it when it’s within eyesight on the counter or within easy reach in the pantry.
  3. Don’t scold children for overeating.
    This is never a good idea, but especially not when a child is depressed and overweight. "That makes them feel bad and makes them more depressed," Weissman says. And ironically, they may end up eating more to soothe their hurt feelings after you've scolded them.
  4. Treat the issue.
    Whether it is depression or being overweight, your child needs treatment. Weissman suggests that parents "first try to deal with the depression and its triggers, then find alternatives to overeating that would be satisfying."
  5. Consider psychotherapy.
    This can help children understand the root of a bad mood that has left them sluggish and susceptible to gaining weight. Finding that understanding can give them motivation to fight back with a healthier lifestyle, Weissman says.

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Replace Depression Eating With Healthy Habits

If children are overeating to compensate for emotional issues, it's important to find their triggers for eating. "The biggest piece is, 'Can I figure out why I'm putting this food in my mouth?'" Weissman says. "'Do I eat when I'm stressed, tired, lonely, when something bad has happened?'" Then you can work together on finding alternatives. These strategies may help:

  • Have your teen keep a journal. Recording triggers of sadness can make patterns of depression and eating clearer to you and your teen. After you recognize the triggers, help her find replacements for unhealthy eating in response to negative feelings.
  • Talk to your child about school. If bad grades are behind feelings of self-loathing, consider tutoring, or talk to teachers about ways to help your child improve his or her performance. If your child is avoiding his crowd because of teasing or bullying, try to help him find more positive social circles or healthy ways cope.
  • Get physical as a family. Activities that families can do together -- a walk after dinner, a game of hoops, a bike ride through the park -- are healthy ways to fight both depression and obesity.

Focus on Health, Not Appearance

Parents walk a thin line in addressing their child's weight issues, says David Ermer, MD, a child and adolescent psychiatrist for Sanford Health in Sioux Falls, S.D. Criticizing your child over his weight and appearance "can go a long way to hurting self-esteem, so the concern should be about health, not image," Ermer says.

Remember that changing how you behave and think is hard work for children as well as adults, so it's important for family members to support each other. "Don't beat yourself up for setbacks," Ermer says. "The goal is to gradually move from bad habits to better habits."

WebMD Feature Reviewed by Hansa D. Bhargava, MD on January 13, 2012

Sources

CDC: "Prevalence of Obesity Among Children and Adolescents: United States, Trends 1963-1965 Through 2007-2008."

Ogg E. International Journal of Eating Disorders, July 1997; vol22(1): pp 89-93.

Reeves G. International Journal of Child Health and Human Development, August 2008; vol 1(2); pp 103-114.

Birch L. International Journal of Obesity, April 2009; vol 33 (suppl 1): pp S74-S81.

Duarte C. Journal of Pediatrics, January 2010; vol 156(1): pp 93-97.

Pine D. Pediatrics, May 2001; vol 107(5): pp 1049-1055.

Christakis N. New England Journal of Medicine, July 26, 2007; vol 357 (4): pp 370-379.

Myrna Weissman, MD, PhD, professor of epidemiology and psychiatry; chief, department of clinical-genetic epidemiology, New York State Psychiatric Institute; Columbia University Medical Center, New York.

Eileen Stone, child and adolescent psychologist, Sanford Health, Fargo, N.D.

David Ermer, MD, child and adolescent psychiatrist, Sanford Health, Sioux Falls, S.D.

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