Childhood & Adolescent Obesity
Worldwide Obesity Levels Have Nearly Tripled Since 1975
The Solution: Individually Tailored Counseling for the Whole Family
Or: Is Your Child One of Them?
With the number of sufferers on a relentless upward curve, obesity has become a global pandemic.
Obesity is defined as a disease by the World Health Organization (WHO), the American Medical Association, and other international health organizations.
The prevalence of obesity in American children and adolescents aged 2-19 years in 2017-2018 was 19.3% and affected about 14.4 million children and adolescents.
In 2019, an estimated 38.2 million children under the age of 5 years were overweight or obese.
The Treatment That Works: A Combination of Therapy for the Child, and Therapy and Counseling for the Parent .
The approach found to be most effective in treating childhood obesity is based on an understanding of the parents as a key element in creating change. Studies show that the family is a crucial factor in the development of obesity among children, and that parents have both the ability and the responsibility to make a change in the family’s lifestyle in order to help their children change their habits and reach a normal weight. In this approach, the emphasis is on the parent-child relationship rather than on weight. Weight loss results from proper treatment of the emotional reasons for overeating, combined with adopting balanced eating habits and physical activity.
Therapy helps the parents look at their child in a way that does not focus on weight but rather sees the child as a “whole” and appreciates their skills and capabilities. This allows families to get out of the frustrating and vicious cycle of conflict, failure, and disappointment.
The purpose of working with parents is to help create a balanced approach to their children’s weight problem, an approach that does not ignore the problem, but at the same time frees them from over-controlling the child’s eating.
The course of therapy includes:
- Identifying the emotional factors in the family that contribute to the weight problem;
- Learning communication that is respectful and non-judgmental, that brings the child closer to the parents;
- Receiving tools for deliberate and proper behavior around eating that is helpful to the child, without deprivation or restricting food;
- Establishing healthy family eating patterns and habits;
- Creating a beneficial, motivating connection that encourages family participation in the process;
- Modeling the implementation of healthy family eating patterns and habits.
Therapy for the child will be considered depending on the child’s emotional needs, and is not always necessary. Usually, working with parents is the right approach.
If the child does need therapy, he or she will receive a combination of support for changing habits, help learning skills for controlling and regulating eating, and assistance in dealing with the emotional and social implications of obesity.
Therapy for Adolescents: An Approach to the Self-Esteem Issues, Shame, and Depression Experienced by Adolescents
Adolescence is marked by a great deal of preoccupation with physical appearance, which is often inextricably tied to self-esteem. This period is characterized by hormonal changes that upset the emotional balance, affect mood, and contribute to weight gain.
Appearance is a significant factor in determining social status, so many overweight adolescents suffer from rejection, social stigma, and mockery. They withdraw, spend hours in front their screens, and avoid physical and social activity. This causes loneliness, low spirits, and even depression and anxiety. All of these lead to overeating, and thus a cycle of weight gain is created and reinforced.
Negative feelings about the body destabilize the emotional state, and being overweight starts to bother even adolescents who were never bothered by it before. They experience lowered self-esteem and self-worth, feeling shame, helplessness, and a lack of control.
They don’t share these feelings with their parents or friends, and loneliness only makes the problem worse.
It’s not easy for teens to share their feelings with their parents, partly due to the natural adolescent desire for privacy and maintaining separation from one’s parents, and partly due to the shame – which also makes it difficult for them to talk about it with friends. Thus they find themselves dealing with the problem alone. Studies have found that obese children often express a sense of self-loathing and perceive themselves as lazy, stupid, and lacking self-control.
Y., 15: “I don’t want to go to parties even when I’ve been invited. I see the way they look at me, and some even tell me to my face. I can’t dress the way I want to anyway. I’d rather stay home. Who would want someone that looked like me?”
N., 13: “I feel like my dad is disappointed in me. Even though he doesn’t say so, I see it in his eyes… he doesn’t understand. I want to make my parents happy, I want to lose weight; I don’t feel good like this. I hate the way I look. I’m ashamed. But I just can’t manage to lose the weight. And then I get angry at myself, and all I want to do is eat. I’m just a loser.”
L., 14: “They’re always looking at what’s on my plate. They don’t believe in me anyway. They’re always commenting and saying – you’ve eaten enough, look at you. It’s offensive and it hurts.”
B., 17: “I feel like I’m ruining the picture of the perfect family my parents would have wanted.”
H., 17: “I’m a failure. I’ve tried so many times and failed. My parents have spent so much money to try and help me lose weight, and I’ve disappointed them every time.”
An example from the treatment of an overweight teenage girl:
During our sessions, it came up that there was jealousy and competitiveness between the girl and her mother surrounding the issue of weight and appearance. It turned out that she was afraid of “beating” her mother at losing weight, lest it cause even worse damage to their relationship. When we had succeeded in calming that anxiety, which was a destructive element in their relationship, it enabled the girl to progressively lose weight without harming her connection with her mother.
Included in therapy:
- Acquiring tools to build controlled, regulated, and balanced eating habits;
- Investigating the emotional factors of overeating: obesity is sometimes an unconscious expression of the rebellion and defiance characteristics of adolescence, or it is the result of negative feelings which lead to overeating;
- Improving self-esteem;
- Improving communication with the parents;
- Acquiring tools to handle social rejection.
Treatment for obesity that relies solely on dietary change and exercise is liable to yield only short-term results and can even risk developing into an eating disorder.
Three things to prevent the development of an eating disorder or gaining the weight back again:
- Come to an in-depth understanding of the emotional causes of eating and treat them.
- Make changes in a gradual and balanced manner, without going to extremes.
- Create a support system for changing habits and learning skills to control and regulate eating.