The Psychological Implications of Childhood Obesity

According to the report published by WHO in May 2022, 58% of adults in Romania are overweight (with a body mass index between 25 and 29.9) or obese (with a body mass index over 30). This article about childhood obesity begins with the information above because it is essential to understand from the start that the chances of a child developing healthy eating habits decrease significantly when raised by adults with unhealthy eating habits.

In this article, the focus will solely be put on obesity caused by emotional factors and not on obesity caused by medical conditions. Therefore, the text below will not refer to obesity caused by syndromes where children experience uncontrollable hunger, such as Prader-Willi syndrome Laurence-Moon-Biedl syndrome, or Down syndrome. It will also not address childhood obesity caused by medical factors (genetic, endocrine, etc.), which always require specific medical treatment.

In an attempt to understand as much as possible about this topic we talked to a specialized psychologist about the causes of childhood obesity and what are the right ways to manage various situations that arise from it.

What does emotional eating mean and how can this habit be controlled?

Emotional eating has its origins in the early years of life when a child is not aware of his emotions, does not recognize them, and doesn’t know how to manage them other than attempting to soothe them as quickly as possible through any means. Whether feeling agitated, angry, tired, sad, or bored, a young child will cry to express and seek help in managing their emotions. Many times, before trying to understand what is happening with the child and what they need, parents try to calm them down by offering food. By repeating this pattern, the child develops the habit of “swallowing” negative emotions through excessive eating. Every time the child receives food at the slightest discomfort, or their crying is suppressed in this manner, the relationship they form with food becomes flawed, and as a result of this erroneous relationship with food, eating disorders may emerge (anorexia, bulimia, obesity, and more).

A first step to avoid this harmful habit would be for parents to take the time to discover what upsets the child, the real cause of their crying, and offer them alternative solutions instead of food. The second step is for parents to teach the child, even from their early years, how to express and manage negative emotions.

What are the first signs of bad eating behavior?

It is important to recognize the first signs of an unhealthy relationship with food in a child. If we notice that a child after the age of 9-10 years old does not follow a regular meal schedule, tends to eat before bedtime or late at night, prefers cold food and consumes larger quantities than expected for their age, eats very quickly, consumes many sweets, or eats while engaging in other activities (meals are taken mostly in front of laptops, phones, TVs, tablets), hides food or snack wrappers, or even hides the fact that they have eaten due to feeling ashamed, it is time to seek professional help and ask ourselves what needs to be changed.

How does the emotional state affect a child’s eating habits?

It also happens that childhood obesity can appear as a form of rebellion when there is an imbalance in experienced situations, and the child perceives them as unfair and unresolved. Food becomes the object with which the child fills the loneliness, inner void, or isolation they experience because they don’t feel understood, listened to, or protected. Obesity becomes the marker of the emotional insecurity experienced by that child. The feeling of insecurity gives rise to impulsive overeating behavior.

What is the best way to communicate with the child in these situations?

A child does not have the emotional and cognitive capacity to understand what is happening to them, nor that they are not to blame for their impulsiveness, excessive hunger, or desire to eat. They will not comprehend that it is not their responsibility to develop differently, acquire different habits, or learn to express their emotions differently, and most importantly, they won’t know that these aspects can be changed. Children have no way of knowing that they only have behaviors that were not properly shaped by the adults responsible for their education and upbringing. If there is no one to explain the emotional process that brought them to that point, they will grow up with the impression that it is their fault and that the extra weight is evidence of their inadequacy (not being good enough, perseverant enough, intelligent enough, ambitious enough, and the list can go on indefinitely). The right path in communicating with the child in these situations is to be open, empathetic, and honest.

What are the social and psychosocial implications of obesity in a child?

The social and psychosocial implications of obesity in a child refer to the effects that obesity can have on the child’s social interactions, emotional well-being, and overall mental health. These implications may include social stigmatization, low self-esteem, body image issues, reduced physical activity participation, and an increased risk of developing psychological problems such as depression or anxiety.

What can be done? What does the therapeutic approach consist of, and how can it be applied without frustrating the child?

For a child to successfully change eating behavior and develop healthy eating habits, he needs both counseling and emotional development to boost self-esteem, just as much as a need for a proper diet. Additionally, they require long-term understanding and support. Dietary changes should be introduced gradually, not all at once. Start by replacing certain elements (e.g., replacing daily sweets with fruits or carbonated drinks with honey lemonades), and once the child successfully incorporates that first change into a daily routine, move on to introducing the next element of the new regimen.

It is crucial that with each change, children are praised and appreciated for their efforts, and they should be helped to acknowledge their achievements. This way, they will grow and strengthen the confidence they need to take the next step in their dietary transformation.

It should never be forgotten that the primary goal is not just for the children to lose weight; the essential objective is for them to understand the concept of a balanced diet, to learn to eat only what is necessary, and to grow into adults with an optimal weight. The family’s objective should be to find a method for that overweight or obese child to become an adult who effortlessly maintains his optimal weight throughout life.

When parents only change the child’s diet and impose restrictions without providing any emotional support or implementing other changes in the family’s general habits, the child may try his best to make those changes but is likely to fail. They may interpret the failure as their own incapability to do what is right for their life. They might perceive or imagine disappointment from others due to their inability to lose weight, leading them into a vicious cycle that is difficult to break without long-term psychotherapy:

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They gain weight because they don’t know how to cope with negative emotions differently.

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They want to lose weight but don’t know what to do to sustain long-term efforts.

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They blame themselves for not losing weight and not sticking to the diet.

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Feeling disappointed, they indulge in self-blame

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As a result of disappointment, they experience even more negative emotions that they don’t know how to handle, so they eat even more.

Why is family counseling necessary?

When discussing the prevention and psychotherapy of childhood obesity, first and foremost, we should talk about what parents need to do to change their lifestyle. Only after that, we address what needs to be sustained in counseling sessions with the child. The younger the child with obesity, the greater the impact of any changes the parents are willing to make. The success of psychotherapy for an obese child relies on the collaboration and willingness of all family members living together with the child to make significant changes in their lifestyle and eating habits. If the adults living with the child are not willing to make permanent lifestyle changes, the psychotherapy for obesity in that child has very limited chances of success.

In conclusion, through counseling and behavioral therapies, we can offer children the necessary tools to manage their emotions and negative feelings without choosing to eat as a coping mechanism. Additionally, family-based interventions and education play an important role in building a supportive environment, giving children the possibility to develop a positive and constructive relationship with food and have healthier habits from an early age.