By Margaret LewinMD,FACP – Medical DirectorCinergy Health
More than 30% of American children are overweight (50% in African American and Latino communities)and more than two-thirds of obese children over the age of 9 will become obese adults. The resulting medical problems of diabetespremature heart diseasestrokegallbladder diseasedegenerative arthritisbreathing problems and sleep apneaas well as cancer of the uterine liningbreastprostate and colon are well-knownbut the psychological problems surprisingly less so. Society in general responds negatively to obese individuals. Obese children in particular are often socially stigmatized and face discrimination from their peersteachersand even physicians and nurses – often leading to poor self-esteem.
Self-esteem refers to an individual’s sense of his or her value or worth – a favorable or unfavorable attitude toward one’s self. Formal studies show that parents’ and peers’ acceptance weigh most heavily on many children’s sense of self-esteem.
In a country with very thin celebrity role models and where it is common to say“you can never be too thin,” being obese can be devastating to self-esteemespecially during childhood and adolescence.
Children can be cruelespecially to overweight peers who are often teased about their weight. Although any child whose physical appearance or intellectual capacity differs from the norm often is subjected to merciless teasingit can be worse for obese children – who are blamed for their “different-ness” and closely watched (and criticized) in their eating and exercise habits. Studies have shown that obese children tend to have a smaller circle of close friendsleading to isolation and loneliness. Parents often join in the torment even if they are overweight. It can be difficult to escape from the self-image of unattractiveness and body dissatisfaction.
LJ Griffiths’ study of children at age 7 ½ showed that obesity predicts a higher likelihood of bullying (boys – presumable because of their physical dominance in their peer group) or being bullied (both sexes) than normal weight (or even moderately overweight) children.
Overweight girls are especially stigmatized when it comes to dating. In a study of adolescentsonly 12% of the students had dated someone who was overweightwith only 8% of boys dating overweight peers.
Formal studies suggest a relationship between self-esteem and health. Whether obese or notadolescents with poor self-esteem are more likely to engage in early sexless likely to use birth controlhave higher rates of teen pregnanciesare more likely to use tobaccoalcohol and illicit drugsand to attempt suicide. Obesity can also lead teenagers into binge-eatingsometimes purging as well. In 2007a study reported a 20 year research of obese adolescents in upstate New York. They found that obese girls were nearly four times more likely than normal weight girls to suffer major depression and anxiety disorders as adults.
Another study on overweight adolescents found that they were less likely to be marriedhad lower household incomes and higher rates of household poverty. The study concluded: “Overweight during adolescence has important social and economic consequenceswhich are greater than those of many other chronic physical conditions.” The New York Times yesterday printed an article saying that child obesity risks death at an early age. Heavier kids are twice as likely to die before age 55 of illness or self-inflicted injury.
Obese children can have a brighter future. This yearSacher published the results of a randomizedcontrolled British trial of the MEND (MindExerciseNutritionDO it) programa family-based community intervention for childhood obesity. Parents and their obese children attended eighteen 2-hour group educational and physical activity sessions held twice weekly in sports centers and schoolsfollowed up by a 12-week free family swimming pass. Compared to the controlsthe study children not only reduced their weight and waistlines and increased their cardiovascular fitness and physical activity levelsthey also had significant improvement in their self-esteem.
Doing something about childhood obesity and related issues of self-esteem is a kindnessbut we also need to do so in our own self-interest. The economic consequences of childhood (and subsequent adult) obesity are staggering and threaten to overtake our healthcare system and national budget. For these reasonsMichelle ObamaSurgeon General Regina BenjaminThe Centers for Disease Control and PreventionFederal Trade CommissionFood and Drug AdministrationDepartment of Agricultureand the nations’ mayors and other local leaders are placing a high priority on combating this growing problem. It will require enormous investing in educationavailability of food in schoolsmaking healthy affordable food more accessible in low-income neighborhoodsbuilding schools within walking distance of residential areasand building playgrounds and walking and biking paths. It will involve setting standards for marketing food to children and reconsidering the nutritional value of foods available on supermarket shelves. These investments are worth it – both to us and our nation’s children.
Dr. Margaret Lewin Chief Medical Director of Cinergy Health A graduate of Case Western University School of Medicine in ClevelandOhioDr. Lewin's undergraduate degree from Purdue University is in AeronauticsAstronauticsand the Engineering Sciences and she holds an M.S. in applied mathematics from Rensselaer Polytechnic Institute.
Board-certified in Internal MedicineHematology and Medical Oncologyshe is a Fellow of the American College of Physicians and Clinical Assistant Professor of Medicine at Weill Medical College of Cornell University. She is affiliated with New York-Presbyterian Hospital and The Hospital for Special Surgery.
Dr. Lewin has worked throughout her career to improve the American healthcare system. She has been on the boards of state and local medical societies and is Immediate Past President of the New York County Medical Society and Immediate Past District President of the American College of Physicians. Her decades-long volunteer work has included service to many local projects and organizations and has been enriched by her medical missions to the Third World.
Dr. Lewin has authored numerous articles in leading medical journals and lay magazinesas well as chapters for medical textbooks. Her areas of special interest and expertise include primary and preventive caretravel medicinemen's health and women's health.
By Margaret LewinMD,FACP – Medical DirectorCinergy Health
More than 30% of American children are overweight (50% in African American and Latino communities)and more than two-thirds of obese children over the age of 9 will become obese adults. The resulting medical problems of diabetespremature heart diseasestrokegallbladder diseasedegenerative arthritisbreathing problems and sleep apneaas well as cancer of the uterine liningbreastprostate and colon are well-knownbut the psychological problems surprisingly less so. Society in general responds negatively to obese individuals. Obese children in particular are often socially stigmatized and face discrimination from their peersteachersand even physicians and nurses – often leading to poor self-esteem.
Self-esteem refers to an individual’s sense of his or her value or worth – a favorable or unfavorable attitude toward one’s self. Formal studies show that parents’ and peers’ acceptance weigh most heavily on many children’s sense of self-esteem.
In a country with very thin celebrity role models and where it is common to say“you can never be too thin,” being obese can be devastating to self-esteemespecially during childhood and adolescence.
Children can be cruelespecially to overweight peers who are often teased about their weight. Although any child whose physical appearance or intellectual capacity differs from the norm often is subjected to merciless teasingit can be worse for obese children – who are blamed for their “different-ness” and closely watched (and criticized) in their eating and exercise habits. Studies have shown that obese children tend to have a smaller circle of close friendsleading to isolation and loneliness. Parents often join in the torment even if they are overweight. It can be difficult to escape from the self-image of unattractiveness and body dissatisfaction.
LJ Griffiths’ study of children at age 7 ½ showed that obesity predicts a higher likelihood of bullying (boys – presumable because of their physical dominance in their peer group) or being bullied (both sexes) than normal weight (or even moderately overweight) children.
Overweight girls are especially stigmatized when it comes to dating. In a study of adolescentsonly 12% of the students had dated someone who was overweightwith only 8% of boys dating overweight peers.
Formal studies suggest a relationship between self-esteem and health. Whether obese or notadolescents with poor self-esteem are more likely to engage in early sexless likely to use birth controlhave higher rates of teen pregnanciesare more likely to use tobaccoalcohol and illicit drugsand to attempt suicide. Obesity can also lead teenagers into binge-eatingsometimes purging as well. In 2007a study reported a 20 year research of obese adolescents in upstate New York. They found that obese girls were nearly four times more likely than normal weight girls to suffer major depression and anxiety disorders as adults.
Another study on overweight adolescents found that they were less likely to be marriedhad lower household incomes and higher rates of household poverty. The study concluded: “Overweight during adolescence has important social and economic consequenceswhich are greater than those of many other chronic physical conditions.” The New York Times yesterday printed an article saying that child obesity risks death at an early age. Heavier kids are twice as likely to die before age 55 of illness or self-inflicted injury.
Obese children can have a brighter future. This yearSacher published the results of a randomizedcontrolled British trial of the MEND (MindExerciseNutritionDO it) programa family-based community intervention for childhood obesity. Parents and their obese children attended eighteen 2-hour group educational and physical activity sessions held twice weekly in sports centers and schoolsfollowed up by a 12-week free family swimming pass. Compared to the controlsthe study children not only reduced their weight and waistlines and increased their cardiovascular fitness and physical activity levelsthey also had significant improvement in their self-esteem.
Doing something about childhood obesity and related issues of self-esteem is a kindnessbut we also need to do so in our own self-interest. The economic consequences of childhood (and subsequent adult) obesity are staggering and threaten to overtake our healthcare system and national budget. For these reasonsMichelle ObamaSurgeon General Regina BenjaminThe Centers for Disease Control and PreventionFederal Trade CommissionFood and Drug AdministrationDepartment of Agricultureand the nations’ mayors and other local leaders are placing a high priority on combating this growing problem. It will require enormous investing in educationavailability of food in schoolsmaking healthy affordable food more accessible in low-income neighborhoodsbuilding schools within walking distance of residential areasand building playgrounds and walking and biking paths. It will involve setting standards for marketing food to children and reconsidering the nutritional value of foods available on supermarket shelves. These investments are worth it – both to us and our nation’s children.
Chief Medical Director of Cinergy Health
A graduate of Case Western University School of Medicine in ClevelandOhioDr. Lewin's undergraduate degree from Purdue University is in AeronauticsAstronauticsand the Engineering Sciences and she holds an M.S. in applied mathematics from Rensselaer Polytechnic Institute.
Board-certified in Internal MedicineHematology and Medical Oncologyshe is a Fellow of the American College of Physicians and Clinical Assistant Professor of Medicine at Weill Medical College of Cornell University. She is affiliated with New York-Presbyterian Hospital and The Hospital for Special Surgery.
Dr. Lewin has worked throughout her career to improve the American healthcare system. She has been on the boards of state and local medical societies and is Immediate Past President of the New York County Medical Society and Immediate Past District President of the American College of Physicians. Her decades-long volunteer work has included service to many local projects and organizations and has been enriched by her medical missions to the Third World.
Dr. Lewin has authored numerous articles in leading medical journals and lay magazinesas well as chapters for medical textbooks. Her areas of special interest and expertise include primary and preventive caretravel medicinemen's health and women's health.