Paediatric obesity continues to be one of the most significant health complications in the twenty-first century.
The current gold standard for weight loss is to feed them less and get them to move more to encourage weight loss. The application of this outdated approach has failed to keep pace with changing environments, and the food industries rapid and innovated product development failing to meet the requirements of obese children.
Despite a plethora of literature highlighting the multifaceted and complex nature of the condition, there has been little advancement made in the prevention and treatment options utilised. Adding to the complexity is that the responsibility for this gold standard option belongs to the parental figure of mothers. However, the mot
hers do not have the skill set to address the complexity of the characteristics that the obese child exhibits.
Obese children present with multifaceted characteristics that are not currently recognised by health professionals rather they focus on the mother as responsible for overfeeding the child. Obese children experience issues such as disordered eating behaviours where they have hyperphagia, steal food, overeat, eat in hiding or eat selectively.
“From the moment I pick him up from school it starts …. feed me, feed me, feed me. When he’s eating breakfast, he’s asking what’s for lunch, and at lunch, he’s asking what’s for dinner – food is always the focus”
They also present with behavioural problems like being argumentative, aggressive, verbally and physically abusive when parents try to control their food intake.
“She’s like ‘I want it and I want it now’, and she screams, you know, like the whole shop then hears.”
Also, they experience social exclusion, stigmatisation, bullying and bias also lead to mental health issues causing depression, suicidal tendencies and self-harm.
“I don’t want to have … any more fights about his appearance. I make sure I put him in a public environment where I know he’s safe ……. If there are too many children, then I can’t keep my eye on him, so we go to the next park.”
Furthermore, the obese child also develops chronic health issues such as hyperlipidaemia, fatty liver disease, insulin resistance, sleep apnoea and breathlessness on exertion. Obese children struggle in an obesogenic environment that perpetuates weight gain and encourages decreased activity. Negatively, the child then becomes the focus of attention for being “fat”, “unhealthy”, “different”, “lazy” and “gluttonous” and the parent becomes the focal point of blame for raising an obese child.
Importantly, the obese child presents with common characteristics of an addict. An addict is described as a person who is addicted to a particular substance or someone who becomes habitually or obsessively focused on a behaviour or substance.
Commonalities found in obese children and addicts include:
- They lie, sneak and hide substances
- They manipulate others to get the substance that gives them pleasure
- They display negative behaviours such as being secretive and stealing
- They shift the blame to other family members
- They become physically, emotionally and verbally abusive towards family
- They experience mental health disorders such as depression, anxiety and suicidal tendencies
- Experience a high dependency on a substance – Addicts are ETOH, Smokes or some legal or illegal drug whereas the food addict is foods that are generally high in fat, salt and sugar
- The addiction interferes with intellectual and physical development
- They show a reduction in their participation in activities such as sports or hobbies they once liked
- They also show a reduction in socialising such as parties, outings with friends and family
- Experience a decrease in quality of life, morbidity and possible early mortality
- They may want to stop but feel powerless how even to start to give it up
- They continue to use the addictive substance despite the onset of multiple health issues.
- They can both span across an entire lifetime
- Family-based therapy is the gold standard approach
The lack of recognition of an obese child’s addictive characteristics by health professionals when selecting treatment options is a barrier to their success. Paediatric obesity is not recognised as part of a mental health condition at this stage therefore the children are failing to receive support from appropriate health professionals. Importantly, until the focus shifts from the mother as the underlying problem and the gold standard treatment option we will continue to fail in our attempts to decrease the incidence of paediatric obesity.
This is an update of the original presentation ‘Obese Children Crave Food and They Will Do Anything To Have It’ presented at the 2017 Australian & New Zealand Addiction Conference.
This update was kindly provided by:
Jessica J Lee, Paediatric Dietitian, School of Medicine Griffith University
Phone+6584280072 email firstname.lastname@example.org
Dr Patricia Lee, Senior Lecturer, School of Medicine Griffith University
Phone +61 7 5552 7865 email email@example.com