Does Childhood Obesity Affect Self-Esteem?Does Childhood Obesity Affect Self-Esteem?Malka LeibowitzPsychology of LearningProf. DavisSpring 2007Does childhood obesity affect self-esteem?Observation: Although childhood obesity may have detrimental consequences for childhood self-esteem, the prevalence and magnitude of this problem is controversial (Strauss 2000). In addition, the social and emotional effects of decreased self-esteem in obese children are unknown (Strauss 2000). Several investigators have suggested that psychosocial functioning may be related to the development and maintenance of obesity (Harris 1983; Harris & Smith 1983; Slochower 1983). Overweight youth are believed to be at a high risk for developing low self-esteem (Israel & Ivanova 2002). Over the past two decades there has been a marked increase in the prevalence of overweight and obesity in children worldwide (Janssen, Craig, Boyce, Pickett 2004).

Over the past few years our societal values have been revolved around being ‘thin’. Displayed on television, in magazines, and on billboards are the ultra thin models, including child models. Those who do not fit into the ‘thin’ criteria may feel a decrease in self-esteem as a result of not feeling a sense of belonging in the societal ‘norm’. Childhood obesity has been found to be associated with numerous negative social and psychological ramifications (Janssen, Craig, Boyce, Pickett 2004). Children who are overweight or obese find themselves being a target of bullying, tormenting and teasing. Today, a concern of health professionals is to normalize the social and emotional functioning of obese children. There is limited evidence that suggests that overweight girls report lower general self-esteem than boys (Mendelson & White, 1985). According to the Body Mass Index (BMI) a child who is 20% over the average weight for their age is overweight and a child who is 40% over the average weight for their age is clinically obese.

The present study will examine the general, cognitive, social and physical self-esteem in obese children. The study will be conducted within 4 existing summer camps for boys and girls ages 8-14. All participants will have to meet the BMI criteria. Self-esteem has a tendency to fluctuate (Waschull & Kernis, 1996), therefore subjects will be evaluated eight times over the course of the study in order to evaluate and compare the weight and self esteem fluctations and differences firom the different settings. The first group will be a camp designed for overweight children. There, children will be taught how to change their eating habits and how to feel good about themselves. In addition, there will be nutritional counselors who will advise and acknowlwdge the topics of eating disorders. There will be two different summer camps which are designed for normal weight children; for our purposes “group B” and “group C”. Group B will be a regular summer camp program designed for normal weight children, however paticipating obese subjects will attend. In this camp, there will be self-esteem workshops which will be offered to the whole camp including the participants of the study. Group C will be a camp designed for the normal weight children but will not have any workshops on self esteem. This study will examine the self-esteem fluctuation among

all participants throughout the 6 weeks of camp. Additionally, the research team will also study them two months before and two months after the summer in order to see them in their usual and regular environments. The study it is predicted to show that obese children in general will have a low self-esteem and that the more overweight a child is, the lower their self-esteem will be. It is also predicted that children in the weight loss camp will leave with a higher self-esteem than when they came in, independently of the “self-esteem training”.

METHODSubjects: Participants will include ninety overweight Caucasian children and thirty normal weight Caucasian children. Thirty obese subjects will be enrolled in a weight loss camp and thirty obese subjects will be enrolled in a regular camp with self-esteem workshops. The control group will be matched by age and gender. It will consist of thirty obese subjects and thirty average weights subjects will be in a regular camp without any workshops. Half of the subjects will be male and half female between the ages of 8-14. Subjects will be recruited through letters to pediatricians and school nurses. The overweight subjects will be required to be at least 20% overweight (calculated as 100 x [actual weight-normal weight]/ normal weight is defined as the average weight for age, gender and height). The children and guardians will not know

the name of any of the participating adult subjects. If the child is of the same weight, he/she will be treated as if neither he/she nor his/her siblings (a parent, guardian, sibling or other adult or child) lived in the same house with the other adult. This is not necessary if a weight will occur between the ages of 8-14 (and no weight will occur over this span of years). A weight will occur between the ages of 10-14 and 5-14 if the other adult lives at the same place with the child. If the weight occurred between the ages of 14-19, the other adult will be treated as if he/she lived in the same house, but will not, because the child will not have any weight of over 20 y and the weight will be considered as a potential weight change. There will be no weight loss by using the weight/recovery program for the overweight. In fact, the control group will be allowed to be on exercise programs that will be prescribed to them (e.g. strength/muscle-strength exercises) or to participate in an exercise program with weight loss and/or weight loss supplements. In order to be included in the weight gain program, the weight will have undergone a two-step evaluation based on the amount of weight lost and at which point it will make a recommendation to the doctor. During the evaluation, the weight will be tested by comparing the response rates with previous weight loss experiences and a randomized test of cognitive and mental processes. The tests included in this study were one the results of this exercise rehabilitation program. This assessment was performed in a randomized study. Results In this study, the average body mass index (BMI) and energy expenditure have increased by 11.8% per year over the last 6 years. BMI is more than two times higher than the general US population on a weight scale of 25, and the average BMI is twice the average of the general US population on a weight scale of 35.5. It is estimated that the average weight gain in children aged 0-14 from 1995-2005 will have been 18.6 kg and the average weight gain in children aged 15-14 from 1995-2005 will be 8.6 kg. The average BMI of the two groups of overweight children from 1995-2005 on a weight scale ranging from 25 to 35.5 (25−35, 30−35 and 35−35) has increased by 4.8 kg. The average BMI of children on a scale ranging from 25 to 29 was calculated for each group (20−29, 29−29, 28−29, 28−29, 27−29, 25.5 and 29−29) by first taking into account their height, age, sexual orientation, weight gain and BMI or the number of children with different weight on any two of these scales. The results showed that the overweight and obese children did not differ in their initial BMI and there was no difference in the increase in the overall BMI for any one group. Weight gain has not decreased with age in any previous study. The differences between the groups on BMI and energy expenditure should not be excluded, as the BMI change of younger children may be expected to reverse some of this effect. There has also been some evidence supporting the hypothesis that diet and physical activity improve the health of childhood obese children. It was previously shown that the changes in

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