Psychological Aspects of Obesity in Adolescence

Abstract

Obesity in adolescence is not a disease entity, but the outward manifestation of a variety of underlying disturbances. The conventional "weight norm" and dieting approach is largely ineffective because it does not take into account individual differences. Normal overweight is found in healthy adolescents who tend to have a heavy constitutional make-up. Overemphasis on reducing can create problems. In disturbed adolescents, similarities are observed in family constellations of some obese and schizophrenic patients. Both families use the child to compensate for parental failure. The sudden demand to reduce may become a starting point for more avid overeating; for anorexia nervosa; or even withdrawal into schizophrenic unreality. In following the development of a large group of obese children, favorable outcome with good social adjustment was achieved by those with least medical attention, no endocrine injections, no enforced dieting. Weight control was self-initiated and voluntary. In others, enforced dieting reinforced existing problems, and total development was unfavorable despite temporary weight loss. Patients who received endocrine treatments suffered the most severe form of mental disturbance. As to conventional treatment approach, the possibility of a psychotic breakdown makes an indiscriminate attack on weight dangerous. Only a better understanding of the underlying problems can give the struggling adolescent a chance for a more constructive life.