Obese children see their lives in dark shades of misery
(HealthDay News) – Despite some efforts to adjust attitudes among overweight children that would make them -- at the very least -- accepting of their condition, obese kid are very unhappy, so much so that a recent study compared their misery with those children who had cancer.
To complicate matters, researchers can't say for sure which comes first, the obesity or the misery.
"It's a complex relationship. We don't know the answer to that," says study co-author Dr. Jeffrey Schwimmer, a pediatric gastroenterologist at the University of California , San Diego , whose research appeared in the Journal of the American Medical Association .
Schwimmer, who works with sick, obese kids at Children's Hospital & Health Center in San Diego , says he was inspired to do the research after he noticed the children seemed unhappy. But he couldn't find any research in the United States to suggest if fat children suffered from a lower quality of life than other children.
The study researchers surveyed 106 patients who were treated at the hospital for obesity. The patients, aged 5 to 18, had an average body mass index (BMI) of 34.7.
The index is a ratio that includes weight and height. To reach a BMI of 33 or higher, a 12-year-old boy who's 5-foot-3 would have to weigh at least 190 pounds.
The children took a test that measured their quality of life by asking questions about issues such as their health, stamina, athletic and school activities, personal relationships and general feelings -- such as whether they were happy or sad, angry or calm.
On a 100-point scale, the obese children reported their quality of life at 67, compared to 83 for healthy, non-obese children surveyed in another study. Parents of both sets of kids were also questioned about the quality of life of their children, and they reported an even larger gap -- 63 versus 88.
Looked at another way, the obese children were 5.5 times more likely to have a poor quality of life than the healthy kids, the researchers say.
"The obese children reported lower quality of life in every single domain," Schwimmer says. "These differences held up even when we looked at issues of gender, race, age and socioeconomic status."
The children also reported poor quality of life regardless of whether they suffered from illnesses such as diabetes and heart disease.
To put the figures in context, the researchers compared them to quality of life surveys of children undergoing chemotherapy.
"They've been demonstrated to have the lowest quality of life of any pediatric health condition," Schwimmer says. "That's why we selected them. It's a tough benchmark."
The quality of life reported by children undergoing chemotherapy was actually a slight bit better than the obese children, the researchers found.
The study doesn't offer any new information about why very heavy children have less fulfilling lives than their skinnier contemporaries. However, Schwimmer suspects social stigma plays a large part.
"From an early age, even at the kindergarten level, children see obese children as different and many respond to them differently," he says. "And certainly by junior high, children who are still obese are clearly ostracized in many places."
Dr. James Rosen, a professor of psychology at the University of Vermont and an expert in weight control among children, says other stressful obstacles confronting heavy children include "not participating in sports, physical discomfort moving around, and the stress of trying to eat healthy when facing a junk food school cafeteria."
Food and weight control can become a "battleground" at home, he adds. And divorced parents may give their obese children conflicting messages about the importance of controlling weight.
An estimated 17 percent of American children are obese, or one in seven, according to the U.S. Centers for Disease Control and Prevention. The rate has tripled since the 1970s.
Schwimmer acknowledges the study didn't look at very heavy children in general, but only those who visited a hospital for treatment of obesity.
On the Web
To learn more about obesity and children, visit the National Institute of Diabetes and Digestive and Kidney Diseases.
SOURCES:
Jeffrey Schwimmer, M.D., pediatric gastroenterologist, University of California, San Diego; James Rosen, M.D., professor, psychology, University of Vermont, Burlington; April 9, 2003, Journal of the American Medical Association
Author:
Randy Dotinga, HealthDay Reporter
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