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Showing posts with label shame. Show all posts
Showing posts with label shame. Show all posts

Wednesday, November 21, 2012

More Tweets With Information on Eating Disorders & Holidays

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Recovery includes recovering from all the SHAME 'Is It Low Self Esteem or Shame?'
Get stuck in the recovery process of almost any mental health addictive behavior - what is this bad feeling anyway?  ABOUT SHAME & RAGE
Want a 'cliff-note' version on how to recover from an ED - try our booklet   How to Recover From an Eating Disorder
The worst problem from the Holidays attacks and paralyzes the individual! Read More on SHAME   
The internal voices of eating disorders are compelling indeed - more info
Stress causes many 'coping behaviors' one is the loss of impulse control. With the Holidays Here read more 

Tuesday, October 30, 2012

How Shame and Guilt can Ruin Recovery

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More Info:  www.addictions.net

Gut-wrenching guilt and shame over your past, if carried with you and allowed to remain, can seriously jeopardize your recovery prospects. When coupled with the recurring cravings and urges to use again, you’re liable to be hit with a double whammy.
What can you do? Are you destined to lug around this useless baggage for the rest of your life? Is there any way out of this morass of guilt and shame you can’t seem to shake? The answer is that there is, but, of course, you’ll have to exert some effort in order to overcome the deficits that guilt and shame have saddled you with.
We’ll take a look at how guilt and shame work to derail your recovery and then cover some practical ways to get past those barriers.
Old Memories Die Hard
What is at the root of the guilt and shame that you feel over your past except old memories that simply refuse to leave? The truth is that we all carry with us memories of what we’ve said and done. It would be impossible not to have them and, quite frankly, our lives wouldn’t have as much meaning if we didn’t keep some memories fresh and ready to review again in our minds.
But when we constantly mull over in minute detail all the things that we’ve said and done that have harmed others to the point where we are paralyzed and incapable of doing the work of recovery, our horizons are limited and we’re not likely to make much, if any, progress in recovery.
Why? There’s no way that we can be proactive if we remain stuck in the past. And the past is what fuels the guilt and shame that we currently feel.
Think about it. You get up in the morning and the first think that enters your head is how worthless you feel and that there’s nothing good that could possibly come from anything you do. You feel this way because of the burden of guilt and shame that you wrestle with every day. Until you learn how to overcome these tremendously self-destructive emotions, you’ll have a continuing uphill battle in recovery.
Negative Breeds Negative
Another way that guilt and shame work to undo your recovery, or prevent it from even getting a firm footing, is that a constant emphasis on negativity – and guilt and shame are most definitely negative – does nothing except foster even more negativity.
It’s hard to think or do anything positive if you’re mired in thoughts about how bad you feel and worried about how others regard you due to your past actions in the grip of your addiction.
All you need to do is look in the mirror and you can likely see the ravages that guilt and shame have created. Your brow may be furrowed, your mouth turned downward in a scowl or you avert your eyes because you don’t like what you see. Your very image is a reminder of the terrible person you now believe yourself to be.
What do you suppose happens the rest of the day after it begins like this? Nothing very promising, more likely than not. Who in their right mind would want to continue this way?
Self-Punishment Doesn’t Cleanse Your Soul
If we believe that we are bad or that we are so guilty of transgressions because of our addiction, we often engage in a never-ending ritual of self-punishment. We berate and belittle ourselves because we believe that we deserve to be punished for what we said and did.
Some of us may even consider ourselves sinners in the truest sense of the word. But having sinned, or committed transgressions against others that have done them harm, doesn’t mean that we are sentenced to a lifetime of penance. It doesn’t mean that we should continue to castigate ourselves and condemn ourselves to a narrow world where we never seek happiness or work to better our way of life.
Beyond being a useless form of self-indulgence, self-punishment in the form of guilt and shame will never cleanse your soul. For that you need to seek the counsel of your spiritual advisor, or take up a heart-to-heart conversation with your Higher Power, or God as you know Him. Bottom line: guilt and shame in the guise of self-punishment do no good whatsoever for your recovery.
No One Else Can Come In
When you are closed up and closed off by guilt and shame, there’s no way that anyone else can get in. That means that your hard-encased and self-imposed mantle of guilt and shame simply won’t permit you to let anyone get close to you, not even a friend.
The most bitter individuals, those who believe themselves to be evil and cast-out by virtue of what they’ve done, engage in another habit that’s self-destructive to recovery from drug and alcohol abuse and that is to refuse to allow themselves to be in the company of friends.
After all, they may think to themselves, who wants to be with me after what I’ve done? Well, what do you think are the prospects for those individuals who remain secluded and bereft of human interaction? They generally continue to sink deeper into their gloomy and self-berating thoughts and fail to take action to help in their recovery.
They often return to their drug of choice as a means to obliterate the pain, if only for a short while.
Suicide is a Real Risk
The longer you carry the oppressive burden of guilt and shame, the worse you feel about yourself and your chances to make a change in your life. Carried to extremes, a continuing emphasis on how terrible you’ve been and all the damage you’ve done to others will eat away at you to the point where you may not see any way out.
This is exacerbated by your shutting yourself off from family and friends, from a refusal to take part in 12-step meetings or seeing your therapist or taking your medication, if prescribed to help you overcome depression, anxiety or other psychological conditions or disorders.
No, not every person who feels overwhelming guilt and shame will be pushed to the point of thoughts of suicide or suicidal actions, but the risk is very real. And the risk will not go away without intervention, without either the individual seeking help or others intervening to get help for the person consumed with guilt and shame.
Turning Your Life Around: First Steps
Okay, enough of the bad news. Now that you’ve got a better idea of the harm that keeping on the trajectory of guilt and shame will result in, it’s time to look at what you can do to start turning your life around. The key is that you need to take small steps, manageable ones, and you might as well begin today.
This all begins with a suspension of disbelief. What’s this? Very simply, what you need to do right now is put a stop to your thoughts that you aren’t worth saving, or that you cannot possibly heal. Just tell yourself that you will, for just today, think that you are worth it, that you do deserve a chance to make your life better. Just today, let’s just start with that.
Of course, there’s a lot more to getting past guilt and shame than telling yourself that you deserve the chance to do so, but this is a necessary first step. You have to allow yourself permission to heal before you can actually begin to heal.
n a way, this is a lot like the suspension of disbelief you went through prior to going into rehab. You had no way of knowing whether or not treatment would work. You probably already had a mountain of guilt and shame you brought with you into rehab, but you at least gave yourself the go-ahead to get help, and you took it.
This shows that you do have what it takes to get past guilt and shame. This is a very real demonstration that it is possible to make a difference in your life. But there’s more work ahead for you to make progress in overcoming these oppressive thoughts and emotions.
Get Some Additional Help
What we’re talking about here isn’t occasional twangs of conscience or guilty feelings about your past. This is the serious stuff, the guilt and shame that’s so overpowering that it lays you flat and you don’t do anything proactive for your recovery.
If this is what you’re carrying around with you, it may be appropriate for you to consider getting some additional help in the form of counseling. Your 12-step sponsor isn’t your counselor, nor is your best friends, loved ones or family members. While they are key members of your support network, they aren’t equipped to deal with such powerful emotions that are wreaking such havoc on you. This isn’t their function, either.
If you have continuing counseling available to you in aftercare or continuing care as a part of your rehab or treatment program, by all means avail yourself of it. There’s no reason why you shouldn’t be able to take advantage of what is readily available to you. The only obstacle here is your unwillingness to admit that you need help.
Again, this is much like the self-denial you once engaged in before you finally admitted you needed help to overcome your addiction in the first place. And you got beyond that barrier, so now it’s time to get past this one.
If you do not have counseling readily available, ask for a recommendation from your treatment facility, your family doctor, your minister or clergyman, or from another trusted advisor. Seeing a psychologist or psychiatrist or other therapist may also be covered under certain federal, state or local programs and your referring physician or facility may have information on where such counseling is available for a pay-as-you-go or reduced rate plan.
The other point to be made here is that getting past guilt and shame isn’t a lifelong pursuit. With effective therapy you can get past these emotions that are counter-productive to your recovery. Once you get involved in therapy and start divesting yourself of the burden of guilt and shame, you will probably wonder why it took you so long to do so in the first place.
What’s next? Take proactive steps to continue in your recovery. Read Get Busy with the Work of Recovery.

More Info:  www.addictions.net

I Hate Myself?

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Why do I hate myself?

Do you catch yourself thinking, "I hate myself"? We hate ourselves for various reasons. Sometimes it is because we say the wrong things at the wrong time. Sometimes we hate ourselves for not living up to our own or another's expectations. The fact is that sooner or later most of us in our lifetime are going to utter the word's "I hate myself." The words "I hate myself" by themselves hold no power over us, but the problem starts when you begin to believe the words. Let's look at some of the reasons why you may come to hate yourself and how to deal with the problems.

  • Rejection - We all must face rejection in our lives. Rejection from members of the opposite sex, rejection over a promotion at work, rejection at a life that does not measure up to the big plans we once had. Rejection will come, but we must not let it consume us. I have learned in the past that when rejection comes, it is not the end of the world. Sure, there are times I am depressed for a little while and there is a lot of self-examination, but over time I learned that rejection is not the end, but the beginning of something else.
  • Love and Acceptance - It is human nature to want to feel the love and acceptance of others, but when it doesn't happen in our timetable, we often turn to ourselves as the source of our failure. When someone does not accept or show love to you, don't hate yourself for it. Rather, take time to consider the situation surrounding why you were not accepted or loved. In the end, you will realize (like I did) that not everyone is going to accept you and love you. If you stay true to who you are, sooner or later you will find the love and acceptance you are looking for.
  • Hitting Bottom - Have you ever felt like you've hit bottom? I'm talking about those times when you say, "If I only had one break, I know I could get out of this situation I am in." I know I have had quite a few times like that in my life and it is not a nice feeling. Many times when we are at rock bottom we get depressed. Our depression can lead to self-pity and self-pity can cause us to say, "I hate myself" for not being able to get out of this.

    Most of the time when we hit rock bottom it is by circumstances of our own making. In our minds, we feel that since we are the one who caused the problem we should be the ones to get ourself out of the problem. When things continue to spiral downward, we start to play the blame game which always leads to wrong conclusions about ourselves. In the end, we start to hate ourselves for allowing things to get this bad. When you hit bottom, don't hate yourself. Swallow your pride and seek help elsewhere.
  • I Make Mistakes - We all make mistakes. I know, I make my share of mistakes everyday. I have found that people are more prone to point out your mistakes than they are to praise you for what you are doing right. If you are not careful, you may start to think that your life is a mistake, which can lead to feelings of hatred towards yourself and others.

    I know my strengths and weakness and I am going to make more mistakes, but I can't let the mistakes get to me. I know it sounds simple and it will take work, but when you make a mistake, learn from it and move on.
Why do I hate myself? - There could be any number of reasons. The reasons I listed above are ones I have personally dealt with in the past. There were times I hated who I was and wanted to change myself so I could be like everyone else.

Then one day I realized that I am not like everyone else. I am me, so I set out to be me and I soon found that I no longer hated myself. I did not take the things that happened to me so personally anymore. I do not know if it will work for you, but isn't it worth a shot? 


More Info: www.addictions.net

Is Self-Loathing an All or Nothing Proposition?

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Several comments to my post on "The Single Self-Loather" were incredibly insightful, and forced me to think about self-loathing in new ways. For instance, Ashley wrote, "Perhaps I still don't grasp what a self-loather actually is—if there is a precise definition. Is it a global self-loathing (i.e. you hate everything about yourself with no redeeming quality)—or are there just some things that you find loathe-worthy which you feel devalues the entire person?" To which Jo replied: "Maybe this reflects the difference between self-esteem and self-worth, the first being more 'situational'... and the other related to your basic worth as a human being? Personally, I have achieved good academic results and 'succeeded' in some important areas, but while I recognize that I am a good student and have academic abilities (and, as such, have at least some self-esteem in certain areas), the feeling of being a bad PERSON pretty much remains the same (i.e. low self-worth)."

As I mulled over these comments, they began to invoke two issues that arise in virtue ethics: the unity of virtues and their variability across situations (or the situationist critique). Before we begin, please understand that I'm not saying that self-loathing is a virtue, though a person can be a "virtuous self-loather" by dealing with other people in a virtuous way despite his or her self-reagrding issues (as described in my last post). All I mean is that there are similar ways in which self-loathing and the virtues are be described or understood, and that claims about the unity of the virtues and the situationist critique have some implications about the nature of self-loathing, which I want to explore.
The unity of the virtues is the claim that possessing one positive character trait necessarily implies possessing all of them. According to this position—which many virtue theorists share, though in vastly different forms—one cannot be truly honest, for example, without also being kind, courageous, and so forth. In other words, there is something essential to being a virtuous person which underlies having the individual virtues, and without that one central, basic thing, you can't be truly virtuous in any specific ways.
Both comments quoted above made me think of self-loathing in similar terms. Does self-loathing imply that you must regard every facet of yourself as inferior, or can you have good opinions of some aspects of yourself and still feel inadequate overall?
I think the answer to this depends on how we understand the nature of self-loathing itself. As I understand it, self-loathing reflects a radical devaluation of one's overall character—in effect, a denial of one's virtues. A self-loathing person considers him- or herself a "bad person," unworthy of concern or love, presumably because the virtues—the good character or personality traits that would justify concern and love—are missing. But do these virtues have to be lacking completely or can some exist and others not? (Never mind the issue of whether one can possess a virtue "partially"—is some kindness better than none, or is halfhearted kindness no real kindness at all? That's a whole other can of worms.)
For some people, feeling like a "bad person" implies a complete lack of any virtues at all. In this view, if a good or virtuous person embodies the unity of virtues, a bad (but not evil) person embodies the unity of lack of virtue. (I'm being careful here not to invoke the opposite of virtue, which would be vice—a self-loathing person can consider herself to be bad in the sense of inadequate or worthy without thinking herself evil.) This is the easiest way to account for self-loathing: obviously, if a person feels he lacks any redeeming qualities at all, he is very likely to loathe himself utterly and completely. If this turns out to be the best way to understand self-loathing, in a backwards sort of way it may also be a supporting argument for the unity of virtues: they're a package deal, and you either have them all or you have none of them.

Is Jo being inconsistent or insincere when she claims to acknowledge her academic success but then downplays her overall quality as a person? Perhaps she does not regard her academic success as reflecting any moral virtue, giving most of the credit to her inborn intelligence or luck rather than her own dedication and perseverance. We may disagree with this judgment, of course, but this would not make her insincere—just modest. More likely, though, she recognizes these positive character traits but does not consider them as important as the other virtues she feels she lacks. This view, however, speaks against the unity of the virtues (or lack thereof), since this position does not usually distinguish between more and less important character traits, simply claiming that they're all connected. The possibility of someone like Jo recognizing goodand bad things about herself implies that her virtues are not unified, that some exist within her while others don't, and that her feelings of inadequacy result from weighing the good and bad against each other—and possibly ranking some, presumably the ones she feels she lacks, as more important—and coming up short overall.
This also suggests a way to combat self-loathing: changing the way you assess your own virtues and lack thereof. If you're a self-loathing individual, besides assessing yourself too harshly, you are likely also overemphasizing the traits in which you feel you fall short—judging those, perhaps not coincidentally, to be the most important ones—and underemphasizing the ones in which you may feel you shine. This may not get to the heart of your predisposition to see yourself in a negative light, but it may help you to remember the ways in which you are a good person, and help you improve your overall self-evaluation.
Next time, I'll discuss the parallels between self-loathing and the situationistic critique of virtue theory: Is self-loathing always the same, or can it vary according to the situation in which it arises?
----------
For a list of my previous Psychology Today posts on self-loathing (and other topics), see here.
More Info?  www.addictions.net

Friday, September 21, 2012

Childhood Obesity

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Childhood obesity has more than tripled in the past 30 years. The prevalence of obesity among children aged 6 to 11 years increased from 6.5% in 1980 to 19.6% in 2008. The prevalence of obesity among adolescents aged 12 to 19 years increased from 5.0% to 18.1%.Obesity is the result of caloric imbalance (too few calories expended for the amount of calories consumed) and is mediated by genetic, behavioral, and environmental factors. Childhood obesity has both immediate and long-term health impacts:

  • Obese youth are more likely to have risk factors for cardiovascular disease, such as high cholesterol or high blood pressure. In a population-based sample of 5- to 17-year-olds, 70% of obese youth had at least one risk factor for cardiovascular disease.
  • Children and adolescents who are obese are at greater risk for bone and joint problems, sleep apnea, and social and psychological problems such as stigmatization and poor self-esteem.
  • Obese youth are more likely than youth of normal weight to become overweight or obese adults, and therefore more at risk for associated adult health problems, including heart disease, type 2 diabetes, stroke, several types of cancer, and osteoarthritis.
Healthy lifestyle habits, including healthy eating and physical activity, can lower the risk of becoming obese and developing related diseases.
Prevalence
In the past 30 years, the occurrence of overweight in children has doubled and it is now estimated that one in five children in the US is overweight. Increases in the prevalence of overweight are also being seen in younger children, including preschoolers. Prevalence of overweight is especially higher among certain populations such as Hispanic, African American and Native Americans where some studies indicate prevalence of >85th percentile of 35-40%. Also, while more children are becoming overweight, the heaviest children are getting even heavier. As a result, childhood overweight is regarded as the most common prevalent nutritional disorder of US children and adolescents, and one of the most common problems seen by pediatricians.


Consequences of Childhood Overweight
Both the short term and long term effects of overweight on health are of concern because of the negative psychological and health consequences in childhood.

Potential Negative Psychological Outcomes:
  • Depressive symptoms
  • Poor Body Image
  • Low Self-Concept
  • Risk for Eating Disorders
Negative Health Consequences:
  • Insulin Resistance
  • Type 2 Diabetes
  • Hypertension
  • High Total and LDL Cholesterol and triglyceride levels in the blood
  • Low HDL Cholesterol levels in the blood
  • Sleep Apnea
  • Early puberty
  • Orthopedic problems such as Blount's disease and slipped capital femoral epiphysis
  • Non-alcoholic steatohepatitis (fatty infiltration and inflammation of the liver)
Further, obese children are more likely to be obese as adults, hence they are at increased risk for a number of diseases including: stroke, cardiovascular disease, hypertension, diabetes, and some cancers.
Contributors to Childhood Overweight
  • Food Choices - diets higher in calories (including fats and simple sugars) and lower in fruits and vegetables are linked with overweight
  • Physical Activity vs. Sedentary Activity - less physical activity and more time spent participating in activities such as watching tv results in less energy expenditure
  • Parental Obesity - children of obese parents are more likely to be overweight themselves. There is an inherited component to childhood overweight that makes it easier for some children to become overweight than others. There are a number of single gene mutations ("genetic alterations") that are capable of causing severe childhood overweight, though these are rare. Even children with genetic risk for overweight will still only become overweight if they consume more calories than they use. Parental obesity may also reflect a family environment that promotes excess eating and insufficient activity.
  • Eating Patterns - skipping meals or failure to maintain a regular eating schedule can result in increased intakes when food is eaten.
  • Parenting Style - some researchers believe that excess parental control over children's eating might lead to poor self regulation of kid's energy intake.
  • Diabetes during pregnancy - overweight and type 2 diabetes occur with greater frequency in the offspring of diabetic mothers (who are also more likely to be obese)
  • Low Birth Weight - Low birth weight (<2500 a="a" epidemiological="epidemiological" factor="factor" font="font" for="for" g="g" in="in" is="is" overweight="overweight" risk="risk" several="several" studies.="studies.">
  • Excessive weight gain during pregnancy - Several studies have shown that excessive maternal weight gain during pregancy is associated with increased birth weight and overweight later in life.
  • Formula Feeding - Breast feeding is generally recommended over formula feeding. Although the exact mechanism in unknown, several long-term studies suggest that breast feeding may prevent excess weight gain as children grow.
  • Parental Eating and Physical Activity Habits - Parents with poor nutritional habits and who lead sedentary lifestyles role model these behaviors for their children, thereby creating an "obesigenic" home environment.
  • Demographic Factors. Certain demographic factors are associated with an increased risk of being overweight in childhood. For example, there is evidence that African-American and Hispanic children 6 to 11 years years old are more likely to be overweight than are non-Hispanic white children of the same age. Asian and Pacific Islander children of the same age were slightly less likely to be overweight.
Measuring Childhood Overweight
Childhood overweight is identified through the measurement of Body Mass Index or BMI. BMI can also be calculated using kilograms (kg) and meters (m), as well as pounds (lbs) and inches (in):


Once BMI is calculated, it can then be used to determine if a child is overweight or not, by comparing the BMI with the CDC growth charts (http://www.cdc.gov/growthcharts/) for children of the same age and sex. Children who have a BMI at or above the 95%, percentile for age and sex are considered overweight. Children with a BMI that falls between the 85%-95% are classified as at risk for overweight. To plot body mass index-for-age percentiles for boys, click here. To plot body mass index-for-age percentiles for girls, click here.
Parents whose children fall in the "at risk for overweight" category should discuss this with their pediatrician or family physician and should carefully monitor their child's growth. Parents whose children fall in the "overweight" category should make an appointment with their pediatrician or family physician to discuss whether treatment is warranted. Screening for other health risk factors (such as blood pressure or lipid profile) may be recommended by your physician. The BMI is just an initial tool in a series of examinations required to determine if your child is overweight. At no time should a child be diagnosed and labeled overweight by a parent, teacher, or other lay (non-medical) individual. Discussions concerning the child's weight should occur only after reviewing his or her condition with a medical professional.
Tips for Parents & Caregivers to Help Establish Healthy Eating Patterns with Kids
  • Parents should choose what children can eat, (what foods and drinks are in the home, what foods and drinks are served at meals and snacks, what restaurants they go to, etc) but among those foods, parents should allow kids to choose whether they eat at all and how much to eat.
  • Fruits and vegetables, as compared to high calorie snack foods (often high fat and high sugar), should be readily available in the home.
  • Serve and eat a variety of foods from each food group.
  • Use small portions - child portions are usually very small, particularly compared to adult portions. More food can always be added.
  • Bake, broil, roast or grill meats instead of frying them.
  • Limit use of high calorie, high fat and high sugar sauces and spreads.
  • Use low-fat or nonfat and lower calorie dairy products for milk, yogurt and ice cream.
  • Support participation in play, sports and other physical activity at school, church or community leagues.
  • Be active as a family - Go on a walk, bike ride, swim or hike together. Limit TV time.
  • Avoid eating while watching TV. TV viewers may eat too much, too fast, and are influenced by the foods and drinks that are advertised.
  • Replace high-sugared drinks, espically sodas, with water and/or low fat milk.
  • Limit fruit juice intake to two servings or less per day (one serving = ¾ cup) - Many parents allow their children unlimited intake of fruit juice (100%) because of the accompanying vitamins and minerals. However, children who drink too much fruit juice may be consuming excess calories.
  • Encourage free play in young children and provide environments that allow children to play indoors and outdoors.
  • Role model through actions healthy dietary practices, nutritional snacks, and lifestyle activities. Avoid badgering children, restrictive feeding, labeling foods as "good" or "bad," and using food as a reward.
Tips for Pediatricians & Other Health Care Professionals to Facilitate the Prevention of Childhood Overweight (from the American Academy of Pediatrics Policy Statement, August 2003).
Health Supervision Recommendations:
  • Identify and track patients at risk by virtue of family history, birth weight, or socioeconomic, ethnic, cultural, or environmental factors.
  • Calculate and plot BMI once a year in all children and adolescents.
  • Use change in BMI to identify rate of excessive weight gain relative to linear growth.
  • Encourage, support, and protect breastfeeding.
  • Encourage parents and caregivers to promote healthy eating patterns by offering nutritious snacks, such as vegetables and fruits, low-fat dairy foods, and whole grains; encouraging children's autonomy in self-regulation of food intake and setting appropriate limits on choices; and modeling healthy food choices.
  • Routinely promote physical activity, including unstructured play at home, in school, in child care settings, and throughout the community.
  • Recommend limitation of television and video time to a maximum of 2 hours per day.
  • Recognize and monitor changes in obesity-associated risk factors for adult chronic disease, such as hypertension, dyslipidemia, hyperinsulinemia, impaired glucose tolerance, and symptoms of obstructive sleep apnea syndrome.
Advocacy Recommendations:
  • Help parents, teachers, coaches, and others who influence youth to discuss health habits, not body habitus, as part of their efforts to control overweight.
  • Enlist policy makers from local, state, and national organizations and schools to support a healthful lifestyle for all children, including proper diet and adequate opportunity for regular physical activity.
  • Encourage organizations that are responsible for health care and health care financing to provide coverage for effective obesity prevention and treatment strategies.
  • Encourage public and private sources to direct funding toward research into effective strategies to prevent overweight and to maximize limited family and community resources to achieve healthful outcomes for youth.
  • Support and advocate for social marketing intended to promote healthful food choices and increased physical activity.
References:
American Academy of Pediatrics. Prevention of Pediatric Overweight and Obesity: American Academy of Pediatrics Policy Statement; Organizational Principles to Guide and Define the Child Health System and/or Improve the Health of All Children; Committee on Nutrition. Pediatrics. 2003;112:424-430
Banis HT, Varni JW, Wallander JL, Korsch BM, Jay SM, Adler R, Garcia-Temple E, & Negrete V. Psychological and social adjustment of obese children and their families. Child: Care, Health, and Development. 1998;14,157-173.
Barker M. Birthweight and body fat distribution in adolescent girls. Arch Dis Child 1997; 77(5): 381-383.
Barlow SE, & Dietz WH. Obesity evaluation and treatment: Expert Committee recommendations. Pediatrics, 1998; 102(3): URL:http://www.pediatrics.org/cgi/content/full/102/3/e29.
Bouchard C and Perusse L. Heredity and body fat. Annual Review of Nutrition, 1988;8:259-77.
Dietz WH. Childhood Weight affects adult morbidity and morality. J Nutr, 1998;128 (2):411S-414S.
Ebbeling CB, Pawlak DB, Ludwig DS. Childhood obesity: public health crisis, common sense cure. Lancet 2002, 360:473-82.
Gortmaker SL, Must A, Sobol AM, Peterson K, Colditz GA, Dietz WH. Television viewing as a cause of increasing obesity among children in the United States, 1986-1990. Arch Pediatr Adolesc Med. 1996;150(4):356-62.
Satter E. How to Get Your Kid to Eat...But Not Too Much. Bull Publishing Company, 1987.
Haas JS. Lee LB. Kaplan CP. Sonneborn D. Phillips KA. Liang SY. The association of race, socioeconomic status, and health insurance status with the prevalence of overweight among children and adolescents. American Journal of Public Health. 93(12):2105-10, 2003
Johnson SL, Birch LL. Parents' and children's adiposity and eating style. Pediatrics, 1994;94:653-661.
Kinnunen TI, Luoto R, Gissler M, Hemminki E. Pregancy weight gain from 1960s to 2000 n Finland. Int J Obes 2003; 27:1572-77.
Kuczmarski RJ, Ogden CL, Grummer-Strawn LM, et al. CDC growth charts: United States. Advance data from vital and health statistics; no 314. Hyattsville, Maryland: National Center for Health Statistics. 2000.
Malina RM, Katmarzyk PT, Beunen G. Birth weight and its relationship to size attained and relative fat distribution at 7 to 12 years of age. Obesity Research 1996; 4(4): 385-390.
Obarzanek E, Schreiber GB, Crawford PB, Goldman SR, Barrier PM, Frederick MM, & Lakatos E. Energy intake and physical activity in relation to indexes of body fat: The NHLBI Growth and Health Study. Am J Clin Nutr, 1994;60:15-22.
Sallis JF. Epidemiology of physical activity and fitness and adolescents. Critical Reviews in Food Science and Nutrition, 1993;33:403-408.
Shapiro C, Sutija VG, Bush J. Effect of maternal weight gain on infant birth weight. J Perinat Med 2000; 28:428-31.
Troiano RP and Flegal KM. Overweight children and adolescents: Descroption, epidemiology, and demographics. Pediatrics, 1998;101(3):497-504.

Childhood Overweight

by L. Bellows and J. Roach1 (05/09)

Quick Facts...

  • Overweight children have an increased risk of being overweight as adults.
  • Genetics, behavior, and family environment play a role in childhood overweight.
  • Childhood overweight increases the risk for certain medical and psychological conditions.
  • Encourage overweight children to be active, decrease screen time, and develop healthful eating habits.
The prevalence of overweight children in the United States has increased dramatically in recent years. Recent reports have reached epidemic levels, with approximately 16 percent of children, 2 to 19 years old, classified as overweight.2 Colorado fares slightly better with close to 14 percent of children considered overweight; however, the same increasing trend seen nationally is occurring in Colorado as well.3 Excess weight has both immediate and long-term consequences and the current issue demands serious attention.

Definitions

Body Mass Index (BMI) is a measure of weight adjusted for height used to determine weight categories. Due to children’s changing body compositions over time and the different growth rates of boys and girls, BMI for children is age and gender specific. BMI for age is determined using gender-specific growth charts that place a child in a percentile relative to weight and height. Weight categories are determined based on these percentiles and are defined as:
Underweight < 5th percentile
Normal 5th to < 85th percentile
At risk of overweight 85th to <95th br="br" percentile="percentile">Overweight 95th percentile and above
The terms obese and overweight are often used interchangeably, although the terms at risk of overweight and overweight are preferred to reference children whose excess body weight poses medical risks.

Consequences of Childhood Overweight

Overweight children and adolescents are at increased risk for several health complications. During their youth, for example, they are more likely to exhibit risk factors for cardiovascular disease (CVD) including high blood pressure, high cholesterol, dyslipidemia, and type 2 diabetes compared with normal weight individuals.4 Additional health complications associated with overweight children include sleep apnea, asthma, and liver damage.444 This study also concluded that if overweight begins before 8 years of age, obesity in adulthood is likely to be more severe. Finally, childhood overweight has psychological and emotional consequences. Overweight children are at an increased risk of teasing and bullying, low self-esteem, and poor body image. Further, overweight children and adolescents are more likely to become obese adults. For example, one study found that approximately 80 percent of children who were overweight at 10 to 15 years old were obese at 25. Another study found that 25 percent of obese adults were overweight as children.

Contributors of Childhood Overweight

There is not one single cause of childhood overweight, rather it is a complex interaction of many variables. Contributing factors include genetics, behavior, environment, and certain socio-demographics.
Genetics. Certain genetic characteristics may increase an individual’s susceptibility to excess body weight, however, there are likely to be many genes involved and a strong interaction between genetics and environment that influences the degree of excess body weight.5 It has been shown that overweight tends to run in families suggesting a genetic link. In some cases, parental obesity is a stronger predictor of childhood overweight than the child’s weight status alone.5
Behavior. Weight gain occurs as a result of energy imbalance, specifically when a child consumes more calories than the child uses. Several behaviors can contribute to weight gain including nutrition, physical activity, and sedentary behaviors.
  • Nutrition - An increase in availability and consumption of high-calorie convenience foods and beverages, more meals eaten away from home, fewer family meals, and greater portion sizes all may contribute to childhood overweight. Further, many children’s diets do not meet nutrition guidelines. For example, only 8 percent of children in Colorado ate vegetables three or more times per day as recommended by the U.S. Department of Agriculture.3, 6
  • Physical Activity - Decreased opportunities and participation in physical activity is another behavior that contributes to overweight children. Being physically active not only has positive effects on body weight, but also on blood pressure and bone strength.7 It also has been shown that physically active children are more likely to remain physically active into adolescence and adulthood.7 Children may spend less time being physically active during school as well as at home. School physical education programs have decreased and children are walking to school and doing household chores less frequently.
  • Screen Time - While physical activity levels have decreased, sedentary behaviors, such as watching television, playing on the computer and with video games have increased. One study found that time spent watching television, videos, DVDs, and movies averaged slightly over three hours per day among children 8 to 18 years old.6 Several studies have found a positive association between time spent watching television and prevalence of overweight in children. Sedentary behavior, and specifically television viewing, may replace time children spend in physical activities, contribute to increased calorie consumption through excessive snacking and eating meals in front of the television, influence children to choose high-calorie, low-nutrient foods through exposure to food advertisements, and decrease children’s metabolic rate.6
Environment. There are a variety of environmental factors that can potentially contribute to childhood overweight, including home, childcare settings, school, and the community. The school and community settings are other environments where children learn about eating and physical activity habits. It is becoming increasingly important for all children to have access to healthful food choices and safe physical activity opportunities. Advocating for innovative school nutrition and physical activity programs as well as ensuring that there are well-lit sidewalks, bike paths, and parks in the community can all help to shift towards a more healthful environment for our children.
Socio-Demographics. Certain ethnic minority and socioeconomic populations have increased rates of childhood overweight.8 Low-income families face numerous barriers including food insecurity, lack of safe places for physical activity, and lack of consistent access to healthful food choices, especially fruits and vegetables.5 Recent reports also indicate racial disparities, with the greatest prevalence among Mexican American boys and African American non-Hispanic girls.2 With both sexes combined, roughly 21 percent of both Mexican Americans and African American non-Hispanics are overweight compared to close to 15 percent for white non-Hispanic.2

Promoting Healthy Habits and a Healthy Weight

Lifestyles and behaviors are established early in life; therefore, a focus on healthful behaviors is vital to promoting healthy weight. The primary goals of overcoming childhood overweight should be healthful eating and increased activity. It is important for children to consume enough calories to support normal growth and development without promoting excessive weight gain. The home, childcare setting, school, and community are all integral to a more healthful environment for our children.
Parents, caregivers, teachers, and community members can promote healthy nutrition and physical activity habits and a healthy weight among children by:
Encouraging Healthy Eating Habits
  • Serve a wide variety of foods, including fruits, vegetables, whole grains, and low-fat dairy products. Provide children with a variety of foods to ensure they get all the nutrients they need for proper growth and development.
  • Know how much food kids need. Keep portion sizes in check to help children maintain their sense of self-regulation –and to know when they are hungry and when they are full.
  • Be a good role model for kids by eating together. Eating meals as a family has been shown to increase fruit and vegetable consumption and decrease the amount of junk foods and sugar-sweetened beverages.
  • Visit USDA’s MyPyramid website (www.mypyramid.gov) for information and tips for eating healthfully.6
Promoting Physical Activity
  • Aim for children to accumulate a minimum of 60 minutes of moderate-to-vigorous physical activity each day. Activity bouts can be all at once or in several bouts spread throughout the day.
  • Increase opportunities for children to engage in physical activity throughout the day. Incorporating daily recess and physical education into the school day will help ensure that children are getting the recommended 60 minutes of physical activity each day.
  • Be a good role model. Engage in activity with children.
  • Limit screen and television time to less than two hours per day. Keep televisions and video games out of children’s bedrooms to help them limit the amount of screen time.
  • Visit the National Institutes of Health’s WeCan™ (Ways to Enhance Children’s Activity and Nutrition) website (www.wecan.org) for ideas on increasing physical activity, decreasing screen time, and improving food choices among children.9

References

2Ogden, C. L., Carroll, M. D., & Flegal, K. M. (2008). High body mass index for age among US children and adolescents, 2003-2006. JAMA, 299(20), 2401-2405.
3Colorado Department of Public Health and Environment, Colorado Physical Activity and Nutrition program. (2006). Overweight, Physical Activity and Nutrition Among Colorado Children and Youth: A Data Resource. Retrieved February 27, 2009 from http://www.cdphe.state.co.us/pp/COPAN/olderadult/childfactsheet04.pdf
4Centers for Disease Control and Prevention. (2009). Overweight and Obesity. Consequences. Retrieved February 27, 2009 from http://www.cdc.gov/NCCDPHP/DNPA/obesity/childhood/consequences.htm
5American Academy of Pediatrics. (2003). Policy statement. Prevention of pediatric overweight and obesity. Pediatrics, 112(2), 424-430.
6United States Department of Agriculture. (2009). MyPyramid: Steps to a Healthier You. Retrieved February 27, 2009 from http://www.mypyramid.gov
7Centers for Disease Control and Prevention. (2009). Overweight and Obesity. Contributing Factors. Retrieved February 27, 2009 from http://www.cdc.gov/obesity/childhood/causes.html
8Institute of Medicine. (2004). Childhood Obesity in the United States: Facts and Figures. Retrieved February 27, 2009 from http://www.iom.edu/Object.File/Master/22/606/FINALfactsandfigures2.pdf
9National Heart, Lung, and Blood Institute. (2009). WeCan! Ways to Enhance Children’s Activity and Nutrition. Retrieved February 27, 2009 from http://www.wecan.org