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Mental Illness Common in Childhood
Obesity By
Salynn Boyles WebMD
Medical News April
7, 2003 -- Teen and childhood obesity is associated with certain psychological
disorders, according to a new Duke University study.
Chronic childhood obesity was associated with a greater likelihood of
depression in boys and hostile and defiant behavior in both boys and girls. But
it did not appear to increase the risk of chronic anxiety, substance use,
attention deficit disorder, or other psychological problems. The
Duke study included almost 1,000 mostly white children between the ages of nine
and 16 living in a rural North Carolina region where childhood obesity was at
least three times more common than in the nation as a whole. The children were
evaluated annually over an eight-year period to determine height, weight,
psychiatric disorders, and vulnerabilities to such disorders. The findings are
reported in the latest issue of the journal Pediatrics. Boys
who remained obese during childhood and adolescence were four times as likely to
experience clinical depression compared with normal-weight
boys or those who were overweight only during childhood or their teen
years. The association was not seen in girls with chronic childhood
obesity, however. "This
is not to say that overweight girls don't have self-esteem issues or depression
associated with obesity," lead researcher Sarah Mustillo, PhD, tells WebMD.
"We were looking at clinically significant depression, which is not the
same as feeling blue. Overall, boys have lower rates of clinical depression, and
this is what we found in the other groups. But chronic obesity in boys was
associated with an elevated risk of depression." Childhood
obesity was associated with a 2.5 times greater likelihood of a disorder known
as oppositional defiant disorder, defined as an ongoing pattern of
uncooperative, defiant, hostile behavior toward authority figures. The disorder
is more common in boys, but the researchers found it to be elevated in both boys
and girls. Childhood
obesity specialist Sarah Barlow, MD, says a child with defiance disorder is less
likely to set limits for himself or follow those set by parents, and this could
easily lead to obesity. Barlow is an assistant professor of pediatrics at St.
Louis University School of Medicine "For
so many families with overweight children, setting limits is a big issue,"
she tells WebMD. "For these kids, making the lifestyle changes necessary to
lose weight may be low on their list of priorities." Mustillo
says it is not clear whether environmental or biochemical factors drive the
tendency toward these depressive disorders in kids with childhood obesity.
Studies in adults suggest hormonal abnormalities associated with obesity play a
role in depression, but little research has been done in children. The
children participating in this study were largely homogeneous, and Mustillo says
it is possible different associations would be seen among different ethnic
populations. "From
a biochemical standpoint we probably all pretty much have the same makeup,"
she says. "But if environmental or social factors are involved, you might
see a difference. There might be fewer of these problems among ethnic groups
where [childhood] obesity is more accepted." |