The Price of Obesity, Physical and Psychological

How I Wish

Jeanna Bryner, managing editor at LiveScience, interviewed Sarah Gable, a researcher at the University of Missouri, about the emotional consequences of childhood obesity: low self-esteem from being teased or bullied, depression, anxiety, and loneliness. These stressful emotions all interfere with not only academic achievement, but every other aspect of life of a child or a teen.

Sadly, nobody really understands what’s going on with this obesity epidemic, although many of us have strong opinions. It’s confusing. Bryner says,

While one paradigm suggests weight leads to teasing, which then leads to psychological issues, another reverses those arrows to suggest depressed kids are less likely to exercise and more likely to gain weight.

What we do know is, a lot of kids are hurting.

Not long ago, Dr. Pretlow’s article “Perspective: Why Do Kids Overeat?” appeared in Clinical Endocrinology News. From studying the responses of thousands of young people, he has noticed that tolerance develops to highly pleasurable foods, and, in this way, these foods act exactly like drugs of abuse. He says,

The way these youth describe their relationship with food comes close to satisfying all of the DSM-IV substance dependence criteria… Morbidly obese kids are likely in addictive tolerance mode and eat more or worse foods to obtain the same coping effect.

For health professionals, Dr. Pretlow offers guidelines in the form of five questions to ask overweight and obese patients. Then he gives us the “prescription” that his patients receive — and any practitioner is warmly welcomed to share these recommendations, which have led to very good results.

The emotional effects of childhood obesity are both short- and long-range. Many of the physical health threats are long-range — most kids don’t think about diabetes and heart disease. Some of the physical drawbacks are short-range, and they are described in Chapter 3 of Overweight: What Kids Say. The various discomforts and awkwardnesses include stretch marks, chafing, saggy skin, the inability to fit into school desks, and so on.

Your average methamphetamine abuser probably didn’t start out thinking, “Here’s the plan. I’ll spend the rest of my life twitching, picking bugs from under my skin, and watching my teeth rot. When I’m 30, I want to look 65.”

Or, imagine a heroin addict saying, “I’m gonna catch a habit that will keep me chronically constipated, put me at risk for HIV/AIDS and prison, and bring misery to anyone who loves me.” The typical junkie probably didn’t formulate his or her future quite this way. This is one of the hallmarks of addiction: The fix is more important than anything.

When a human of behemoth proportions appears in the landscape, we might compare these two propositions, and consider which makes more sense:

1. This person woke up one morning and said: “Hey, I think I’ll put on about 300 pounds so I won’t fit behind a steering wheel or in an airplane seat. In fact, I’ll get so big, both hips will touch the sides of the average shower stall at the same time. Brilliant idea! Let’s git er done!”

… Or:

2. This person is in the grip of an irresistible compulsion, in other words, an addiction.

Your responses and feedback are welcome!

Source: “Childhood Obesity Takes Psychological Toll, Too,” LiveScience, 02/14/10
Source: “Perspective: Why Do Kids Overeat?,” Clinical Endocrinology News Update, 07/09/10
Image by coxphotography, used under its Creative Commons license.

2 Responses

  1. When I was in weight watchers years ago and managed to lose 67 lbs, (not my “goal weight”, btw) I used to have dreams about mint patties, eating a whole box in my dreams, they tasted so good, sweet minty chocolateness sliding down my throat, feeling the sugar in my bloodstream, a calming yet energizing effect. I’d wake up in a cold sweat, freaking out, unsure whether I’d eaten the box of mints or not, the dream was that real. A friend of mine at the time who was a substance abuse counselor was amazed at the dreams, said they were classic junkie dreams that he heard every day. He mentioned one client who he thought her real problem was food, not drugs. She kicked heroin easily but was enormously overweight and talked constantly about fast food and sugar.

    I have type II diabetes and noone can tell me which came first, the diabetes or the sugar rushes. I’m believing lately that they’re both intertwined and can’t be untangled, just part of my own personal biochemistry, shared by other family members. Another theory says I’m just lazy and lack willpower. I prefer the former.

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Profiles: Kids Struggling with Weight

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The Book

OVERWEIGHT: What Kids Say explores the obesity problem from the often-overlooked perspective of children struggling with being overweight.

About Dr. Robert A. Pretlow

Dr. Robert A. Pretlow is a pediatrician and childhood obesity specialist. He has been researching and spreading awareness on the childhood obesity epidemic in the US for more than a decade.
You can contact Dr. Pretlow at:


Dr. Pretlow’s invited presentation at the American Society of Animal Science 2020 Conference
What’s Causing Obesity in Companion Animals and What Can We Do About It

Dr. Pretlow’s invited presentation at the World Obesity Federation 2019 Conference:
Food/Eating Addiction and the Displacement Mechanism

Dr. Pretlow’s Multi-Center Clinical Trial Kick-off Speech 2018:
Obesity: Tackling the Root Cause

Dr. Pretlow’s 2017 Workshop on
Treatment of Obesity Using the Addiction Model

Dr. Pretlow’s invited presentation for
TEC and UNC 2016

Dr. Pretlow’s invited presentation at the 2015 Obesity Summit in London, UK.

Dr. Pretlow’s invited keynote at the 2014 European Childhood Obesity Group Congress in Salzburg, Austria.

Dr. Pretlow’s presentation at the 2013 European Congress on Obesity in Liverpool, UK.

Dr. Pretlow’s presentation at the 2011 International Conference on Childhood Obesity in Lisbon, Portugal.

Dr. Pretlow’s presentation at the 2010 Uniting Against Childhood Obesity Conference in Houston, TX.

Food & Health Resources