Stress, Boredom, Activity, and Childhood Obesity

Laila having exercises

Researchers at Iowa State University, after studying the lives and health of over 1,000 teenagers, have concluded that adolescent obesity is very much connected to the increasing levels of stress. For starters, 47% of the adolescents they studied were overweight or obese. But after six years of collecting data and interviewing the children and their mothers, it became clear that the number of stress factors in a teen’s life make a big difference. Looking at only the teens who have reported four or more stressors, the number of overweight or obese kids has increased to 56%. Stress makes a noticeable difference.

This is reported by PsychCentral’s senior news editor, Rick Nauert, Ph.D., who has earned his credentials in the areas of information science, health care administration, health fitness management, and physical therapy. He is currently a faculty member at the State University of Texas in San Marcos.

Dr. Nauert lists the stress factors taken into consideration as academic problems, consumption of drugs and alcohol, depression or poor mental health levels, acting out or aggressive behaviors, and lack of future orientation. He quotes Brenda Lohman, assistant professor of human development and family studies at Iowa State:

We found that an adolescent or youth who’s more stressed — caused by such things as having poor grades, mental health problems, more aggressive behavior, or doing more drugs and alcohol — is also more likely to be overweight or obese.

This is a bit confusing because while poor grades, aggressive behavior and indulgence in intoxicating substances can certainly cause stress (as can being grounded by parents or arrested), some might also argue that poor grades, aggressive behavior and substance abuse are also the signs, symptoms and results of stress. Are they causative of obesity, or concurrent with obesity? Then, to complicate things even more, there is the vicious-circle effect. Whatever is bothering the kid in the first place causes stress-eating, then obesity, then other undesirable outcomes. Which is why, Lohman adds,

It could possibly be that the obesity is leading to these stressors too. And so the work that we’re doing right now looks at which one of these is really coming first: the stressors or the obesity. We know that it is cyclical and that all of these factors just compound on each other.

What it all points to is the clear message that health care professionals need to take a holistic approach. Simply attempting to treat the weight status will probably fail, as long as underlying and co-existing problems remain unaddressed.

One of the big problems for children and teens is what they tend to describe as boredom, which is more likely an amalgam of emotions they don’t recognize, can’t identify, or prefer to disguise under another name. It’s very unhip to feel depressed, rejected, inadequate, etc. To be bored, on the other hand, is the epitome of cool. Boredom implies that you’re such a worldly individual that nothing the present scene can offer is capable of exciting you. While this may be true of some international rock-star’s kid, it’s obviously not the actual problem of the average American child.

Why Are Children Overweight?” is the 22-minute presentation Dr. Pretlow has created earlier this month for the Royal College of Physicians National Obesity Forum in London. He looks at this “boredom” issue, especially in Slide 30. Dr. Pretlow talks about displacement activity, a common reaction to stress. A person might tap his foot, play with a pencil, chew on his or her fingernails, or eat. Dr. Pretlow suggests that binge-eating is a double-whammy combination of stress-eating (displacement activity) and comfort-eating. This brings to mind a quotation from Dr. Douglas Hunt, who wrote No More Cravings, back in 1987:

It is not just nervousness that provokes fat people to overeat — any emotion will do… The only emotion that can prevent overeating in the truly obese is stark, raving terror.

Well, it’s not really possible to keep an overweight person in a constant state of stark, raving terror, so that is not an option as a therapeutic modality. Something can be done, however, about the everyday anxiety. In his practice helping overweight kids, Dr. Pretlow has come to the conclusion that stress control is key. In “Why Do Kids Overeat?” (PDF), he suggests that kids be guided and encouraged to find other sources of comfort, and other channels to release nervous tension. Some of the alternative are hobbies, pets, meditation, counseling, deep breathing, taking a walk, playing a musical instrument, reading, joining a club, doing volunteer work, and engaging in active play.

As a displacement activity, to discharge nervous energy, shooting hoops is just as effective as eating a bag of chips. Gym class may not help kids much once they are already fat, but channeling the energy into non-eating activities can help them avoid ever getting fat in the first place. Kids really need to find things they enjoy doing, things that involve the actual bodily motion. In other words, exercise, or even a milder activity.

When a kid has both hands in a sandbox, there are no hands left to hold the snacks with. Okay, maybe they’re not sweating off the pounds, but they’re learning important things, unawares. They’re learning that a temporary sensation of hunger is not the worst thing in the world. They’re learning that it’s possible to become so absorbed in an activity that you didn’t even notice you were hungry, until the lunch bell rang.

Linda Spangle, Dr. Pretlow, and others have pointed out that there is a special class of “motor foods” — the foods that take physical energy to chew — like nut-filled candy bars, fibrous meats, trail mix, crunchy breakfast cereals, popcorn, and chips, among others. These are the foods that attract us when we’re literally mad enough to bite something. Keep this concept in mind, it will be relevant in the last paragraph.

Here are some deep thoughts from a philosopher known as Osho, who urges us to understand the difference between action and activity. They are not the same, or even similar, but opposite:

Action is when the situation demands it and you act, you respond. Activity is when the situation doesn’t matter, it is not a response; you are so restless within that the situation is just an excuse to be active… Action is moment to moment, spontaneous; activity is loaded with the past. It is not a response to the present moment, rather, it is pouring your restlessness, which you have been carrying from the past, into the present. Action is creative. Activity is very destructive — it destroys you, it destroys others.

Exactly! Eating in response to healthy hunger is action. Eating to alleviate tension, to placate the restlessness that infests and infects you is just what the term “displacement activity” implies: Activity rather than action. Not the same thing. Osho gives this example of the distinction between the two:

You are hungry, then you eat — this is action. But you are not hungry, you don’t feel any hunger at all, and still you go on eating — this is activity. This eating is a kind of violence: you destroy food, you crush your teeth together and destroy food; it gives you a little release of your inner restlessness. You are eating not because of hunger, you are simply eating because of an inner need, an urge to be violent.

Your responses and feedback are welcome!

Source: “Stress Contributes to Childhood Obesity,” PsychCentral, 05/15/09
Source: “Why Do Kids Overeat?” (PDF), Weigh2Rock, 07/10
Source: “Action vs. Activity,” ParaTheatrical ReSearch
Image by Salim Virji, used under its Creative Commons license.

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Profiles: Kids Struggling with Weight

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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.

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