Childhood Obesity in Taiwan

Taiwan 2011

The first thing to know is that “ED” stands for Emotional Disturbances, and the second thing is that there is a standardized test called the SAED, which stands for Scale for Assessing Emotional Disturbance. Researchers from Australia’s Monash University collaborated with teams from three Taiwanese medical and educational institutions to study more than 2000 Taiwanese kids whose ages ranged from 6 to 13 years. This test was the tool used to measure their emotional vulnerability.

The question on the researchers’ agenda was whether children and young teens who are obese are more at risk for developing psychological problems than normal-weight kids. They also wanted to know how gender plays into this. The larger concern is how to make sure that kids are able to do their best in school, because academic performance is vitally important, and emotional difficulties often manifest as behavioral difficulties at school.

Study co-author Emeritus Professor Mark Wahlqvist stated the problem in these terms:

Childhood obesity has been associated with psychological problems, but little is known about its association with ED in the educational setting, especially by gender. Knowledge of how emotional disturbance and obesity might be linked is currently limited, especially in Asia where child obesity is on the rise; and where societal and parental focus is often intense in regard to schooling; frequently with gender favoritism.

In the cultural milieu of Taiwan, the inability to learn is regarded as a much more serious handicap than it might be in some other countries. Preparation for a productive adulthood is all-important, and inappropriate classroom behavior is seen as a great liability. Emotional disturbance that manifests as depression, and as difficulty in getting along with others, interferes with education in an unacceptable way.

No surprise here

Not surprisingly, the study concluded that obese kids are indeed at higher risk of having psychological problems. Of the children tested who were deemed to have emotional disorders, more were obese than normal weight. Almost 17% of the boys were obese, against nearly 12% of the girls, and those ratios were found to stay pretty constant up through the age groups. But the likelihood of emotional disturbance increases with age.

Almost a quarter of the obese children had relationship problems, whereas the relationship difficulties of the merely overweight children were just a fraction of a percent higher than the normal-weight children. The boys were more likely to have what the study defined as relationship problems, while the girls were more likely to display what the study called “inappropriate behavior” in school.

East and West

It would be interesting to compare results of the same test given to the same number of children from, for instance, California. The Taiwanese traditions and expectations for behavior, as applied to girls, might be so different as to render the conclusions meaningless. But the big picture is more significant than any quibbling about gender issues. The overall message of this study and others like it is that obesity and emotional problems are often closely associated, and the researchers determined that interactions between body composition and emotions in the developing years are “extensive and complex.”

If emotional difficulties cause obesity, grownups need to do whatever they can to make sure that children are psychologically healthy — not just so they don’t get fat, but because they can learn better, and because psychological health is generally preferable for a whole galaxy of reasons.

If obesity causes emotional difficulties, grownups need to do what they can to make sure that kids are physically healthy and within their normal weight ranges. They need help to avoid the stress of coping with obesity in addition to the burdens of academic work and career preparation. No matter where on the globe children grow up, everyone wants to see them develop into productive members of society.

Your responses and feedback are welcome!

Source: “Childhood obesity linked to emotional issues,” MedicalXpress, August 2013
Image by Luca Rossi.

Leave a Reply

Your email address will not be published. Required fields are marked *

FAQs and Media Requests: Click here…

Profiles: Kids Struggling with Weight

Profiles: Kids Struggling with Obesity top bottom

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