Health and Quality of Life Are Inseparable


Yesterday Childhood Obesity News looked at information indicating that when teenagers lose weight, their QOL (Quality of Life) scores rise. For a lot of teens, both obesity and depression are persistent coexisting conditions, although one or the other might arise first. An obese adolescence is worse for boys. Or maybe it’s worse for girls.

“Results are inconsistent,” says the report “Obesity and Mental Health” issued by Britain’s National Obesity Observatory, and that much seems obvious. Some studies show that overweight children and adolescents have low self-esteem and a poor self-image. Others, not so much. In regard to severely obese children treated in clinical settings, their health-related Quality of Life scores are similar to those of children receiving cancer treatment. There is much concern over the relation between obesity and depression, and between obesity and a low QOL. On the other hand:

Literature reviews have concluded that in spite of adverse social and interpersonal consequences, obese children may only have moderate levels of body dissatisfaction and few are depressed or have low self esteem.

So, not all obese teenagers are depressed. But don’t they all have mental health issues? Because if there isn’t some kind of emotional or psychological problem, why are they obese, and why don’t they do something about it?

In NOO’s summation, “The health-related quality of life of severely obese children treated in clinical settings has been reported to be particularly poor.” What part of Quality of Life would not count as being health-related? For a 300-pound teenager, wouldn’t the morbid obesity issue affect every facet of his or her Quality of Life? Let’s look at the different areas and aspects covered by QOL testing, as described by the NOO.

Behavioral: lower levels of physical activity, lower perceived athletic competence, unhealthy diets and loss of control in eating”
If a mental health disorder is the cause of the obesity, it can manifest here as a lack of energy to exercise. All the things mentioned here are definitely health-related.

Biological: disruption of hormonal pathways”
The hormones run everything in the body and the brain. When obesity triggers abnormal hormonal secretion, all kinds of things can go wrong. If the obesity began because of a mental health disorder, there can be medication side effects, with interior chemical changes.

Psychological: low self-esteem, body dissatisfaction, perception of being overweight”
Being a fat kid can really mess up a person’s head. Combined with a mental health disorder, obesity can include what the NOO calls “low expectations of weight loss attempts.” The patient’s attitude is defeatist — “I can’t do this. It’s too hard. I’ve got too much else on my mind. It will take too long. It’s no use. People won’t feel differently about me if I’m thinner anyway. And if they do treat me different just because I’m thinner, they are shallow morons that I don’t want to associate with.” Every therapist and counselor has heard an abundance of this kind of talk.

Social: stigma, social rejection and weight-based teasing”
If a mental health disorder is present, perhaps caused or exacerbated by a stressful family situation, the difficulty increases. Young children are pretty much stuck with the parents they have, no matter how enabling, sabotaging, cruel or coercive those folks might be in regard to weight problems. Teenagers have so many other issues to cope with that an obese adolescence is sometimes the least of their worries. A child wounded by teasing in school might wind up 10 years later trapped in a horrible marriage but unwilling to leave, because as a fat teenager they were lucky enough to find one partner, but as a fat grownup they might never find another.

There is no possible area of life whose quality remains unaffected by obesity. The confusing landscape encompasses obesity caused by depression, and depression caused by obesity, and is a fertile breeding ground for vicious cycles of all kinds. For anybody, and especially for an obese child or teen, physical health must be inextricably bound up with Quality of Life.

Your responses and feedback are welcome!

Source: “Obesity and mental health – National Obesity Observatory,” National Obesity Observatory, March 2011
Image by Keirsten Balukas


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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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