Neglectful vs. Overly Involved

Man plucking bass guitar

Health professionals have to be very careful about assigning blame to parents. When treating an obese child, doctors and counselors can explain how the cooperation and support of the entire family are necessary. The thing they can’t say is that if the family were actually cooperative and supportive, it’s quite possible the problem wouldn’t exist in the first place. The sad truth is that environmental neglect (i.e., neglectful parent behavior) is strongly associated with childhood obesity. This is the message of a masters thesis titled “Development of the Posttraumatic Stress Symptoms — Childhood Obesity Model” by Kristi Wilsman of Western Kentucky University, which of course contains complete references.

Maltreatment of a child is likely to do long-lasting damage that can manifest in numerous ways, including neurobiological changes and physical and psychological symptoms that continue far into adulthood. Here is a short list: depression, anger, post-traumatic stress disorder, poor body image, low self-esteem, and eating disorders. Trauma is often linked with obesity, and with each adverse experience, Wilsman says, “the likelihood of negative outcomes increases dramatically.”

Poor academic performance is mentioned prominently, including the relatively low reading and math test scores earned by obese kids. As if that weren’t enough, other studies have shown that overweight and obese kids are more likely to be worried and stressed about things in general, and to feel tired, and even to be comparatively aggressive. Add to this the discrimination practiced against overweight children and it makes for a dismal school experience.

Negative coping skills

Inadequate nutrition and a sedentary lifestyle are associated with the inability to handle negative emotions and general stress. Eating disorders come under the heading of maladaptive coping strategies (comfort eating, napping, etc.) that bring short-term comfort but also long-term misery. Research done back in 1994 by I. Lissau and T.I. Sørensen indicated that neglected children are nine times as likely to become obese. Other research, namely the Adverse Childhood Experiences study, looked at occurrences of various kinds of abuse — psychological, physical, sexual — and found that

…adults who experienced four or more adverse experiences (such as psychological, sexual, or physical abuse) as a child had an increased chance of developing alcoholism, drug abuse, depression, physical inactivity, and severe obesity in early adulthood.

The ACE researchers took care to note that these behaviors are not so much lifestyle choices as lousy and misapplied coping skills. Just to put the icing on the cake, if the parents also have post-traumatic stress symptoms (which is very probable), they are unlikely to seek help for either their children or themselves.

The gift of passion

Previously, Childhood Obesity News talked about the opposite of neglect — the overly busy family that signs the kids up for everything. Perhaps part of their trouble is that parents choose too many of the activities. Sure, they may not want their kid growing up to be either a mechanic or a biker — but if he spends his teens tearing apart motorcycles instead of eating everything in sight, that’s a victory. Pacifist parents might hate the idea of hand-to-hand combat. But if a daughter wants to get into jiu-jitsu, why not go with the flow and be thankful that she is strong and fit, and hanging out with other strong, fit kids?

We also related the story of entertainer Paul Gilmartin, who was an alcoholic adult for many years before achieving sobriety. But Gilmartin is convinced that he was saved from earlier and equally serious trouble by his passion for the guitar. When he was a kid, playing music was the countervailing influence that kept him away from hard drugs.

Childhood is the time to offer a young person a buffet of activities to sample, without cramming any of them down her or his throat, because manufactured activities can do more harm than good. In her book Overwhelmed: Work, Love and Play When No One Has the Time, Brigid Schulte proposes that children prosper when they are intrinsically motivated. If a parent can be tolerant, there’s a good chance of avoiding trouble. A child with a genuine passion for something will probably not be lured by recreational eating or comfort eating, because inside there won’t be such a big empty hole to fill.

Your responses and feedback are welcome!

Source: “Development of the Posttraumatic Stress Symptoms — Childhood Obesity Model,”, August 2012
Image by Tim Weber

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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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