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Article of Interest - Behavior Issues

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Bridges4Kids LogoBehavior Problems Feed Childhood Obesity
Study finds overweight kids twice as likely to misbehave.
by Steven Reinberg, HealthDay News, November 3, 2003
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If your child is antisocial, anxious, dependent, depressed, headstrong, hyperactive or withdrawn, the likelihood of his or her becoming obese is greatly increased, a new study says.

"We found that children who are overweight are twice as likely to have behavioral problems compared with children who don't have behavioral problems," says study author Dr. Julie Lumeng, a researcher investigator at the University of Michigan.

Most obese children do not have behavior problems, Lumeng says. But behavior problems seem to be one cause of obesity, she adds.

The research team was curious if behavior problems start before children become overweight, and if they contribute to becoming overweight. "We found that normal weight children who have significant behavior problems are five times more likely to become overweight over the following two years," Lumeng says.

In their study, reported in the November issue of Pediatrics, Lumeng's team collected data on 755 children, aged 8 to 11. The parents of these children completed a questionnaire that asked about their child's behavior.

"The mind and the body are so interrelated that you cannot ignore a child's mental health," Lumeng says. "If we as a country are trying to stem the tide of obesity in children, we really have to look at the root of what is triggering children's behavior leading to obesity."

Lumeng believes that to lessen the chance of becoming obese, behavior problems need to be recognized and treated.

Lumeng says the reasons why behavior problems lead to obesity remain unknown. "It could be that these children don't go outside and play as much as other children, or maybe they spend too much time watching TV, or maybe they are using food to make themselves feel happier."

Parents who have a child who shows significant behavior problems should see their pediatrician and get the child into therapy, Lumeng advises.

Pediatricians need to investigate the behavior problems of their normal weight patients and get them help. They also need to be aware of behavioral problems among their patients who are already obese, she adds.

One of the goals in dealing with behavior problems is to prevent children from becoming overweight, Lumeng notes. "If you can treat the behavior problems, hopefully, you can prevent the progression to obesity."

Lumeng says the epidemic of obesity in the United States, of which the child with behavior problems is a small piece, is a result of the ever-increasing ease that has become a hallmark of society.

In addition, she says food in restaurants is being super-sized and food is so much more accessible. "These are the reasons that the average American child is becoming obese today," she says.

David Katz, an associate clinical professor of public health at Yale University, comments that "it comes as no great surprise that behavioral problems in childhood increase the risk of weight gain over time and obesity."

"Restrained eating in our 'toxic' nutritional environment is difficult for all and it's much more difficult for those with emotional and behavioral difficulties," he adds.

Katz agrees with Lumeng that physical activity is likely to suffer in children with significant emotional and behavioral problems who cannot "simply go out to play with friends."

In addition, he notes American parents have difficulty cultivating healthful eating habits in even the most emotionally balanced children. Children with emotional and behavioral problems are much more of a challenge, Katz adds.

"While this research is valid and interesting, its importance should not be over-interpreted," Katz says. "The critical message of our day is that all children are at increasing risk of obesity. Currently, nearly 80 percent of adults are overweight, and the rates of childhood obesity are rising rapidly."

If something is not done, there will be a generation of adults in whom the prevalence of obesity is nearly 100 percent, he says. "This is the big picture, the crisis at hand, and the take-away message for anyone concerned about childhood obesity."

More information

To learn more about obesity in children, visit the American Obesity Association and the U.S. Centers for Disease Control and Prevention.

SOURCES: Julie Lumeng, M.D., research investigator, Center for Human Growth and Development, University of Michigan, Ann Arbor; David Katz, M.D., M.P.H., associate clinical professor, public health, Yale University, New Haven, Conn.; November 2003 Pediatrics


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