CHILD OBESITY

Child Obesity

Child Obesity

Introduction

There is an extensive body of literature and research examining the personality and psychological characteristics of obese individuals. Empirical findings have associated personality characteristics of the obese with dependency, passivity, low assertiveness, self-consciousness, and low self-esteem. Investigators have consistently proposed that obese people have higher degrees of depression and overwhelming internal anxiety states than nonobese individuals. In addition, several studies have reported that obese people have a tendency to develop somatic disorders and neurotic habits leading to maladjustment.

Despite this interest in the etiology and phenomenology of obesity, little has been reported examining the effect of early onset obesity on adult psychopathology. In the extant literature, there exists no agreement on the relationship between early onset obesity and later psychological functioning. Although some researchers suggest that patients with a history of childhood obesity experience greater problems in maintaining weight loss as adults (Krotkiewski et al., 1977), others refute this claim (Jeffery, Wing, & Stunkard, 1978; Linet & Metzler, 1981; Wing, Marcus, Epstein, & Kupfer, 1983). Patients with early onset obesity have been reported to experience greater body image disturbance than individuals with late onset obesity (Stunkard & Burt, 1967), although Faubel (1989) argued that there is no difference between depression and body image disturbance in individuals who became obese early or later in life.

Despite the paucity of research examining the relationship between childhood onset obesity and psychological adjustment later in life, one would surmise that early onset obesity would correlate with more psychopathology in adulthood. Genender et al. (1982) reported that patients who developed obesity during adolescence were heavier than patients who reported childhood onset obesity. And Jeffery et al. (1978) stated that individuals with juvenile onset obesity were less overweight than those with late onset obesity. Overall, most empirical investigations have found no substantial differences between childhood and adult onset obesity (Wing, Nowalk, Epstein, Scott, & Ewing, 1985).

This study was different because it examined the relationship between the age of onset of obesity and psychiatric symptomatology in an obese adult population. Because of the chronic and insidious psychological impact of obesity on personality formation and adjustment (Mills, 1992), we hypothesized that individuals with childhood onset obesity in the present study would show greater levels of psychopathology than patients with adolescent or adult onset obesity.

Method

The SCL-90-R was administered to a sample of 37 obese subjects (27 women and 10 men) in outpatient treatment for obesity. The SCL-90-R is a 90-item self-report symptom inventory developed by Derogatis (1975) and designed primarily to determine psychological symptom patterns of psychiatric and medical patients. The instrument is composed of 10 clinical scales and 3 global symptom indices measuring levels of somatization, depression, anxiety, obsessive-compulsiveness, hostility, interpersonal sensitivity, phobic anxiety, paranoid ideation, and psychoticism.

Subjects were recruited from a university-affiliated outpatient eating disorders clinic where they received multidisciplinary treatment including dietary, medical, behavioral, and psychological interventions. Subjects were diagnosed using clinical standards for obesity. The obese subjects ranged in excess weight from 25 to 365 pounds over their ideal body weight according ...