- Meeting abstract
- Open Access
Future directions in prevention and treatment of children obesity and eating disorders
Italian Journal of Pediatrics volume 41, Article number: A72 (2015)
The childhood obesity epidemic has promoted many healthcare programs focused on nutritional education in order to teach correct nutrition and to promote early diagnosis and care of overweight/obese children including offering them a correct food supply.
For almost 20 years, however, scientific literature has pointed out that eating disorders (ED), which typically onset during adolescence, are increasing, and that dieting (restrictive behaviors, adopted today by many adults and adolescents, mostly managed without the support of a professional format, to match the ideal of thinness proposed by the media and being or feeling overweight are likely to be the most avoidable facilitating factors [1–4].
Body stigma, shared by those with obesity and ED  and based on the attribution of a strong personal responsibility in the onset of these diseases, has been shown to increase stress, blood pressure, cortisol, oxidative stress, C-reactive protein and worse glycemic control, while decreasing motivation for physical activity (PA) encouraging a sedentary lifestyle. Stigma also increases psychosocial issues, such as depression, body-image distortion, loss of oral control and affects motivation and effectiveness of treatments.
Primary care staff are increasingly asked to promote parents awareness on their children being overweight although this has been recognized as a trigger for the onset of an ED , but at the same time they are not provided with adequate means to run a truly effective therapeutic program (strategies to promote change, such as the patient-centered motivational interview) and the suffering related to family and professional weight-derision.
Children are then pushed to see themselves as fat, to dislike themselves and go on a diet, focusing dangerously on food, body and weight and with the result of being bullied in many life contexts such as home, school, medical services. All this leads to dysfunctional eating patterns, loss of control and increased BMI. It has been reported that obesity is the strongest predictive factor to the onset of an ED . The pervasive and universal body and weight-stigma enhances restrictive behavior and creates a vicious circle that leads to a real ED epidemic among young adults . It's time to think about obesity prevention and treatment in a different way (Tables 1 and 2), getting to know EDs [8, 9] and using tools that do not favor them, protecting children against weight-stigma, especially ones coming from parents, educators and health workers .
Field AE, Austin SB, Taylor CB, Malspeis S, Rosner B, Rockett HR, et al: Relation between dieting and weight change among preadolescents and adolescents. Pediatrics. 2003, 112 (4): 900-906. 10.1542/peds.112.4.900.
Neumark-Sztainer D, Wall M, Story M, Standish AR: Dieting and unhealthy weight control behaviors during adolescence: associations with 10-year changes in body mass index. J Adolesc Health. 2012, 50 (1): 80-86. 10.1016/j.jadohealth.2011.05.010.
Finistrella V, Manco M, Corciulo N, Sances B, Di Pietro M, Di Gregorio R, et al: Eating Disorders and Psychopathological Traits in Obese Preadolescents and Adolescents. J Am Coll Nutr. 2015, 9 (2): 1-8.
Patton GC, Selzer R, Coffey C, Carlin JB, Wolfe R: Onset of adolescent eating disorders: population based cohort study over 3 years. BMJ. 1990, 318 (7186): 765-768.
Puhl R, Suh Y: Stigma and eating and weight disorders. Curr Psychiatry Rep. 2015, 17 (3): 552-
Allen KL, Byrne SM, Forbes D, Oddy WH: Risk factors for full- and partial-syndrome early adolescent eating disorders: a population-based pregnancy cohort study. J Am Acad Child Adolesc Psychiatry. 2009, 48 (8): 800-809. 10.1097/CHI.0b013e3181a8136d.
Sim LA, Lebow J, Billings M: Eating disorders in adolescents with a history of obesity. Pediatrics. 2013, 132 (4): e1026-e1030. 10.1542/peds.2012-3940.
Griffiths S, Mond JM, Murray SB, Touyz S: The prevalence and adverse associations of stigmatization in people with eating disorders. Int J Eat Disord. 2004, doi: 10.1002/eat.22353
De Luca G, Tanas R, Ruggiero F, Chiavetta S, Sicoli C, De Luca F, et al: La pediatria di famiglia ed i disturbi del comportamento alimentare nelle prime fasi dell'adolescenza. Rivista Italiana di Medicina dell'Adolescenza. 2013, 11 (): 5-9.
Marucci S: Buone pratiche di cura nei disturbi del comportamento alimentare: verso le linee guida. Rivista Italiana di Medicina dell'Adolescenza. 2013, 11 (): 35-40.
Dietz WH, Baur LA, Hall K, Puhl RM, Taveras EM, Uauy R, et al: Management of obesity: improvement of health-care training and systems for prevention and care. Lancet. 2015, 385 (9986): 2521-2533. 10.1016/S0140-6736(14)61748-7.
Golan M, Hagay N, Tamir S: The effect of “in favor of myself”: preventive program to enhance positive self and body image among adolescents. PLoS One. 2013, 8 (11): e78223-10.1371/journal.pone.0078223.
Lobstein T, Jackson-Leach R, Moodie ML, Hall KD, Gortmaker SL, Swinburn BA, et al: Child and adolescent obesity: part of a bigger picture. Lancet. 2015, 385 (9986): 2510-2520. 10.1016/S0140-6736(14)61746-3.
Puhl RM, Neumark-Sztainer D, Austin SB, Luedicke J, King KM: Setting policy priorities to address eating disorders and weight stigma: views from the field of eating disorders and the US general public. BMC Public Health. 2014, 14: 524-10.1186/1471-2458-14-524.
About this article
Cite this article
Tanas, R., Caggese, G. & Marucci, S. Future directions in prevention and treatment of children obesity and eating disorders. Ital J Pediatr 41, A72 (2015). https://doi.org/10.1186/1824-7288-41-S2-A72
- Eating Disorder
- Eating Disorder
- Child Obesity
- Obesity Prevention