Obesity in Adolescence
This chapter reviews research addressing obesity during adolescence. Epidemiologic findings indicate that obesity has increased dramatically in adolescents during the past several decades so that currently approximately one-third of adolescents in the United States are overweight, with about 17 % considered obese. Rates of obesity are greater among youth from ethnic minority and lower-income families. Overweight adolescents have a high likelihood of remaining overweight as adults. Etiologic factors indicate the important role of hereditary, early growth, and environmental factors, with behavioral factors of excessive caloric intake and decreased energy expenditure resulting in positive energy balance and increased adiposity over time. Review of the correlates of obesity reveals that adolescents have increased risk for several physical health disorders, including high blood pressure, high cholesterol, metabolic syndrome, type 2 diabetes, orthopedic problems, sleep apnea, asthma, and fatty liver disease. Psychosocial correlates of obesity in adolescents include increased risk for problems related to body image problems, self-esteem, social isolation and discrimination, depression, and reduced quality of life. Research on interventions for obesity in adolescents reveals the challenges of weight control over time; however there is some support for the efficacy of behavioral interventions targeting reduced caloric intake, increased physical activity, and reduced sedentary behavior. Medical interventions including pharmacological and surgical approaches have shown some efficacy, but more research is needed to demonstrate their safety and acceptability, as well as long-term effects. In recent years, Internet-delivered behavioral interventions have shown some promise and these approaches will likely be needed in order to more effectively reach the population of overweight adolescents. Given the tremendous challenge in successfully treating obesity during adolescence, and the costs of its continuation into adulthood, a public health approach is needed to address the environmental factors that are responsible for the increased incidence of obesity in youth.
KeywordsPlacebo Cholesterol Sugar Obesity Depression
- Allison, D. B., Matz, P. E., Pietrobelli, A., Zannolli, R., & Faith, M. S. (1999). Genetic and environmental influences on obesity. In A. Bendich & R. J. Deckelbaum (Eds.), Primary and secondary preventive nutrition (pp. 147–164). Totowa, NJ: Humana Press.Google Scholar
- Bell, P., Redd, P., & Rainie, L. (2004). Rural areas and the internet. Washington, DC: Pew Internet and American Life Project.Google Scholar
- Britz, B., Siegfried, W., Ziegler, A., Lamertz, C., Herpertz-Dahlmann, B. M., Remschmidt, H., et al. (2000). Rates of psychiatric disorders in a clinical study group of adolescents with extreme obesity and in obese adolescents ascertained via a population based study. International Journal of Obesity, 24, 1707–1714.PubMedCrossRefGoogle Scholar
- CDC. (2009a). Overweight and obesity. Retrieved January 31, 2011, from http://www.cdc.gov/obesity/defining.html.
- CDC. (2009b). Overweight and obesity. Retrieved January 31, 2011, from http://www.cdc.gov/obesity/causes/health.html.
- CDC. (2011). Basics about childhood obesity. Retrieved from http://www.cdc.gov/obesity/childhood/basics.html.
- Doak, C. M., Visscher, T. L., Renders, C. M., & Seideil, J. C. (2006). The prevention of overweight and obesity in children and adolescents: A review of interventions and programmes. International Life Sciences Institute Obesity Reviews, 7(111–136), 2006.Google Scholar
- Eaton, D., Kann, L., Kinchen, S., Shanklin, S., Ross, J., Hawkins, J., et al. (2008). Youth risk behavior surveillance—United States, 2007. MMWR Surveillance Summaries, 57(4), 1–131.Google Scholar
- Fontaine, K. R., & Allison, D. B. (2002). Obesity and the internet. In C. Gairburn & K. Brownell (Eds.), Eating disorders and obesity (2nd ed.). New York: Guilford Press.Google Scholar
- Fox S. (2005). Digital divisions. Washington, DC: Pew Internet, October 5.Google Scholar
- French, S. A., Story, M., Neumark-Sztainer, D., Faulkerson, J. A., & Hannan, P. (2001). Fast food restaurant use among adolescents: Associations with nutrient intake, food choices and behavioral and psychosocial variables. Division of Epidemiology, 25, 1823–1833.Google Scholar
- Garcia-Morales, L. M., Berber, A., Macias-Lara, C. C., Lucio-Ortiz, C., Del Rio-Navarro, B. E., & Dorantes-Alvarez, L. M. (2006). Use of sibutramine in obese Mexican adolescents: A 6-month, randomized, double-blind, placebo-controlled, parallel-group trial. Clinical Therapeutics, 28, 770–782.PubMedCrossRefGoogle Scholar
- Kamath, C. C., Vickers, K. S., Ehrlich, A., McGovern, L., Johnson, J., Singhal, V., et al. (2008). Behavioral Interventions to prevent childhood obesity: A systematic review and meta-analyses of randomized trials. The Journal of Clinical Endocrinology and Metabolism, 93, 4606–4615.PubMedCrossRefGoogle Scholar
- Kantor, L. S. (1999). A comparison of the US food supply with the Food Guide Pyramid recommendations. In E. Frazo (Ed.), America’s eating habits: Changes and consequences (pp. 71–95). Washington, DC: USDA/Economic Research Division.Google Scholar
- Lin, B. H., Guthrie, J., & Blaylock, J. R. (1996). The diets of America’s children: Influence of dining out, household characteristics, and nutrition knowledge. Washington, DC: U.S. Department of Agriculture, Economic Research Service, No. AER746.Google Scholar
- Lin, B. H., Guthrie, J., & Frazao, E. (1999a). Away-from-home foods increasingly important to quality of American diet. Washington, DC: U.S. Department of Agriculture, Economic Research Service, Agricultural Bulletin No. 791.Google Scholar
- Lin, B. H., Guthrie, J., & Frazao, E. (1999b). Nutrient contribution of food away from home. Washington, DC: U.S. Department of Agriculture, Economic Research Service, Agricultural Bulletin Number 750.Google Scholar
- Meyer, J. M., & Stunkard, A. J. (1993). Genetics and human obesity. In A. J. Stunkard & T. A. Wadden (Eds.), Obesity: Theory and therapy (2nd ed., pp. 137–149). New York: Raven Press.Google Scholar
- Miller, J., Gold, M. S., & Silverstein, J. (2003). Pediatric overeating and obesity: An epidemic. Psychiatric Annals, 33(2), 94–103.Google Scholar
- Murray, E., Burns, J., See Tai, S., Lai, R., & Nazareth, I. (2009). Interactive health communication applications for people with chronic disease. The Cochrane Library, 1. http://www.thecochranelibrary.com.
- Ornelas, I. J., Perreira, K., & Ayala, G. X. (2007). Parental influences on adolescent physical activity: A longitudinal study. International Journal of Behavioral Nutrition and Physical Activity, 4(3).Google Scholar
- Patrick, K., Sallis, J. F., Prochaska, J. J., Lydston, D. D., Calfas, K. J., Zabinski, M. F., et al. (2001). A multicomponent program for nutrition and physical activity change in primary care. Pediatric and Adolescent Medicine, 155, 940–946.Google Scholar
- Putnam, J., & Gerrior, S. (1999). Trends in the US food supply, 1970–1997. In E. Frazo (Ed.), America’s eating habits: Changes and consequences (pp. 133–160). Washington, DC: USDA/Economic Research Division.Google Scholar
- Saperstein, S. L., Atkinson, N. L., & Gold, R. S. (2007). The impact of Internet use for weight loss. Obesity Research, 8(459–465), 2007.Google Scholar
- Srinivasan, S., Ambler, G. R., Baur, L. A., Garnett, S. P., Tepsa, M., Yap, F., et al. (2006). Randomized, controlled trial of metformin for obesity and insulin resistance in children and adolescents: Improvement in body composition and fasting insulin. The Journal of Clinical Endocrinology and Metabolism, 91, 2074–2080.PubMedCrossRefGoogle Scholar
- Stallings, V. A., Archibald, E. H., Pencharz, P. B., Harrison, J. E., & Bell, L. E. (1988). One-year follow-up of weight, total body potassium, and total body nitrogen in overweight adolescents treated with the protein-sparing modified fast. The American Journal of Clinical Nutrition, 48, 91–94.PubMedGoogle Scholar
- Steele, R. G., Aylward, B., Jensen, C. D., Cushing, C. C., Davis, A. M., & Bovaird, J. A. (2012). Comparison of a family-based group intervention for youths with obesity to a brief individual family intervention: a practical clinical trial of Positively Fit. Journal of Pediatric Psychology, 37, 53–63.Google Scholar
- Tippett, K. S. & Cleveland, L. E. (1999). How current diets stack up: Comparison with dietary guidelines. In E. Frazao (Eds.), America’s Eating Habits: Changes and Consequences (pp. 51–70). ERS Agriculture Information Bulletin No. 750. Washington, DC: US Department of Agriculture.Google Scholar
- Tuffrey, C., & Finlay, F. (2002). Use of the internet by parents of paediatric outpatients. Archives Disease Children, 87(534–536), 2002.Google Scholar
- Wardle, J., Volz, C., & Golding, C. (1995). Social variation in attitudes to obesity in children. International Journal of Obesity Related Metabolism Disorders, 19, 562–569.Google Scholar
- Winett, R. A., Roodman, A. A., Winett, S. G., Bajzek, W., Rovniak, L. S., & Whiteley, J. A. (1999). The effects of Eat4Life internet-based health behavior program on the nutrition and activity practices of high school girls. Journal of Gender, Culture, & Health, 4, 239–254.PubMedCrossRefGoogle Scholar