Childhood Obesity: The Impact of Stress on Growing Children

Childhood obesity has become a growing health concern with the potential to significantly increase mortality and reduce life expectancy in the United States

The link between childhood obesity and the associated risk of poor health affects not only the physical condition, but also psychological outcomes for children and teens (Parks et al., 2012). Childhood obesity rates have climbed to 17 percent (National Institutes of Health, 2016). During the 1960’s, only 5 to 7 percent of children were considered obese; but in just 3 decades, childhood obesity numbers have more than doubled in U.S. Children and tripled in adolescents and teens (Sanyaolu et al., 2019 as cited in Hales, Carroll, Fryar & Ogden, 2015-2016). It is important to understand that not every child with additional weight is considered at risk for obesity. Many children grow at different rates with varying body type and weight. To better understand issues related to childhood obesity, we must first examine how obesity is determined. Growth Charts developed by the Centers for Disease Control (CDC) are used to indicate Body Mass Index (BMI). The BMI correlates to the composition of the body and age in children; this is different than how BMI is determined in adults (CDC 2021). Additionally, in children and teens, BMI is divided into sex-specific categories. It should be noted, however, BMI measurements do not indicate an overall picture of health. BMI measurements are used as a screening tool to indicate potential risks for further consideration by individuals and healthcare providers (CDC 2021). However, the CDC (2021) defines childhood obesity as having a Body Mass Index (BMI) at or above the 95th percentile for age.

Along with the physical implications of obesity such as diabetes, childhood obesity can be linked to problems with emotional and social well-being leading to poor self-esteem and depression. The biology of stress has been shown to influence stress regulation symptoms; children experiencing stress early in life are at risk for developing negative behavioral, cognitive, and social-emotional effects (Miller & Lumeng, 2018). The purpose of this paper is to describe how stress can cause and contribute to childhood obesity and discuss how Bronfenbrenner’s contextual theories can address ongoing stress factors within the family and the surrounding socioeconomic and sociocultural climate.

The causes of childhood obesity: Stress as a factor in ongoing childhood obesity.

Personal, family, and environmental stress can increase a child's risk of obesity. For this paper, psychosocial stress will be used as a broad term to encompass negative living conditions known to cause stress in children such as divorce, illness (mental or physical), abuse, and poverty primarily found within the family and surrounding community. For example, early stressful experiences in the home can include witnessing violence or trauma, maltreatment, and chaotic living environments (Miller & Lumeng, 2018). Additionally, children living in poverty and material deprivation has been associated with early life stress (Miller & Lumeng, 2018). Miller and Lumeng (2018) found childhood obesity was associated with childhood stress across populations. For these reasons, it is important to consider the psychosocial stressors encountered during the formative years of childhood and how these factors impact physical and emotional health. For example, some children use conventional coping mechanisms such as overeating to deal with strong emotions. Their parents might have similar tendencies, modeling behavior for their children. Parental behaviors influence eating and physical activity while also controlling limits on activities such as gaming (Miller & Lumeng, 2018). Additionally, poor communities with limited resources and access to healthy foods are more likely to purchase fast food, frozen meals, and convenience items. Add to this, the potential lack of safe spaces for physical activity contribute to ongoing community psychosocial stressors and increased childhood obesity risk. Longitudinal work with adolescence in the U.S. has shown that psychosocial stress, such as chronic poverty, is associated with increasing obesity (Miller & Lumeng, 2018). Recent studies in school-aged children with low income are associated with clinical biology stunting the sympathetic nervous system highlighting a correlation between psychosocial stressors and childhood obesity (Miller & Lumeng, 2018).

Preventing psychosocial stress: Bronfenbrenner’s microsystem and exosystem.

Urie Bronfenbrenner, an American psychologist, developed the Ecological Systems Theory. The theory explains how a child’s development is affected by a social environment. The ecological systems range from closer relationships, such as the family unit to expansive environments, such as American culture or society as whole. Bronfenbrenner’s microsystem is the smallest unit indicating a child’s immediate environment. This is most often the family, or people with which the child lives. This microsystem can be seen as the first line of defense in preventing childhood obesity.

The parents, or family unit, as the microsystem can contribute to more healthy habits to decrease stress and risk for obesity. We know parents provide both nature and nurture aspects of the childhood environment. According to Birch and Ventura (2009), dietary preferences are strongly influenced and established by caregivers early on. Wang and Veugelers (2012) agree that healthy eating and active living improves mental health and cognitive functioning in children at risk for obesity. Parents and caregivers can reduce the impact of psychosocial stress on weight gain through modeling behavior, providing healthy foods, and supporting physical activities. Addressing parental stress may assist in changing parental modeling behavior. Parental stress can affect child stress. According to Miller and Lumeng (2018), feeding styles in mothers with psychosocial stressors have been associated with childhood emotional eating and weight gain. By addressing parental stressors through therapeutic intervention, we can help families establish better strategies of management in healthy living.

The exosystem in Urie Bronfenbrenner’s Ecological Systems Theory is the second system that can provide a socio-cultural component to childhood obesity prevention. The exosystem is describes as 2 or more environmental settings that can be linked. This system may or may not contain the child and may operate and affect the child regardless. The exosystem can be seen as a larger system providing support, including financial and cultural, along with prevention messaging.

The exosysem may work to identify and recommend steps to assist the microsystem in the prevention of childhood obesity. Miller and Lumeng (2018) have identified that interventions targeting parental management strategies can be successful in treating childhood obesity. For example, helping parents engage in healthy practices through text and other technology driven support can help remind parents of healthy strategies (Miller and Lumeng, 2018). Additionally, continuing to address the issues of community poverty and safety through health education and policy has a significant potential to reduce the effects of psychosocial stressors for both parents and children at risk.

Childhood psychosocial stressors create and contribute to an environment that supports and perpetuates the increasing numbers of childhood obesity. From strained family relationships to parental divorce, illness, abuse and poverty, the well-being of children is being impacted by these psychosocial factors, significantly increasing risk for childhood obesity. The strong emotions associated with these stressors create an environment that increases poor eating habits, low activity levels and reduced well-being. Using Bronfenbrenner’s Ecological Systems Theory, both microsystem as family and ecosystem as socio-cultural influence can help reduce the risk of childhood obesity. Informing and adjusting family behavior along with broad educational programs can assist in reducing psychosocial stressors that create childhood obesity by informing better self-care practices and alleviating poor environmental conditions.

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References

Birch, L. L., & Ventura, A. K. (2009). Preventing childhood obesity: What works? International Journal of Obesity, 33(S1), S74–S81. https://doi.org/10.1038/ijo.2009.22

CDC. (2021, December 3). BMI for children and teens. Centers for Disease Control and Prevention. https://www.cdc.gov/obesity/basics/childhood-defining.html

Miller, A. L., & Lumeng, J. C. (2018). Pathways of association from stress to obesity in early childhood. Obesity, 26(7), 1117–1124. https://doi.org/10.1002/oby.22155

National Institutes of Health. (2016, December). What causes obesity & overweight? https://www.nichd.nih.gov/health/topics/obesity/conditioninfo/cause

Parks, E. P., Kumanyika, S., Moore, R. H., Stettler, N., Wrotniak, B. H., & Kazak, A. (2012). Influence of stress in parents on child obesity and related behaviors. Pediatrics, 130(5), e1096–e1104. https://doi.org/10.1542/peds.2012-0895

Sanyaolu, A., Okorie, C., Qi, X., Locke, J., & Rehman, S. (2019). Childhood and adolescent obesity in the United States: A public health concern. Global Pediatric Health, 6(6). https://doi.org/10.1177/2333794x19891305

Wang, F., & Veugelers, P. J. (2008). Self-esteem and cognitive development in the era of the childhood obesity epidemic. Obesity Reviews, 9(6), 615–623. https://doi.org/10.1111/j.1467-789x.2008.00507.x