it’s easy to become desensitized to the statistics. But the shocking
It’s clear that obesity is an intricate, obstinate problem. But
figures can’t be ignored: Since 1980, the prevalence of obesity
multiple causes also means there are many angles from which
among kids and adolescents in the United States has tripled,
behavioral health experts can make a mark in fighting the
according to the Centers for Disease Control and Prevention
epidemic. “Obesity is now the second leading cause of death
(CDC). Estimates from the National Health and Nutrition
in the U.S. and is expected to beat out smoking to become the
Examination Survey (NHANES) show that 31. 7 percent of U.S.
leading cause. It’s a health-behavioral problem that’s going
children and teens were either overweight or obese in 2008.
to bankrupt the country,” says 2012 APA President Suzanne
Among low-income families and certain ethnic groups such as
Bennett Johnson, PhD, who made fighting obesity one of the
Hispanic boys and black girls, the rates are even higher.
central themes of her presidency. “We’re not going to solve this
The harms of extra pounds are well documented. Obese
problem if people are passive.”
children are more likely to have high blood pressure, high
cholesterol, breathing problems such as asthma and apnea,
fatty liver disease and type- 2 diabetes, which historically only
One obvious place for psychologists to focus their efforts is in
affected older, overweight adults.
the home. “It all starts with the family,” says Leonard Epstein,
The repercussions of excess weight extend to the brain,
PhD, chief of the Division of Behavioral Medicine at the
too. Last fall, Po Lai Yau, PhD, and colleagues at New York
University at Buffalo.
University’s School of Medicine reported that in adolescents,
In studies over 30 years, Epstein has found that the most
obesity and metabolic syndrome (the set of obesity-related
successful ways to help kids shed pounds are interventions
factors that increase the risk for coronary artery disease, stroke
that combine diet, physical activity and behavioral
and diabetes) are linked to changes in brain structure as well
recommendations. In an analysis of more than a dozen studies,
as impairments in learning and
attention span (Pediatrics, 2012).
Obese kids and teens are also
more likely to have social and
psychological problems, such as
depression, and are at increased
risk of bullying and poor self-esteem.
The causes of obesity are
just as complex as its ill effects.
Think back to the “ecological
model” of child development
that’s a staple of Psych 101, says
Maureen Black, PhD, chief of
the Division of Growth and
Nutrition at the University of
Maryland School of Medicine.
The model is depicted as a
series of concentric circles. The
small central circle represents
the child. Moving outward, the
circles represent ever-broader
influences on that child’s
development: the family, the
neighborhood, the school, the
community, the society at large.
“That’s a perfect metaphor
Video: Dr. Brian Wansink is
working with schools to design
lunchrooms that encourage kids
Epstein, along with Denise
Wilfley, PhD, director of the
Weight Management and
Eating Disorders Program at
Washington University in St.
Louis, and colleagues concluded
that such lifestyle-based
interventions lead to meaningful
long-term weight loss in kids
(Health Psychology, 2007).
The shape of those
interventions isn’t always
intuitive, however. That’s why
solid research is so important.
For example, most obesity
treatments focus on what people
shouldn’t eat, Epstein says. But
he has discovered that kids lose
more weight when behavioral
treatments focus on increasing
fruits and vegetables, rather
than avoiding high-calorie foods
The most effective lifestyle
interventions are those that
target both parents and children
simultaneously. “Obese kids live
for obesity,” Black says. Focusing
exclusively on individual
children is blaming the victim,
she adds. Kids are getting
walloped at every level with cues
to eat more healthily. Learn more
about his Smarter Lunchrooms
in families with obese parents,
and kids model their parents’
behaviors,” Epstein says. Helping
parents and children modify
those behaviors as a family leads