Psychological Effects of Tween Obesity

Childhood obesity, which impacts 13.9% of two to 5-year-olds, 18.4% of 6 to 11 year olds, and 20.6% of 12 to 19 year olds, can result in a number of psychological issues. Weight issues can be particularly difficult during the tween years due to the unique social atmosphere this age group faces.

Here's what parents should know about the psychological effects of childhood obesity, so that they may help their child deal with challenges and other related problems.

Self-Esteem Issues

Childhood obesity is more than a physical problem. Tweens tend to be hyper-aware of how they compare to others, which makes them self-conscious and feeling alone. Many of these social comparisons hinge on superficial features, such as clothing choice, facial attractiveness and, yes, weight. As a result, a tween with obesity may feel out of place among their slimmer peers.

Perhaps not surprisingly, researchers have found lower levels of self-esteem in children and tweens with obesity compared to their average-weight peers. One team of researchers found that 9- to 12-year-olds with obesity had self-esteem issues that went far beyond physical self-worth. In other words, tweens with obesity tended to be unhappy with themselves in various ways—including socially—not just unhappy with their appearance.

Higher Levels of Depression

The middle school years are difficult years even under the best of circumstances, but more so for children with weight issues. In addition to making many social comparisons with their peers, tweens tend to fixate on how other people react to them.

Peers play an increasingly important role in a tween’s life, so positive social interactions are key to a tweens’ psychological well-being. As a result, higher levels of depression have been found in children and tweens with obesity.

Increased Behavioral Problems

Almost all tweens will act out at some point or another, but parents of tweens with obesity have reported more behavior problems in their tweens with obesity compared to parents of tweens of average weight.

Internalizing and Externalizing

In particular, parents noted that their obese children had more "internalizing" problems (problems in which anger is directed inward), which may manifest as depression, anxiety, or eating disorders. They also had “externalizing" problems (problems in which anger is directed outward), such as aggression, defiance, and backtalk.

School Performance and Friendships

The parents also rated their obese tweens as being less competent in school and in social settings, putting their academic success and friendships at risk. Being held back a grade, lower test scores, and not going onto college have been linked to students with obesity, especially in female students. 

Higher Risk of Eating Disorders

Obesity is a risk factor for eating disorders, including binge-eating disorder, anorexia nervosa, and bulimia nervosa. This risk is partly attributed to efforts to lose weight, which can easily lead to unhealthy behaviors like restricting eating or exercising vigorously. What's more, if an obese child is teased by peers about their weight, it can make them more vulnerable to binge eating. Low self-esteem and low self-efficacy, which are common in obese children, are also risk factors for eating disorders.

How Parents Play a Role

Parent perception may play a role in these findings, however, since those who sought treatment reported more behavior problems than those who did not seek treatment. In other words, it might be that the parents who saw obesity as a problem needing treatment were more likely to associate other behaviors as problematic as well; whereas those who didn’t seek treatment may not have seen obesity or other behaviors as problems at all.

All in all, obesity may result in a number of psychological issues during the tween years. Therefore, taking steps to remedy the issue through changes in nutrition and physical activity can have important physical and psychological benefits. If you think your child is suffering because of a weight-related issue, contacting your child's pediatrician is a natural first step to getting your child the help they need.