08/05/2010

Dear Patti,
I’m starting college next year and am working this summer at my first job as a counselor in a sleep-away camp for children and adolescents (ages 7 to 14) struggling with obesity. Our camp mostly focuses on exercise and teaching our kids about food choices. I know I’m young and I’m not trying to be a know-it-all or anything, but it seems like there are psychological reasons for this problem that aren’t being addressed. Some of these kids are shy and self-conscious, but they’re really sweet, and it would be such a shame for them not to get the same start in life as others their age.
 
As counselors, we’re encouraged to think for ourselves and make suggestions. At the next staff meeting I’d like to talk about underlying psychological issues so we could figure out how to better support these kids emotionally. I’d love any thoughts you have.  
— Lilly

Dear Lilly,
While having knowledge of psychosocial factors that influence childhood obesity isn’t the same as knowing how to create a supportive environment, it’s a good starting point for you and your fellow counselors. 
 
Educating these young campers about healthy eating habits is vital. Oftentimes children with obese parents become obese themselves — a condition not only influenced by genetics but by imitating eating behaviors they’ve observed at home. Early experiences of consuming high-fat cooking, fast food, sugary snacks and processed food can impact a child’s development of obesity. This may also be combined with parents or caretakers who are either overly strict — thus making “forbidden” foods even more desirable to consume in secret — or exert pressure to always clean their plates and ignore the internal cues that they’re already full. A positive summer experience can work toward reversing those habits by teaching a child how to develop self-control when eating and appropriately regulating calorie intake.
 
Your camp exercise programs are a positive step as well. Studies have found that overweight children who are unhappy experience a decreased level of depressive symptoms after participating in regular, vigorous and aerobic exercise with their peers. While lack of routine physical activity and an unhealthy diet are direct contributors to childhood obesity, there are underlying psychosocial factors as well. High-stress environments, for instance, tend to support the idea that food is an accessible coping mechanism for difficult living situations. Likewise, children who are neglected, abandoned, rejected, sexually abused or regularly exposed to physical violence are more likely to develop weight problems. Depression is a factor, too. In a national study of 12- to 17-year-olds, mental problems such as depression, anxiety, low self-worth, behavior problems and bullying were all associated with being overweight. 
 
With more than their share of social pressure to conform to specific standards of social attractiveness, these kids may benefit from the positive experiences that a support group provides. In addition, they could very well have in their past negative incidents of being teased or bullied that they may need to talk about. It would be extremely helpful for the counselors at your camp to learn to express empathy through reflective listening. 
 
Don’t get discouraged if they express ambivalence or try to argue. Be patient with their resistance and, whenever possible, use this venue as an opportunity to motivate, encourage and inspire. Help them write a list of all their good qualities and talents and keep the list with them to read from whenever they’re feeling frustrated. Support them to exercise for enjoyment rather than just to lose weight, and encourage them to stay involved with people that make them feel good about themselves.