In the best of circumstances, teen years are tough. For an overweight teen the social, psychological, and health challenges can be staggering, with both immediate and long-range effects. We know that one-quarter to one-half of all obese teens are destined to be obese adults. And over the past 3 decades the rate of obesity in adolescents has more than doubled, leading policy makers to rank it as a critical public health threat.
At a time when appearance and fitting in with friends is of paramount importance to developing a positive sense of self, obese adolescents are more socially stigmatized by their peers, suffering discrimination and isolation. They report having fewer friendships and lower self-esteem. Followed into young adulthood, overweight teens are more likely to drop out of high school, less likely to marry, and have a lower family income. They report lower quality-of-life satisfaction and their lifespan is shorter than those who weigh less.
Being overweight also decreases the likelihood of participating in sports or even general daily activities. They might be embarrassed about their appearance or their ability to perform. Their weight stops them from participating and the lack of physical activity contributes to further weight gain, setting in motion a cycle that is difficult to break. As the teen’s weight increases, their activity decreases to the point where it becomes uncomfortable or even painful to exercise.
Adolescent obesity further sets the stage for significant health problems that are normally not seen at this age – high blood pressure, high cholesterol, high blood sugar, and high triglycerides. Thirty-three to 50% of obese teens already have multiple risk factors for heart disease which will manifest themselves earlier in adulthood.
Of particular concern is the incidence of type 2 diabetes. Historically type 2 was rare in children but the incidence has increased 10-fold in recent decades. One-third of toddlers today are expected to be affected by this costly and debilitating condition at some point in their lifetimes.
The risk for type 2 diabetes increases by 4% for every pound of excess weight. Ninety-five percent of children diagnosed with type 2 are in the 85th percentile for weight. The increasing numbers of teens being diagnosed with type 2 diabetes has tremendous public health implications. The longer a person has the condition the greater their risk for complications – heart disease, kidney problems, blindness and amputation. Over the next 30 years, diabetes is expected to claim the lives of 62 million Americans. Many of these will be the overweight teens of today.
There are other health problems common in overweight teens. Overweight girls are more likely to exhibit precocious puberty and overweight boys have delayed maturation. The excess fat sets up endocrine changes causing early maturation for girls and delayed maturity for boys. Joint pain and gait abnormalities occur because of excess weight on the thighs and the need for a wider base of support. Flat feet and very wide feet result from the continuous weight bearing load, making it difficult to get properly fitting, supportive shoes. Breathing difficulties further restrict simple activities like climbing stairs, and sleep apnea can impact on school attendance and performance because obese teens are chronically tired.
Although the energy in = energy out equation seems basic, in reality it is extraordinarily complex. One needs to consider all the factors that impact on its balance – genetics, societal, cultural, environmental and psychological. Changes on many levels in numerous environments will have to occur before we will see a reversal or even stabilization in the current rate of adolescent obesity. If efforts are not made our health care system will bear an enormous burden for the early onset of chronic and debilitating diseases. Sadly, overweight teens are less likely to become healthy, active, productive, young adults.