Body Image, Eating Disorders, and Obesity in Youth

Dramatic increases in childhood obesity have many health professionals concerned. Future health complications of obese children include heart disease, high blood pressure, diabetes, and high lipid levels. These chronic diseases are extremely costly and can lead to premature death. Several studies have demonstrated that obese children will become obese adults. Health professionals have begun implementing interventions early in life to circumvent future health problems. Understanding the development, prevention, and treatment of eating disturbances is the only way to combat obesity and eating disorders. Thompson and Smolak's collaborative anthology has accumulated current research on the assessment, prevention, and treatment of eating irregularities in youth.

Development of eating disorders derives from a number of factors. Perhaps the greatest factor in developing an eating disorder is one's own family. In "Family Functioning, Body Image, and Eating Disturbances," Ari Steinberg and Vicky Phares collaborate to show the overwhelming influence family has on the development and maintenance of maladaptive body image and eating disturbances. They argue that family dysfunction and problematic communication styles serve to exacerbate eating disorders. Family dysfunction has been known to be directly related to negative self-esteem and related indirectly to eating disturbances. Also, children internalize a parent's communicating beliefs about weight, dieting, and exercise. Thus, this calls for greater attention of all family members, i.e. parents and siblings, effect on the development of eating disorders in youth.

In "Assessment of Body Image Disturbance in Children and Adolescents," Rick Gardner argues that assessment of body image disturbances is important for understanding the development of eating disorders. Most studies have explored high school aged and college aged young adults, but Gardner believes that dissatisfaction with one's own body image begins at a much earlier age. In fact, we should study the manifestation of body image awareness in younger children. Young children are particularly susceptible because of parental influence. Recent research has shown that children, particularly girls, under the age of 10 have begun to show signs of body image disturbances. Thus, assessment of body image disturbances in younger children demands careful consideration.

Robinson and Killen describe the use of Bandura's Social Cognitive Theory as the foundation for their intervention: Obesity Prevention for Pre-Adolescents (OPPrA). Aimed at ethnically and socio-economically diverse adolescents, this intervention not only provides health education in the classroom but also includes educational material for parents: dietary materials focus on healthy foods, such as fruits and vegetables, while material about physical education focus on enjoyable activities. Parents were sent newsletters and videos that taught basic parenting skills, nutrition, and family-centered physical activities.  In addition, Robinson and Killen offered separate classes to high-risk adolescents and their parents.  By focusing on positive behavior and feedback, Robinson and Killen's study showed that children demonstrated healthy behaviors and enjoyed being physically active.  Robinson and Killen suggest that positive results will occur if behavioral change is a part of early intervention. 

Faith, Saelens, Wilfley, and Allison offer an overview of past interventions and provide insight for future prevention and treatment techniques. They explain that the most important ingredient of successful intervention is parental involvement. Future interventions must overcome environmental, family, peer, and child specific challenges. Aiming interventions at the correct group of adolescents is important to provide appropriate treatment for obese individuals. Genetic research enables health professionals to predict which non-obese adolescents will become obese, and prescribe, if necessary, the correct type of medication for maximum weight loss. It is evident from this article that the prevention and treatment of obese children will become more sophisticated and more precise as technology advances.

The material in this book is comprehensive. Graduate students and health professionals will find this book to be an invaluable resource for current research in the assessment, prevention, and treatment of body image disorders. Also, the anthology identifies behavioral change as the primary source of prevention and treatment. Behavioral change is a burgeoning research field in the health sciences. By understanding how food preferences develop and the pressure that society, parents, and peers place on good looks, it is easier to create and implement effective interventions. Researchers and health professionals must understand all aspects of these disorders in order to treat and prevent them; this book is a tremendously useful guide for understanding eating disturbances in youth.

© 2004 Joe and Tiffany Ulatowski

Tiffany S. Ulatowski is General Manager of The Plaza Executive Health Club in Salt Lake City, Utah. She earned a Master of Science degree in Health and Fitness Management from American University in Washington, D.C. She created and implemented a health education initiative for children in Mississippi while working for the Baptist Memorial Health Systems. Her research interests include the prevention and treatment of childhood obesity and the psychological factors related to the development of eating irregularities in early adolescence.

Joe Ulatowski is a Ph.D. student in the department of philosophy at the University of Utah. His interests include metaphysics and epistemology, particularly the philosophy of logic, foundations of mathematics, and philosophy of science