Características psicológicas del desarrollo del niño obeso y con sobrepeso en la niñez temprana

Abstract

Child obesity is considered a global pandemic and has become one of the public health problems of the XXIst Century. There was an impressive worldwide growth among infants and children from 1990 to 2013 (OMS, 2014b). Without intervention, these infants and children will probably be obese/overweight during childhood, adolescence and adult age, and will suffer the physical, psychological and social consequences of this illness. This investigation aims to study psychological characteristics associated to overweight and obesity during early childhood (4 and 7 years of age). Specifically, differences between children with and without overweight/obesity in temperament and perception of social and personal adjustment are analysed. Parents', teachers' and children's perceptions were compared. The influence of eating behaviour in the family environment associated to child obesity was also considered. The sample consisted of 123 children of 4 and 7 years of age with and without obesity/overweight from different schools in Cartagena (Murcia). Children were weighted and measured to calculate their BMI index and classify them in obese, overweight or standard. Parents filled out the CBQ questionnaire about their children temperament. To evaluate the social and personal adjustment, the BASC (Behavior Assessment System for Children by Reynolds and Kamphaus, 1992; Silva y Martorell, 2001) was used. Parent Scales (BASC-P), teacher Scales (BASC-T) and the self-report (BASC-S) for 7-year-olds were applied. Parents also completed the Eating Behavior Questionnaire. Results show that there are significant differences in children with and without overweight/obesity in temperamental variables related to negative emotionality (specifically, anger, distress, fear and sadness) as well as low intensity pleasure. As to personal and social adjustment, perceptions greatly differ depending on who reports: 7- year-old children did not differ depending on BMI, but parents and teachers report some problems in personal and social adjustment. Parents of overweigth/obese children report more problems in adaptability and adaptive abilities. Teachers indicate that overweight/obese children have more externalizing (agressiveness, hyperactivity) and internalizing (depression) problems, as well as less social abilities, adaptive abilities and adaptability. In relation to eating behavior, results show significant differences from four years of age. Thus, parents of overweight/obese children more frequently use food to regulate their children's behavior and these children also self-regulate themselves through food. Their food preferences as well as their food habits were worse and they have difficulties to perceive satiety. Conclusions point to the complex relations between factors that influence the development and maintenance of obesity: a high negative emotionality combined with forms of regulation based on food used by parents can originate the trend towards emotional eating and the preference for unhealthy food. This will end in overweight that, in turn, will create problems in social and personal adjustment; and these problems, in a vicious circle, can increase obesity when emotional food is used to find comfort. The consequences of an early stigmatization of overweight/obese children in the school setting are also discussed.