Everyday Stress: Child & Adolescent Obesity 2015
Part of
Obesity 16 items
Educational content from recorded physician discussions — not medical advice. Talk to your (or your child's) care team about your situation.
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What the experts said
Stress has been implicated in the development, maintenance, and exacerbation of obesity and obesity-related comorbidities through both physiological and behavioral pathways.
Stress can dysregulate the endocrine system, causing elevations of stress hormones and insulin levels, and over time contribute to accumulation of visceral fats.
Chronic stress negatively impacts cognition and mood, leading to increased worry, problems with concentration, planning, and focusing.
Stress decreases sleep quality and reduces engagement in healthy behaviors including healthy diet, regular physical activity, and restful sleep.
The relationship between stress and obesity is reciprocal: stress makes it difficult to maintain healthy behaviors, which contributes to weight gain, which then exacerbates the body's stress response.
Tolerable stress (such as loss of a loved one or moving to a new city) is buffered by social support or stress management techniques.
Toxic or chronic stress requires prolonged activation of the stress response and there is evidence it can lead to adverse changes to brain structures and organ systems.
Examples of toxic stress for children include residing in homes with domestic violence, abusive situations, poverty, and teasing/bullying experienced by children struggling with weight.
Children's metabolic and neurocognitive systems have not yet fully matured, making them particularly vulnerable to fundamental effects from stress.
Stress can exacerbate medical problems in children including asthma and diabetes, and increases mental health problems.
Among girls, stress increases internalizing disorders like anxiety and depression; among boys, conduct disorder or behavioral problems in school are more common.
For children struggling with weight, excess weight may have already elevated stress hormones, and additional stress further exacerbates this situation.
A CDC retrospective study of approximately 18,000 adults found a strong correlation between adverse childhood experiences (ACEs) and later development of medical and mental health problems.
Individuals who experienced at least one adverse childhood experience were more likely to have subsequent ACEs, suggesting the importance of early intervention.
Individuals who identify as ethnic minorities often report greater stress levels on a daily basis.
Immigrant populations, particularly first or second generation, experience greater stress from overt discrimination, subtle prejudice, stereotypes, and language barriers.
In immigrant families, children who are more fluent in both English and their native tongue often must navigate interactions with government or healthcare settings, creating stress and changing family dynamics.
Ethnic minority and immigrant populations are less likely to seek mental health services or other resources.
There is a strong link between stress experienced by those living in poverty and obesity, with significant overlap between low-SES communities and high obesity rates.
Food deserts—areas with lack of access to fresh fruits and vegetables and grocery stores but overabundance of calorie-dense, nutritionally poor convenience foods—put children at greater risk for obesity.
Parental financial and economic stressors are tied to a child's stress level.
Children in distress may exhibit physical symptoms (vague gastrointestinal problems, stomach aches with no medical cause), difficulties with concentration and attendance, academic problems, social withdrawal, sleep disturbances, and in extreme stress, bedwetting.
Psychologically, stressed children may ruminate more, have increased anxiety, possibly panic attacks, or behaviorally act out in school.
Stress eating or emotional eating is a common stress response seen in clinic, where engaging in comfort eating provides short-term relief.
During stress, people crave foods that are highly salty, fatty, or sugary rather than healthy foods like broccoli or fresh fruit.
There is evidence that highly salty, fatty, or sugary foods can diminish arousal in the body, providing short-term stress relief.
Emotional eating creates a cycle: short-term relief followed by feelings of shame, guilt, and regret (especially for those struggling with weight), leading some to turn back to food to suppress those emotions.
Studies suggest that when youth are stressed and turn to food, they also tend to engage in eating in response to other emotions, not just stress.
Children thrive with consistent routines for dinners, bedtimes, and physical activity, knowing what to expect.
Lack of consistent routine can be stressful for young children.
Middle school age children experience stress from puberty-related body changes, which can be a source of embarrassment and make them targets for bullying and teasing.
Teenagers experience greater importance of what others think of their appearance, pressure from friends to engage in certain behaviors, natural separation from parents creating household tension, and poor sleep patterns.
Teens struggling with weight report no longer eating lunch in the cafeteria because they are targets of ridicule or teasing and feel judged about what they eat.
Many overweight teens cannot sit comfortably in classroom chairs with attached desks, creating daily logistical stress.
Some overweight patients report fear of using public facilities at school because they may not be able to hold their weight, risking embarrassment.
The Perceived Stress Scale is one of the most widely used stress measures, consists of about 10 items, takes less than 10 minutes to administer, is written at middle school level, and is appropriate for adolescents.
A higher score on the Perceived Stress Scale indicates someone feels more overwhelmed, out of control, and stressed out in general.
The Perceived Stress Scale measures a patient's perception of their ability to handle stress rather than the types or amount of stress they face.
Physical activity does wonders for improving mood, concentration, and focus, and is a great way to get blood circulating.
Brief bouts of physical activity during homework (dancing, jumping jacks, short walks) can help manage stress by getting blood circulating and giving the mind a break to refocus.
Diaphragmatic breathing activates the parasympathetic nervous system, helps decrease heart rate, boosts mood and blood circulation, and helps the body return to homeostasis.
Deep breathing takes less than 3 minutes to teach a child.
For deep breathing to be effective as a stress management tool, children should practice twice daily for 3-4 minutes, ideally paired with a daily activity like brushing teeth or showering.
Children and adolescents are recommended to get at least 9 hours of sleep, and most teens fall 1-2 hours short of that.
Sleep deprivation has a depressed effect on mood, decreases energy, and makes it difficult to engage in effective coping strategies.
Daily physical activity can help increase sleep pressure at night.
Eliminating caffeine in the afternoons, establishing bedtime routines, having consistent wake/sleep times, and limiting screens 30 minutes before bed can improve sleep quality.
The first line treatment for anxiety involves teaching patients how to manage stress more effectively through stress management techniques.
The PASQL is a measure of overall well-being and how children feel they are adjusting.
Children are losing time to be creative and bored because they are using so many screens; being bored is not a bad thing.
Studies show that the level of parental stress children perceive has been associated with increases in child fast food consumption, poor sleep quality, decreased likelihood of meeting physical activity recommendations, and less likely boundaries on screen time.
When parents are stressed and unable to cope, it is difficult to set boundaries and be present with children, leading to more convenient paths like eating out.
Children look to parents for how to interact with the world; if they see a parent managing time efficiently and making time for physical activity and healthy habits, those behaviors will seem natural to them.