The Psychological Pain of Childhood Obesity
It Hurts to Be Me
"I don't want to be here."
Members of the Saturday morning Teen Group smile as 16-year-old Lisa begins her check-in with the same opening words she uses every session. Everyone knows the words are Lisa's signature -- a dismissal of therapy as a waste of time -- but then she quickly starts sharing her excitement at buying a new outfit at the mall and her hope that a "really cute" transfer student will invite her to an upcoming school dance.
"I already have an appointment to have a manicure and pedicure done at the same time as I get my hair highlighted. If Steve doesn't ask me then it's his loss. I'll just go with some of my girlfriends. Maybe I will dance with someone else and make him jealous!"
Group members whistle and applaud her statement and laugh as she responds with an exaggerated bow.
It's nice to see Lisa feeling good about herself and optimistic about her life. What a contrast to two years ago when she locked herself in her bathroom and, sobbing uncontrollably, said she would kill herself if she had to go back to school.
It took months of individual counseling sessions before Lisa was able to talk about the episode that triggered her active suicidal feelings.
"There is this boy, Fred, who is ugly and a real bully. He and his friend Pete call me 'wide-load' and 'porker' when we wait for the afternoon bus. So I started waiting for a later bus to avoid them. That afternoon, as his bus passed by me, he stuck his head out the window and spit a glob of phlegm on me. They both were laughing and saying that's what fat girls get.
"I was in shock and just wanted to throw up. Other kids saw what happened, but no one said anything. I just wanted to disappear. I felt ugly, ashamed, and really scared, and maybe that I deserved it for being different. I couldn't tell my parents what happened. We just don't talk about my weighing 250 pounds. I guess they have given up on me because I have been overweight all my life. I just know that I would rather be dead than get humiliated like that again."
One of 9 Million
Lisa is one of the more than 9 million American youths between the ages of 6 and 19 -- that's 15 percent of this age group -- who are clinically overweight or obese. Another 15 percent are considered at risk of becoming overweight. And the statistics are not significantly better for preschoolers. The latest figures indicate that over 10 percent of young children between ages 2 and 5 are overweight.
The Surgeon General has called childhood obesity an epidemic but this public health term does not begin to do justice to the emotional nightmare that kids like Lisa endure on a daily basis. The stress of being stigmatized and teased by peers -- and sometimes, even family members -- is understandably overwhelming.
A study in Archives of Pediatrics & Adolescent Medicine (August 2003) found that three of ten girls in grades 7 to 12 report being teased about their weight by their peers. One of four boys in this age group gave the same report. These adolescents had lower self-esteem than their peers, low levels of satisfaction with their bodies, and showed symptoms of clinical depression. Most tragically, this group was two or three times as likely to contemplate or attempt suicide as their average-weight peers.
Feeling Normal
Lisa is fortunate to be receiving therapeutic treatment. Individual counseling sessions help her find words to express hidden pain. Behavioral modification and cognitive therapy offer new ways of coping with ongoing feelings of helplessness and vulnerability. Therapeutic techniques using play, drawing, sculpting, and writing with her non-dominant hand facilitate release of memories that hurt too much to be expressed. If necessary, medication can be administered to reduce agitation, anxiety and depression.
But it is group therapy that Lisa loves best, and it's the modality that seems to be most effective with teens. She has developed new friendships and become open to trying new behaviors. Observers often wonder how the kidding around, laughter and sometimes-silly behaviors that characterize the Saturday morning Teen Group help the healing process.
"I feel like a normal kid when I am here on Saturdays," says Lisa. "Everyone accepts me as I am, whether I am in tears or happy. It really helps me to not feel alone when the other kids talk about their problems. We help each other. I just feel better about me and know that the bad things that other kids did to me were because of their problems, not because of me."
Looking Better
Lisa has lost 75 pounds in the last twelve months. It took almost a year of individual and group therapy before she decided to consult her family doctor about a weight-loss plan. He referred her to a nutritionist, who encouraged more exercise and helped create a meal plan that Lisa can live with.
"I thought the weight loss plan was going to be horrible," confides Lisa. "I pictured my stomach grumbling and nothing to eat but salads. But my nutritionist is really nice, and we have figured out how to include pizza and an occasional sub into my plan. If I really feel awful and just want to binge my brains out, I call one of the kids in the group and we just talk until the impulse passes. We do that for each other and then laugh about it afterwards."
Lisa is quick to share why she always begins her daily report in group with the words "I don't want to be here."
"When I came into treatment, I really didn't want to be here at all -- not just not in therapy; I wanted to be dead. The prospect of being teased for being fat every day of my life just made me shut down emotionally. I went through the motions but my grades were poor and I was just plain numb most of the time. No one really knew how awful it was. Not even me.
"Now I just can't think of anything worth dying for. And I can't think of a place I want to be more than with my friends. Sure, I lost some weight, and I will lose more pounds. But you know, if I never lose another ounce, I like myself. And I like my body. And, like I said about Steve, anyone who can't see 'me,' isn't ready to be with a really great person.
"But I don't ever want to forget how horrible growing up was for me. So I start my sharing with that sentence. Just to remember that no matter what problem I have, it can get better, even if I don't think so at the moment."
Lisa is a success story. But there are 9 million more overweight and obese kids who need help navigating their childhood and adolescence. If you know such a youth, reach out to have a conversation and listen to what he or she may not be saying. A small investment of time and caring pays life-altering dividends.
Copyright 2004 Judy Battle
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