Adolescent Obesity and its effects
...ldren (Laessle et al., 2001). Several studies have demonstrated that the presence of a mother or father changes an adolescents’ eating patterns because of loss of self-control in specific situations, namely, when family members are monitoring eating (Laessle et al., 2001). Some adopt habits from their parents through imitation and reinforcement techniques. By using the learning model [which deals with reinforcement and modeling (Gullotta et al., 1999)] eating behaviour could be due to result of former reinforcing processes during family meals, when the parent probably prompted high eating rates and large bites to get the plate empty. The adolescent then has a discriminative stimulus for eating, meaning that the presence of the mother had the same effect, even when she is not prompting (Laessle et al., 2001). Like Pavlov’s dog salivated to the sound of a bell, these adolescents have been classically conditioned to finish their plates in the presence of their parent to possibly get a treat or desert (Gullotta et al., 1999). Also, if considering that the mother has become a discriminative stimulus for stress and anxiety in obese children, which then causes the observed eating style as a coping mechanism (Laessle et al., 2001). Adolescents in this situation would eat solely on the basis that food had a calming effect, to dull the pain from the parents, a common outcome in both types of familial influences. Peers Influences Because obese adolescents live in a culture that condemns their physical appearance and blames them for their condition, it is logical to assume that they would react emotionally to the negative attitudes and discrimination (Riva, 1996). During the adolescent period, negative attitudes from peers tend to do the most harm socially and emotionally. Since adolescents’ preoccupation with appearance comes out of shame and social pressure from peers it can lead to psychological consequences such as decreased self-esteem, distorted body image, and feeling of helplessness and frustration in response to unsuccessful dieting efforts (Riva, 1996). These outcomes are similar to those when discussing parenting styles of obese adolescents, the combination of the two giving negative reactions can be threatening to the emotional stability of an adolescent. At emotional level, obese subjects not only tend to recognize the “abnormality” of their attitude towards eating but strongly desire excess eating despite their sharing the negative connotations socially attributed to it (Riva, 1996). The obsessive-compulsive disorder of overeating also has satisfactory benefits to the individual adolescent in a part of the overeating cycle. When depressed, the moment of eating for obese subjects makes them feel “strong” and even “superior,” thereby compensating for their rather weak and fragile personalities (Riva, 1996). These feelings of superiority, is why it is so hard to break the overeating cycle leading to obesity. The cycle begins in a low state when the adolescent feels depressed about their less than ideal body image that leads them to overeating to feel “stronger.” Although after the rush of being “strong” subsides, an increase in weight and lower self-image results, leading to overeating again. This cycle can cause obesity in adolescence. Obese adolescents too often feel socially isolated, have low impulse control and are more socially anxious, passive and dependant on their families than non obese adolescents (although being dependent on the family has also shown to have a negative impact) (Morrill et al., 1991). It has also been shown that this deficit in social interaction and dependency on parents has found overweight pupils to be at a disadvantage in both social and educational encounters. Teachers perceived overweight individuals to be less attractive, and less enthusiastic than either their normal weight or underweight age-mates. They also had more difficulty being admitted to the college of their choice than did non-obese applicants even though their IQ scores and college admission tests were similar (Morrill et al., 1991). Even being slightly overweight jeopardized their academic careers as much as being grossly overweight (Morrill et al., 1991). Since even teachers show this negative stimulation and the normal/underweight students model the teachers’ behaviour towards the obese adolescent. This is perhaps why obese adolescents are more likely to experience social stress than are their peers (Morrill et al., 1991). Overweight children are involved in more negative peer interactions, and often associate with ethnic minorities because they share the same feelings including: passivity, expectation of rejection, progressive withdrawal and obsessive concern with self-image, which are all outcomes as the familial influences as well (Morrill et al., 1991). Prevention Program Since there is no known cause for obesity, and it can be partly attributed to genetics, it is difficult to make a primary prevention that will totally phase out overeating and obesity. This prevention would start at an early school age hoping to deal with and rid the social stigma towards overweight people and to make overweight people more assertive to deal with the social stigmas. The prevention program will use Albert Baduras ideas in the social learning theory using an educational perspective for assertiveness training. Goals of the Program To provide people of all ages with opportunities to build strong self-esteem, an environment free of discrimination and a least-restrictive learning situation in which the student may develop physically, mentally and emotionally (Morrill et al., 1991). The program will stress assertiveness and training to be implemented into the school systems. Methodology/Implementation Under the Social Leaning Theory (which is based on behaviour that can be explained by reinforcement techniques and modeling), Bandura stated that cognitive processes that mediate behavioural change are influenced by prompting or modifying the self-efficacy or experience leading to the mastery of skills or tasks (Gullotta et al., 1999). Adolescents learn from viewing other that are successful, when they observe a model, through encouragement and interpretations of self-efficacy expectations, and by observing others with fear provoking disorders in able to understand and handle these dysfunctional fears (Gullotta et al., 1999). In order to implement assertiveness training and self-esteem boosting, it is important to use modeling techniques as well as prompting and reinforcement. Both group and individual activities should be implemented so one doesn’t feel embarrassed about the group activity, especially when doing it for the first time. Activities of the Program Assertiveness training is to promote assertiveness in overweight individuals who lack social competence, and to reduce the aggressive behaviour of normal weight individuals. The goal is to help the overweight children or those at risk for binge eating to have a higher self-esteem so they can assert themselves in social settings and to make those who socially isolate them to realize their way of life and to be less stereotypical, thus promoting less negative attitudes towards those who are overweight. This will also give the overeaters the confidence to stand up to peers and family members increasing their own self-control. In working in large groups one general activity is possible, the activity should consist of three parts. First adults or older peers role-play and demonstrate how to act assertive and not aggressive or passive in certain social situations (i.e. how to act if s new student comes to the class and is overweight). Although focusing on specifically obesity and overweight may be detrimental to child’s emotional state, therefore a broad range of social situations should be implemented, creating assertiveness in all areas of life. Secondly, the children need a chance to play role reversal themselves, acting out set “prompted” situations. And finally, students give feedback to the way others act out and deal with the scenes given. Hidden focuses of the program for overweight versus normal or underweight children is seen in appendix A-1. It is not the separate learning groups that is the most important, it is the way they integrate together to practice the same types of activities. By emphasizing rewards and strengths, the children will not feel they are being punished for the type of behaviour they normally exert. Also, by letting the children give appraisals to other students, the children will be more likely to practice the behaviour outside the program setting, now knowing what others like the best of their behaviour. Also it is a key necessity that the models, or instructors, also model the assertive behaviour themselves; so the children can them learn through imitating their elders. Instructors should also stress the importance of independent thinking so interpersonal and individual skills have further time to develop. In addition to the group activities, it is also important for some individual activities. While implementing the independent activities it must be stressed that they are individual works and that no one else will have the right to see them unless they want to. By creating...