Overweight kids have a tough time. Their self-esteem suffers and they can’t keep up with the other kids.

Yet very often, the pain of childhood obesity (search) goes unnoticed.

A new study adds to growing awareness of this issue. With the ever-increasing childhood obesity problem, more and more kids are suffering emotionally, writes researcher Joanne Williams, PhD, with the Centre for Community Child Health at the Royal Children’s Hospital and Murdoch Children’s Research Institute in Australia.

A large number of children and adolescents could be experiencing major problems with quality of life due to their weight, Williams adds. Her report appears in the current issue of The Journal of the American Medical Association (JAMA).

Only a few studies have looked at this aspect of childhood obesity. One study published in 2003 showed that overweight kids have similar physical, emotional, and social problems as kids with cancer. However, for overweight kids the problems were often worse. Kids get sympathy when they have cancer — but not when they’re overweight.

In her study, Williams and her colleagues set out to determine just how much childhood obesity and its impact was recognized — by the kids and their parents.

Childhood Obesity and Self-Esteem

Researchers focused on nearly 1,600 Australian children, 8 to 13 years old. All were growing up in similar homes and neighborhoods, so none was more disadvantaged or well off than anyone else.

The kids each completed detailed surveys. Among the quality-of-life issues covered: Were they happy in school? Did they have friends? Were they involved in games and activities that involved running and jumping? How did they feel about that?

In similar surveys, parents provided their own perspective on their kids’ happiness.

Three years later, researchers again checked in on the kids to identify childhood obesity and its impact. At that point, 76 percent of the kids were normal weight, 20 percent overweight, and 4 percent obese.

Overall, overweight kids’ perception of their quality of life was much lower than that of normal-weight kids. Obese kids felt their quality of life was even lower. Physical and social functioning were the most severely affected. Emotional and school-related issues were less affected.

Surprising Finding

Surprisingly, perception of quality of life among overweight kids and parents was not as severely affected as seen in earlier studies. This is of particular concern because if parents don’t see being overweight or obese as much of a problem, they are less likely to seek help.

If neither children nor parents perceive a health effect, it seems unlikely that they will seek health care or initiate behavioral change that might lead to a healthier weight, and consequently lessen the long-term health risk for the current generation of children, the researchers say.

“Our findings may explain why so few parents of overweight children express concern about their child’s weight,” writes Williams. With one-quarter of the world’s kids being overweight or obese, even making minor inroads in addressing this problem can make a difference, she notes.

The problems are worse for overweight kids than for overweight adults, says Tracie Miller, MD, director of pediatric clinical research at the University of Miami School of Medicine.

“[Obese] kids are expected be as active in gym class as the other kids,” she tells WebMD. “Adults can protect themselves from that type of environment. They stay away from gyms. But kids are forced into it. Also, there’s a fair amount of depression among obese children, a lot of poor self-esteem. It means that kids may tend to overcompensate in other ways. They want attention, to fit in, to be more popular, but that may mean they get into trouble.”

Miller is setting up an exercise program to tackle childhood obesity. “It’s exciting to see not only physical changes in these kids, but we’ve also seen an improvement in attitude,” she tells WebMD. “After the 12 weeks is over, the kids continue to come in and participate because they love how the exercise makes them feel. It changes their emotional psyche in a very, very positive way. They fit in better in school; they have more energy, and can keep up with the other kids.”

By Jeanie Lerche Davis, reviewed by Michael W. Smith, MD

SOURCES: Williams, J. Journal of the American Medical Association (JAMA), Jan. 5, 2005; vol: 293; pp: 70-76. Tracie Miller, MD, director, pediatric clinical research, University of Miami School of Medicine. WebMD Medical News: “Obese Children Suffer Like Cancer Kids.”