The first step of the model evaluated confirms that adults with a low socioeconomic and educational level show higher levels of psychological distress. Furthermore, the relationship between these two factors is found to be inversely proportional: the lower the socioeconomic status, the greater the emotional distress of the parents.

The second stage of Hemmingsson’s theoretical model holds that parents’ emotional distress generates a worse family environment. The results of the study are consistent with this idea and show that parental emotional distress predicts lack of family cohesion, disunity between partners, less capacity to cope with change and a less caring relationship with their children. The study therefore reveals that parents may have less emotional availability to meet their children’s needs or respond to them emotionally.

Negative family environment was evaluated through scores based on parents’ answers to several psychological questionnaires that were conducted. These tests measured the emotions expressed through comments that were critical of their partner, family cohesion, adaptation to change and parents’ bonding.

Children who grow up in conflictive family environments are also found to have higher levels of psychological distress. According to the survey results, the worse the family environment the greater the child’s anxiety and depression and the lower his or her self-esteem. The surveys show that 58% of overweight children and 65% of children with obesity have a clinical psychological disorder, the most common being anxiety, in contrast with the 20% of children of normal weight who experience this. The latter percentage falls within the parameters considered normal in childhood, as established by the Ministry of Health, Consumer Affairs and Social Welfare.

The study also confirms that the child’s psychological distress predicts the appearance of a sensation of loss of control when eating. This sensation, which has been studied in other countries, also in children with obesity, clouds the child’s awareness of the amount of food he or she is eating. This shows that caloric food intake is greater in children with anxiety and depression, as they use food to mitigate their sadness, either as consolation or as a sort of “self-medication” to resolve conflicts.

The next stage shows that children who are unable to control their urge to eat have a higher body mass index.

According to the survey results, 49% of children with obesity and 24% of overweight children admitted to losing control when eating, as opposed to 3.7% of children of normal weight. This confirms the direct relationship between loss of control when eating and children gaining weight. Furthermore, previous studies show that this imbalance during childhood increases the risk of obesity in adult life.

This study highlights the need to consider each person’s social, family and psychological variables in the appearance of childhood obesity with the aim of including them in the prevention strategies of governments and schools alike. In this respect, we consider it essential for doctors and nutritionists, but also psychologists, to work together in the treatment of this pathology. Along these lines, it is especially important for treatment to go beyond prioritising weight loss in children and to understand the role played by food in the regulation of psychological distress by children.

To this end, new weight control strategies should be promoted that include psychological and family factors alongside existing initiatives such as a healthy diet and physical exercise. In this respect, this new proposal should enable both children with obesity and their parents to identify and regulate their emotions better in order to improve the family environment and reduce the social stigma this disease causes. A stigma that is related to myths such as mere gluttony, lack of effort and laziness, factors that have little to do with childhood obesity.

HEMMINGSSON, E. (2014): «A new model of the role of psychological and emotional distress in promoting obesity: conceptual review with implications for treatment and prevention», Obesity Reviews, 15(9):769-779.