Is it worse to be fat or just to feel fat?

Quality of life is lower in obese children but it is unknown how much of that correlates to self-evaluation. If adolescents think they are “far too fat,” they forfeit a lot of their quality of life, whatever their actual weight.

If adolescents consider their weight “just right,” their quality of life is the same as if they were of normal weight, even if this is not true.

The results of a new survey say the proportion of German adolescents who think they are overweight has been increasing more rapidly in recent years than the proportion of those who really are overweight. As children have become fatter more of them still feel pressure to be thin even though they are told they should love themselves for who they are.

In the course of the recent German Health Interview and Examination Survey for Children and Adolescents (KiGGS) study, almost 7000 boys and girls aged between 11 and 17 years were weighed and asked about their self-assessment, ranging from “far too thin” to “far too fat.” In addition, they all completed a questionnaire about quality of life.

As a result of their analysis, the scientists established that about 75% of adolescents are of normal weight. Nevertheless, almost 36% of boys and 55% of girls thought that they were “too fat,” although only about 18% of the adolescents were really overweight. 7% to 8% of the adolescents were actually underweight.

In an editorial in Deutsches Ärzteblatt International, Johannes Hebebrand states that adolescents are exposed to considerable social pressure to be thin and he thinks that it is remarkable that as many as 40% of the subjects thought that their weight was right, in spite of the ideal of slimness and the stigma of being overweight. Well, 75% of them were normal weight. Hedebrand seems to be lamenting that more kids don't feel bad about their weight while criticizing that very thing.

Kids are fat. It may be the overwhelming marketing of corporate greed or western wealth or lazy parenting but more children are obese than ever.

Kids are also insecure and in anxiety about a lot of things, today just as they were 2,000 years ago. It's difficult to contend that kids should be allowed to forego their physical health - and the expense of future health care - in the interests of a self esteem moving target that can never be hit.

Article: Deutsch Arztebl Int 2008, 105[23]: 406-12 DOI: 10.3238/arztebl.2008.0406