Do Low Self-Esteem and External Control in Childhood Predict Adult Obesity?

Current concern about the childhood obesity epidemic is largely driven by the notion that overweight and obese children have a greater risk of becoming overweight and obese adults. So far, however, efforts to reverse or even contain the prevalence of childhood obesity have yet to produce results.

Currently, much of the efforts to address obesity focus on improving nutrition and physical activity, but as blogged before, the results so far are modest.

Now new data suggests that perhaps rather than targeting nutrition and physical activity, the best targets for preventing and reversing the obesity epidemic may be emotional issues including self-esteem and self-efficacy rather than harping on the simplistic notion of energy in and energy out.

New data on the possible importance of this issue comes from a study by Andrew Ternouth and colleagues from King’s College London, UK, just published in BMC Medicine.

They examined data on around 6,500 individuals from the UK 1970 Birth Cohort Study (a representative sample of individuals born in the UK in one week in 1970) regarding the possible role of childhood emotional problems and self-perception as predictors of adult obesity.

Using sophisticated analyses and correcting for numerous potential confounders like childhood body mass index, parental body mass index, and social class, the researchers found that childhood emotional problems, low self-esteem and an external locus of control at age 10 predicted adult weight gain at age 30, whereby these effects tended to be stronger in women than in men.

The authors appeared particularly impressed by the strong impact of external locus of control on weight gain. As explained by the authors,

“Locus of control concerns individuals’ perceptions of the extent to which their own actions affect their destiny. Those with an internal locus of control believe that their behaviours have an important influence on outcomes, whereas those with a more external locus of control believe that their fate lies more in the hands of others, or is dependent on circumstance.

An external locus of control may be related to low self-efficacy, a lack of belief in one’s own capabilities, which in turn could lead to a feeling of loss of control of one’s actions.

While studies have shown that people with a more internal locus of control tend to be more physically active, a more external locus of control has been linked with disordered eating behaviours such as binge eating.

I cannot help but wonder if this “locus of control” issue is perhaps far more important than we may have considered in the past. Given that we are living in a time where overprotection and overscheduling of children is the norm, I wonder if kids today have a much lower sense of being in control of their lives than ever before.

In the era of “helicopter” parents and organized sports, where children are forced to live by a schedule dictated by the busy lives and (often) irrational fears of their parents, it would not surprise me that we are rearing a generation of kids, who truly experience and believe that their destiny lies in the hands of others.

Will this generation of kids, therefore, as adults, be less able to make “sensible” food choices or engage in “self-directed” play than earlier generations? Do the very kids, who are forced to eat healthy as kids, seek out junk food as adults? Do the very kids, who sucked at soccer or hockey but had to go simply because their parents thought it good for them, turn into sedentary adults?

if emotional problems, poor self-esteem and external control promote obesity, should the solutions not ultimately lie in improving mental health, increasing self-esteem and letting kids be kids?

Are our attempts at banning junk food and prescribing more physical activity simply toying with the “symptoms” rather than addressing the root causes of these “behaviors”.

To be clear, I am not saying that eating crap and not moving enough are not part of the problem. I am merely suggesting that the path to changing these behaviors may not lie in simply teaching people about healthy eating and the benefits of physical activity.

As blogged before, perhaps our messages around healthy eating and more activity do little more than perpetuate the prevailing model of “blame”, which does little to address either the emotional problems or the poor self-esteem and lack of control that may in the end be the real cause of the obesity problem.

Could it be that the root cause of unhealthy eating is not junk food but rather the “NEED FOR” junk food? After all, if no one NEEDED to buy junk food (be it for economic or hedonic reasons), wouldn’t it simply shrivel and disappear?

Could it be that with LESS organized sports and FEWER restrictions more kids would be playing outside, disappearing into the neighbourhood never to be seen again till dinner?

I would certainly love to hear opinions on this post!

Edmonton, Alberta