Obesity is not a psychological disorder, but some researchers and clinicians argue that it should be considered a mental or behavioural issue [10
]. As it currently stands, obesity remains a medical condition, and, perhaps for this reason, research has focused neither on understanding the psychological impact of living with obesity nor the influence of mental health on the development of obesity. Although mental health professionals have been involved in the treatment and/or prevention of obesity, it is implicitly assumed that weight loss or the prevention of weight gain, respectively, will solve the psychological/emotional issues than may accompany excess weight which may not be the case. It should be noted that the treatment of pediatric obesity may vary with age particularly as approaches to childhood obesity migrate to a more integrated shared-responsibility model of service delivery [11
]. The focus of this paper is on psychosocial constructs as they relate to influencing the prevention of childhood obesity and as such experiences from clinical settings or evidence of successful family-based treatment approaches are beyond the scope of this paper.
Some psychosocial factors have been identified and studied; however, research usually examines each construct independently with little consideration for the relationship between excess weight and a broad range of psychosocial constructs concurrently [12
]. Research has not yet uncovered a clear model to elucidate these relationships. It is unclear to what extent psychosocial issues coexist in overweight/obese children or whether the strength or nature of the association changes with increasing weight [12
]. A recent review by Wardle and Cooke [13
] included 53 studies examining the relationship between obesity and psychosocial factors distinguishing clinical and community samples. Evidence for a causal or predictive relationship between obesity and mental health is inconclusive at best. The direction of the relationship between mental health and obesity certainly remains unclear as most of the studies are cross-sectional (e.g., [13
]). Of the limited longitudinal data available, some studies find evidence that mental distress predicts overweight or weight gain (e.g., [15
]), others find no associations between weight status and mental health (e.g., [17
]), and one found that behavioural issues predicted becoming overweight [19
]. Despite these associations, it is clear that not all overweight/obese children experience psychosocial issues. In fact, some research suggests that concern about weight and shape (not actual weight) [20
] and/or being the victim of weight-based teasing [23
] may in fact account for any individual differences in psychosocial outcomes [12
Despite the inconsistencies and uncertainties arising from the current evidence base, there appears to be some consensus that obesity is a potential risk factor with regard to children's and adolescents' psychological and emotional well-being and that vigilance for potential difficulties is a responsible approach to take [23
, page 193].