Chapter 9

Understanding and Preventing

Risks for Adolescent Obesity

Chapter Author:
M.A. Pentz
 Purpose

Address adolescent obesity risk and

prevention from the former, developmental
perspective, with discussion of intervention
aimed at universal prevention.
 Epidemiology
 The prevalence of overweight children and
adolescents in the 6-19 year old age range
is upwards of 15%.
 31% of adults are now considered
overweight.
 Obsesity Risk

 Obesity risk: age- and gender-adjusted

body mass index (BMI)>85%, while obesity
is an adjusted BMI >95%
 Obesogenic trajectories vary according to
dietary/eating habits and physical activity.
 Obesogenic trajectories rise more
dramatically starting at about age 10 or 11.
 Factors that Contribute to
Increased Obesity Risk
 Physiological factors related to puberty emotional
dysregulation, poor impulse control, metabolic
changes, and negative body image, in turn, have
significant relationships to obesity risk in adolescents.
 Either directly or indirectly, failure to achieve
developmental tasks, e.g. positive parent-child
communication, modeling of healthy eating and
exercise behavior, may heighten risk for obesity.
 Emerging social influences family and peers exert
social influence through the modeling of eating
behavior and food selection.
 Risk Factors by Context
 There may a be a neurobiological link
between drug use risk and obesity risk
through the endocannabinoid system,
which drives sensation seeking.
 Many contextual risk factors that have been
recently identified for adolescent obesity
were previously found for drug use and
violence in adolescents.
 Theoretical Approaches to
Understanding Adolescent
Obesity Risk by Context
 Social Development Model: an individual could
exhibit either positive or negative behaviors, or
both, depending on the social context for behavior
 Several individual risk factors are relevant to
adolescent obesity risk.
 Sensation-seeking related to low impulse control
 Previous maladaptive or negative behaviors
 Exposure to negative modeling influences by peers and
by parents
 Lack of parental supervision
 Theoretical Approaches to
Understanding Adolescent
Obesity Risk by Context
 Problem Behavior Theory: hypothesizes that risk
factors interact to affect multiple problem
behaviors, particularly risky sexual behavior,
drug use, and delinquency.
 Cognition-Affect-Behavior-Dynamic model:
developed to explain risk for conduct problems
and aggression in children.
 Integrative Transactional Theory: developed to
explain development and prevention of risk for
drug use and violence in adolescence.
 Prevention of Adolescent
Obesity Risk
 The relative lack of evidence-based
obesity prevention programs for
adolescents suggests a need for
expediting the translation of findings from
effective Type I studies of prevention in
other health behavior areas such as drug
abuse, to obesity.
 Reasons for the Lack of
Efficacious Programs
Insufficient theory
 Theories account for relatively little
intervention effect on actual obesity risk
behavior.
Insufficient attention to context
 One possible reason that effective obesity
prevention programs are lacking is that they
may not be designed to change all the
contexts that affect eating.
 Reasons for the Lack of
Efficacious Programs
Need for multi-component intervention
 “Multi-component” has been variously
defined as a school program with
additional activities, or school programs
with parent involvement.
 Multi-component programs for adolescent
obesity prevention have the potential to
impact on multiple contexts for behavior.
 Translating Evidence-Based
Programs for Drug Abuse to
Obesity Prevention
 An obesity prevention program that is
directly translated from an evidence-based
drug use program, may have dual benefits
of prevention.

 PATHWAYS has been developed to

address adolescent obesity prevention.
 Research Implications
 Future research will likely continue attempts
toward translation of intervention methods from
one health behavior area to another, particularly
from tobacco and drug use prevention to obesity
prevention.
 Researchers need to focus on counteracting the
pervasive and multiple influences on risk that is
most likely to produce significant change in
eating or physical activity.
 Conclusions
 Understanding and preventing risks for obesity in
adolescence pose multiple challenges for research.
 Future health promotion programs can be expected to
be comprehensive, involving multiple components
and contexts for behavior that are assumed to have
synergistic effects over time.
 Understand how to promote healthy lifestyle
behaviors in general in adolescents, rather than
focusing on preventing specific health risk behaviors.