When obesity is not experienced as a disease

Abstract

Denial of obesity in adolescents is a significant challenge for intervention. Despite the alarming rise in obesity, many adolescents and their families do not recognise the severity of the condition, which complicates the implementation of effective treatments. A study revealed that 75% of adolescents with obesity do not perceive their condition as a health problem¹.

Maternal perception plays an important role in the denial of obesity, as 60% of mothers underestimate the weight of their children with obesity. This underestimation can reinforce denial in adolescents and perpetuate a lack of awareness regarding the risks associated with obesity in childhood and adolescence².

Depression, a common comorbidity among adolescents with obesity, affects 40% of this population. This condition not only hinders adherence to treatment and necessary behavioural changes but also contributes to the denial of obesity. Depression fuels a cycle of demotivation and avoidance, in which adolescents downplay the importance of their weight and health, further complicating effective clinical intervention³.

Body image distortion is another key factor complicating the management of obesity. Fifty-five per cent of adolescents with obesity perceive themselves as slimmer than they actually are, suggesting the presence of body image disorders⁴. It is essential to differentiate the denial of obesity from body image disorders, as the latter can lead to the development of inappropriate eating behaviours. When a patient begins to lose weight, there is a risk of becoming obsessed with the loss, potentially leading to a shift from restriction to binge eating or other eating disorders. Therefore, the approach to obesity must be cautious to avoid fostering the development of these disorders.

An interdisciplinary approach that includes psychological therapy, nutritional education, family support, and the incorporation of physical activities (such as dance, dance therapy, or sports) facilitates more effective treatment. These activities not only promote physical health but also improve self-esteem and body perception, contributing to a deeper and healthier understanding of obesity in adolescents.