Obesity in Children and the "Myth of Psychological Maladjustment": Self-Esteem in the Spotlight

Purpose of review: There are contrasting views regarding the psychological well-being of children with obesity. Responding to limitations of existing evidence, Jane Wardle in 2005 argued for a “myth of psychological maladjustment”. This review looks again at self-esteem. Recent findings: The different characterizations of self-esteem each offer value. Global self-esteem is reduced in nearly all studies of youth with obesity. Dimensional self-esteem reveals physical appearance, athletic, and social competence as the most affected areas, confirmed by research that has operationalized low self-competence. Children with obesity are also more likely to be victimized by their peers, generally and for their fatness. Victims who bully others appear to preserve some aspects of self-esteem. Summary: A relatively small proportion of youth with obesity has low self-esteem but those with severe and persistent obesity are especially compromised. Weight loss is only weakly associated with improved self-competence suggesting the value of resilience and assets approaches to improving well-being.