With an aim to highlight the
vulnerability of adolescents with extreme obesity, Megan Benoit Ratcliff and
colleagues studied the high risk behaviors of adolescent high school students
(HSS) with BMI greater than or equal to 99th
percentile for age and
The results were startling:
• Extremely obese adolescents comparatively tried
cigarettes more frequently. Girls - adjusted gender-stratified odds ratios
(OR): 2.0 and boys - OR: 1.5.
• Female HSS with extreme obesity
portrayed greater odds of drinking alcohol/using drugs before their last sexual
encounter as compared with their normal-weight counterparts - OR: 4.6.
• Male students with extreme
obesity portrayed greater odds of smoking before age 13 - O R: 1.4.
The findings were contrary to the
belief that social isolation and the stigma associated with obesity would let
very obese teens engage in fewer risky behaviors as compared with typical
adolescents. One of the investigators, Meg Zeller, finds it further worrisome
because 'obese adolescents are already at greater risk for the development of
additional chronic health conditions, the likes of which may be exacerbated by
cigarette smoking, resulting in compound health risks'.
The investigators of the present
study corroborate the fact that 'obese adolescents are more likely to be
socially isolated and peripheral to social networks than are healthy weight
peers'. However, the findings of this study challenges the general view that
'adolescents with extreme obesity may be even less fully engaged in age-salient
contexts (school, work, peers, romantic relations), and therefore less likely
to be exposed to or engage in what might be considered normative high risk
Psychiatrists, S. Hossein Fatemi
and Paula J. Clayton, mention in their book 'The medical basis of psychiatry' -
'Socio-cultural factors play a strong role in shaping the course of adolescence,
so the coping mechanisms and issues such as sexual behavior, substance use,
etc. must be considered in context rather than solely being the results of
individual pathology'. By relativity, it can be deduced that extremely obese
adolescents are doubly affected by the socio-cultural and environmental
stressors. Probably this is what leads them to these vulnerabilities.
The investigators of this study
concluded - 'These behavioral risks, combined with the well documented medical
and psychosocial comorbidities associated with adolescent extreme obesity,
further illustrate the vulnerability of this cohort of youth. Pediatric health
care providers, who are increasingly adept at tracking BMI and addressing
weight-related concerns, should persist in assessing normative adolescent
behaviors, even among the most extremely obese youth, given the potential for
their engagement in comparable, if not more dangerous, risk-taking'.