Psychological assessment of the obese child and adolescents: principles

Research demonstrated that the eating behaviour of obese individuals consists of a wide variety of patterns like eating caloric rich food to compensate for negative feelings, vomiting after overeating, eating at night, restrained eating, meal skipping (1). It may be difficult to grasp and treat these eating behaviours specifically when they are related to psychological factors. Early assessment and treating of these problems in children is important as they can easily reach more serious levels for which more intensive and expensive interventions are required (2) and they can hinder weight loss. Therefore, the following chapter aims to summarize psychological antecedents observed in paediatric obesity. The literature indentified several psychological models that can guide a thorough psychological assessment. There is no ‘leading’ theory and clinicians will test different hypotheses when an obese child applies for help. Restraint attitudes, emotional factors, learning mechanisms, personality and family variables will always be explored to help tailoring the treatment program to the individual needs of the child. Therefore it is recommended to construct a psychological profile of every obese child seeking treatment. The models, the psychological factors and the specific measures to be used in an assessment will be presented. Finally, issues related to screening in a paediatric setting are discussed