Abstract
This chapter reviews research addressing obesity during adolescence. Epidemiologic findings indicate that obesity has increased dramatically in adolescents during the past several decades so that currently approximately one-third of adolescents in the United States are overweight, with about 17 % considered obese. Rates of obesity are greater among youth from ethnic minority and lower-income families. Overweight adolescents have a high likelihood of remaining overweight as adults. Etiologic factors indicate the important role of hereditary, early growth, and environmental factors, with behavioral factors of excessive caloric intake and decreased energy expenditure resulting in positive energy balance and increased adiposity over time. Review of the correlates of obesity reveals that adolescents have increased risk for several physical health disorders, including high blood pressure, high cholesterol, metabolic syndrome, type 2 diabetes, orthopedic problems, sleep apnea, asthma, and fatty liver disease. Psychosocial correlates of obesity in adolescents include increased risk for problems related to body image problems, self-esteem, social isolation and discrimination, depression, and reduced quality of life. Research on interventions for obesity in adolescents reveals the challenges of weight control over time; however there is some support for the efficacy of behavioral interventions targeting reduced caloric intake, increased physical activity, and reduced sedentary behavior. Medical interventions including pharmacological and surgical approaches have shown some efficacy, but more research is needed to demonstrate their safety and acceptability, as well as long-term effects. In recent years, Internet-delivered behavioral interventions have shown some promise and these approaches will likely be needed in order to more effectively reach the population of overweight adolescents. Given the tremendous challenge in successfully treating obesity during adolescence, and the costs of its continuation into adulthood, a public health approach is needed to address the environmental factors that are responsible for the increased incidence of obesity in youth.