Children who are obese are much more likely to be bullied and to display emotional and behavioural problems, a new Irish study has found.
Researchers looked at 111 children attending the W82GO! Healthy Lifestyle service at Temple Street Children's Hospital, which is a programme aimed at helping children and teenagers who are overweight and obese.
The service is delivered by a multidisciplinary team, including a paediatrician, dietitian and clinical psychologist.
Currently in Ireland, at least one in four children aged nine is overweight or obese.
The study found that the vast majority of children attending W82GO! were over the age of five. The average age at initial consultation was 10 years old. Almost half of referrals came from consultants based in the hospital, while over one-third were GP referrals.
At the time of initial screening, one in three children disclosed emotional difficulties, and almost half of these were already linked to mental health services prior to beginning W82GO!
These emotional difficulties included low self-esteem, low mood and deliberate self-harm.
At least one in four of the children reported behavioural problems, with just over half of these already attending counselling or mental health services.
Meanwhile, almost one-third also reported learning difficulties, while around one in six reported some sort of developmental delay which had required intervention.
Bullying was also found to be a big issue, with almost two in three having been teased about their weight in the past and one in nine missing school as a result.
While almost half of those who had been teased were teased by their peers, a small percentage said they were teased by complete strangers.
The effects of bullying were low self-esteem, low mood and absenteeism from school. This often led to social isolation and difficulties mixing with peers during activities, such as sports.
The researchers pointed out that caring for these children is particularly complex because of their potential emotional, behavioural and learning difficulties.
"Left untreated, the health consequences of obesity are severe, therefore a multi- disciplinary team approach is needed. This must include a psychologist and all members of the team must be mindful of the complex issues these children have.
"Moreover, given the increasing prevalence of childhood obesity, all professionals working with children must consider the psychological difficulties these children have and their potential effect on treatment," the researchers said.
Details of these findings are published in the Irish Medical Journal.
I had the nickname Chubby in school... at the time in school I thought it was kinda cool but as I got older into my teens it got to me a bit, and so I lost weight through calorie restriction back in the 90s... unfortunately in adulthood I went to 18.5 stone because of poor understanding of diet but now I'm back to being 12 stone and athletic because I control my carbohydrate intake