Title : Pediatric obesity, addiction and family dynamics Concept of co-obesity
Abstract:
Introduction: The obesity epidemic has been a crucial health concern over the past few decades. Multiple contributing factors have been identified at various levels: genetic, biological, environmental, social, economic etc. In many ways obesity presents some similarities with substance dependence and abuse. The term “co-dependency” originates from the realm of addiction. Co-dependency mechanisms can also appear between parents and children and enable obesity. Aim: This research features the concept of co-obesity within the paediatric population. It develops new ideas and ways of thinking about food and food system, including an integrative biopsychosocial model of parent-child co-dependencies in obesity. This work has quite a significant impact as it retraces 30 years of literature on the subject but also because the obesity epidemic is constantly expanding. Materials and Methods: Between January 2020 and May 2020, a literature search based on electronic bibliographic databases as well as other sources of information (grey literature) was conducted in order to investigate the most recent data on obesity, addiction and co-dependencies. Some clinical examples of these concepts applied to everyday life were chosen to illustrate how they are all linked together, especially in terms of familial co-obesity (between children and parents). Results: Many studies link obesity and addiction, even though, the Diagnostic and Statistical Manual of Mental Disorders (DSM) does not list obesity as a psychiatric disorder. Both obesity and addiction share a common neural basis and use the same reward pathways which has been described and studied through many works. Dopamine certainly plays an important part in that system. Pediatric obesity is particularly worrying but might offer an opportunity for intervention, and once tackled, reduce the severity of adult obesity. Working with children, means working with families, and investigating intrafamilial contributing dynamics. The concept of co-obesity emerged from the addiction model applied to pediatric obesity. Clinical examples illustrate an integrative biopsychosocial model of parent-child co-dependencies in obesity. Conclusion: Co-obesity often emerges from great altruism, tolerance towards inappropriate and maladaptive behaviours and emotions that are difficult to manage. A new and promising model of intervention is developed, based on addiction techniques (withdrawal/abstinence) associated to behavioral strategies (distraction, alternative behaviors, distress tolerance, trigger avoidance and stress lessening). Keywords: Pediatric Obesity; Addiction; Co-dependence and Co-dependency; Co-Obesity; Family Dynamics; Family Intervention.
