Table of Contents
STUDIES IN PHYSICAL CULTURE AND TOURISM
Vol. 11, No. 1, 2004
CZESŁAW SZMIGIEL1, JAN FENCZYN2
1Institute of Rehabilitation, Academy of Physical Education, Cracow 2Institute of the Humanities, Academy of Physical Education, Cracow
Correspondence should be addressed to: Jan Fenczyn, Institute of the Humanities, Academy of Physical Education, Al. Jana Pawła II 78, 31-571 Cracow, Poland.
Table of Contents
Key words: simple obesity, self-evaluation, girls 12-16.
The paper presents the results of research into self-evaluation amongst 75 obese girls (E) and the same number of non-obese girls (C). Anthropological pediatric research provided the basis for the division into the groups E and C. The primary research method was an author devised list of 31 pairs of contrastive adjectives that constituted characteristic features: external appearance, physical, psychic and psycho-social features. The research results obtained from self-evaluation were subjected to a statistically comparative test-U for both structural components (percentages) within the range of the differentiated characteristic features. The statistical analysis showed the existence of significant differences in the self-evaluation of obese and non-obese girls. Socially unacceptable features prevailed in the self-evaluation of the obese girls examined, which points to the creation within them of a generalized negative view of themselves as the result of psychic traumas suffered and their resultant complexes. This phenomenon is particularly visible amongst individuals aged 12 and 16. Significant within the obese 14-year-old group is the influence of the action of defensive mechanisms of character upon their self-evaluation. The specific research results allow for a precise, chiefly age dependent, psychotherapeutic programme of action in relation to individuals undertaking movement rehabilitation as a result of existing simple obesity.
One’s own image of oneself constitutes a fundamental element in the structure of the subject’s personality, determining to a significant degree the whole of his features and adaptive processes. Within the developmental age the formulation of a realistic image of one’s self occurs within the age 12-16 [1], i.e. the period of adolescence and social maturing of young people. Characteristic for the age under consideration are two fundamental regularities: heightened criticism and self-criticism, as well as the attachment of particular attention to external appearance, including the build of one’s own body [2]. Hence equally any dissimilarity in appearance (e.g. obesity, disablement, albinism, cachexia, etc.) can constitute the cause of psychic trauma and hang ups [3, 4] that permanently warp the image of one’s self and have negative repercussions upon the adaptation of the individual to his or her surroundings. Relatively often the reasons for the occurrence of psychic traumas and complexes linked to external appearance is obesity that occurs within the Polish population in around 9.1 – 8.8% of adolescent young people [5]. According to W. Klish [6] the majority of obese children suffer from a lack of a sense of their own worth, while in around 10% of these depression can be observed.
It needs to be emphasized that the appearance of obesity at the age of 12 in almost 75% of cases augurs for obesity in adult life [6]. Simple obesity appears somewhat earlier amongst girls; this fact can be associated with the generally low level of movement activity as well as with the hormonal and morphological conditions for the accumulation of unnecessary fatty tissue. During the period of adolescence the views of peer groups take on an especial significance [1] as does the degree of acceptance by the said group. In turn the social status within the group determined by means of sociometric tests correlates highly with physical attractiveness [7]. Adolescent young people prefer a variety of features of external appearance depending on sex. Boys want to, first and foremost, look ‘manly’, to be slim, tall, and muscular. Girls want to be slim, and to lend themselves beautifully to the canons of fashion in force with regard to figure [6, 8].
The aim of the research was to determine:
whether there existed differences in self-evaluations of appearance between girls who were obese and those who were not, as well as determining what the said differences depended upon.
whether the age of those surveyed had an influence upon the appearance of differences in self-evaluation amongst the girls surveyed.
The test grouping comprised 150 girls aged 12-16. This incorporated two 75-strong groups – an experimental group (E) made up of obese girls (with simple obesity) and a control group (C) which comprised schoolgirls who were not obese. Each group comprised three twenty-five-person strong age subgroups: 12-, 14-, and 16-years old.
Anthropometric methods (assessment of somatic features)
Within the framework of the anthropometric research the following were applied: standard pediatric measurement of height and body weight as well as measurements of the thickness of the skin-fat folds under the shoulder blade, over the triceps and on the belly. The data obtained as a result of the anthropometric research in conjunction with an interview and the pediatric research constituted the basis for the allocation of a given individual to groups E or C. The composition of the experimental group included individuals whose body weight in relation to height was higher than 97 percentiles on a percentile height-weight grid devised by R. Kurniewicz-Witczakowa [9], which according to J. Kopczyńska-Sikorska’s evaluation [10] constitutes a criterion for obesity; the reasons for obesity were achieved on the basis of a detailed interview and pediatric examination.
Psychological methods (self-evaluation research)
The psychological research employed a list of adjectives compiled by J. Fenczyn and Cz. Szmigiel and was modeled upon similar lists which dealt with the problem in more detail, for example, S. Siek’s work [11]. The list is composed of 31 pairs of contrasting adjectives amongst which 7 pairs are related to physical features, 6 pairs to external appearance features, 11 pairs to psychological traits, while the remaining 7 to psychosocial features. The respondents’ task involved underlining in each of the pairs that feature which in their opinion they possessed.
The anthropometric research
On the basis of our own material (in total 796 selected individuals were examined), simple obesity occurred less often than it was indicated in other general Polish figures. Within the age groupings obesity occurred with the following frequency: 12 years – 8.7%, 14 years – 6.6%, 16 years – 7.6%.
The differences in the average body weight in groups E and C, treated together as equal in the subgroups differentiated by age tested with the use of Student’s t-testturned out to be statistically significant, though obviously higher values than the average were typical for those tested from group E.
The twelve- and sixteen-year-old girls from group E achieved a higher average value of height than their peers in group C, in turn the fourteen-year-olds tested from group E were shorter than the fourteen-year-olds from group C. In both cases Student’s t-testfailed to show that the differences observed were statistically significant in nature.
Self-evaluation research
An analysis of the distribution of choices of traits made in relation to the age of the respondents showed that:
The choices of the sixteen-year-olds from group E in relation to physical features indicate the smallest statistical important differences as opposed to the oldest respondents from group C. The oldest surveyed from group E more often considered themselves as ‘strong’ (p = 0.05) and ‘not trim’ (p = 0.05) than their peers.
Fourteen-year-olds from group E more often than the fourteen-year-old girls from group C attribute to themselves features such as: ‘untrim’ (p = 0.05), ‘sluggish’ (p = 0.01), ‘static’ (p = 0.05) and ‘quiet’ (p = 0.01). So in the case of those surveyed from the youngest subgroups a predominance in choices for certain features can be noted which are not differentiated in the older groups.
It is possible to explain the noted differences in the self-evaluation choices concerning physical features made by the respondents from group E in relation to the age subgroup in the following way: a relatively large amount of inter-group differences statistically significant in the 12- and 14-year-old subgroups can be induced by significant self-criticism on the part of the girls towards their physical features. The choice by obese 14 year olds of different features than those made by the 14 year olds from group C could be determined by an increase in the stock of social experience as well as changes within the system of recognized values.
The fall in the quantity of features differentiating the subgroups E and C amongst the 16 year olds can be caused by the effect of the ‘ego’ defence mechanisms; for physical features do not possess a spectacular character, within the realm of survey research one can admit to their possession or not with reasonable impunity. Obese girls, irrespective of age, tend to ascribe to themselves features considered to be socially unapproved which would speak favourably for the views of A. Kępiński [3, 4], M. Żebrowska [1], A. Birch and T. Malim [2] as well as W. Klish [6], in which one of the complications caused by obesity is a lowered self-evaluation as well as psychic traumas and complexes.
A comparison of the distribution of choices regarding external appearance in the age groups showed that:
obese 16-year-old girls from E group significantly more often than their colleagues from group C consider themselves to be ‘untrim’ (p = 0.01) and ‘plain’ (p = 0.01) ‘fat’ (p = 0.01) as well as ‘unkempt’ (p = 0.05).
14-year-olds from group E significantly more often than their peers from group C described themselves as: ‘plain’ (p = 0.01) and ‘fat’ (p = 0.01).
obese 12-year-olds in comparison to their non obese peers statistically more often ascribed to themselves such features of external appearance as: ‘untrim’ (p = 0.01), ‘plain’ (p = 0.01), ‘fat’ (p = 0.01), ‘unkempt’ (p = 0.05) as well as ‘unfemale’ (p = 0.01).
Features of external appearance turned out to clearly and forcefully differentiate between the subgroups E and C selected on the basis of the age of those surveyed. The said differentiation occurred clearly in the 12 and 16 year olds. The beginning and end of the period of biological maturation and social adolescence seems to clearly favour intensification of self-criticism and open forms of manifesting worry linked to the possession of features that are socially unacceptable, particularly by peer groups. Obese girls often ascribe to themselves such features. An exception appears to be 14 year olds who show the lowest number of such features. This is most surely connected with the particularly strong influence of personality defence mechanisms and also the relatively limited base of social experience with simultaneously heightened motivation to gain the acceptance of one’s surroundings.
The U test conducted amongst inter-group (E/C) comparisons on the respective age levels showed that:
obese 16 year olds were significantly more often than their non-obese peers to consider themselves to be ‘unintelligent’ (p = 0.05), ‘incapable’ (p = 0.01), ‘timid’ (p = 0.05), ‘impatient’ (p = 0.05), ‘unbalanced’ (p = 0.01), and ‘hung up’ (p = 0.01). Obese girls more often than their peers from group C labeled themselves in relation to the features possesses that enjoyed social approval, such as ‘good’ (p = 0.01) and ‘assertive’ (p = 0.01).
14 year olds from group E significantly more often then 14-year-old respondents from group C indicated possession on the part of themselves of psychic features such as: ‘good’ (p = 0.05), ‘capable’ (p = 0.01), ‘patient’ (p = 0.01), ‘lively’ (0.01), ‘open’ (p = 0.01). It is worth drawing attention to the fact that these are socially accepted positive features.
12 year olds with simple obesity significantly more often than their peers from group C pointed to their possession of psychic traits such as ‘incapable’ (p = 0.01) ‘sad’ (p = 0.05) and ‘reserved’ (p = 0.01). They are mentioned as their positive features far more often than in group C: ‘level-headedness’ (p = 0.01) and ‘assertiveness’ (p = 0.05).
In a similar way to their reaction to features of external appearance the obese subgroups 16- and 12-year-olds also display in relation to their psychic features significant self-criticism. 16-year-old obese girls are often inclined to attribute to themselves socially unacceptable traits. Within the 12-year-old group this tendency is less evident. The above fact can be explained by a more limited ability for self-reflection [12] on the part of the younger respondents. A tendency to ascribe to oneself negative features also in the psychic area of things could advocate the creation amongst obese individuals of a general negative self-evaluation [6] which is the result of the psychic traumas suffered as well as an indication of existing complexes. The 14-year-olds, as opposed to the previously mentioned subgroups, ascribed to themselves features that enjoy social recognition. This fact may be explained as an attempt to compensate for conscious inadequacies in external appearance. One may also explain the said incomplete ability for self reflection through a simultaneous lack of ability to make use of returnable information (the role of ‘the social mirror’ – A Kępiński [3]) or the relatively strong influence of ‘the ideal me’ upon ‘the actual me’ [13, 14, 15].
The comparison of the inter-group distribution of socio-psychological feature choices using the U test yielded the following findings:
the oldest girls from group E far more often than the oldest surveyed from group C described themselves as: ‘sociable’ (p = 0.01), ‘untruthful’ (p = 0.01) and at the same time ‘cooperative’ (p = 0.05);
the 14-year-old respondents from group E more often than their peers from group C considered themselves to be ‘sociable’ (p = 0.01);
the youngest surveyed from group E ascribed to themselves more often than their counterparts from group C socio-psychological features like being ‘unkind’ (p = 0.05), ‘unsociable’ (p = 0.01) as well as ‘uncooperative’ (p = 0.05).
Amongst obese girls from the youngest groups there is a noticeable prevalence of negative choices regarding traits from the point of view of social opinion. This certainly is a form of withdrawal reaction formulated in response to the attitude of a peer group towards those surveyed.
The 14 and 16 year olds from group E strongly emphasize their ‘sociablity’. This fact can be interpreted as a move to seek acceptance and social approval while at the same time being an attempt to break existing hang ups. 16 year olds significantly often pointed to their ‘untruthfulness’ as a negative feature possessed by them. The development of this trait should be linked to personality defence mechanisms. Obese girls can try through lying to rectify the image of themselves in the eyes of the peer group, and in extreme situations even in their own eyes.
On the basis of the results obtained one may state that:
The self-evaluation of obese girls differs noticeably in statistical terms from the self-evaluation of their non-obese peers.
There is a predominance of socially unapproved features amongst the choices made by the obese girls surveyed. This appears to point to the general existence of a negative view of themselves amongst these girls, which is the result of psychic traumas suffered earlier and the complexes created.
One may observe, depending upon the age of those surveyed as well as the category of features in which the self-evaluation was undertaken, certain regularity. The self-evaluations of the youngest (12-year -olds) and the oldest (16-year-olds) obese girls are fairly similar to each other. Characterized by criticism, they are composed chiefly of a strongly negative image of themselves. The obese girls of 14, however, create a clearly separate group. Their self-evaluation is negative in the cases of obvious features yet, for example, in the area of psychological traits, which are directly inaccessible to instant observation (verification), the girls surveyed evaluate themselves in positive categories, and what is more they do so statistically more often than their non-obese peers.
The results of our research remain in accordance with the opinions of O. Allison, V. Basile, H. Yuker [16], and Radoszewska [17] who state that obese children of school age have a sense of being physically rather unattractive, negatively evaluating their own appearance and feeling even disliked by others. In a similar way obese teenagers have a sense of being rejected. They do not feel as if they belong to their peer group [2, 17]. They often describe themselves as unaccepted, lonely individuals [17, 18]. Such a view of oneself in psychological terms, for example in psychoanalysis, is treated as a symptom that manifests itself in various aspects of psychopathology [3, 19, 20]. One may accept that the consequence of a personality that is characterized negatively is helplessness and often experienced depression [17].
The traditional approach of recommending a low calorie diet and exercise to the patient predominates in therapeutic approaches to the matter of obesity. These recommendations are important and constitute the basic etiological factor in obesity, yet they do not exhaust all therapeutic possibilities. More recent approaches, holistic in nature, place special importance upon the need to introduce a psychological factor to the process of therapy. This particularly is the case amongst children and young people. This leads to the arousal of positive motivation amongst the patient, to the start of treatment upon the obesity and the undertaking of the demands of the therapeutic process. Following the completion of somatic treatment the treatment of the traumas experienced by the patient in his/her previous state of obesity is highly advisable.
Therefore in the treatment of simple obesity amongst young adolescents a multi-disciplined approach is called for:
A moderate low-calorie diet of 1000-1300 kcal/24 hours with limited quantities of carbohydrates and animal fats.
Regular exercise which is a valuable supplement to dietary treatment. It is important to suggest moderate exertion as the obese person is, as a rule, out of condition. Especially beneficial forms of exercise include swimming, exercises in water, as well as cycling and long walks, which are much better ways of energy consumption than running, badminton also being a preferable form of activity. Thanks to increased movement it is possible to maintain a energy balance without severe restrictions on diet which can result in a shortfall in dietary intake, e.g. of iron, calcium, magnesium, potassium and other that are so important for children and young people [21]. Extremely important for effective exercise is regular long-term participation in a given sporting programme.
Psychological or psychiatric action in joint accordance with the above mentioned treatment with the aim of elimination of the psychic complications of obesity and therefore removal of possible depression, the effects of psychic traumas and a return to a sense of one’s own worth. These actions should have a dual aim: awakening, maintenance and subsequent intensification of positive motivation in relation to treatment recommendations; and realization of self-evaluation.
The psychological effect of obesity amongst young people is a subject rarely touched upon in literature concerning the problem of obesity. This is an aspect much less analyzed than the dietary approach or raising the level of physical activity. Yet our research shows the importance of psychotherapy in the treatment of girls during biological adolescence and the period of social maturity.
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