TABLE 25–3. Sample psychiatric evaluation for overweight
or obese youth
|Area of concern||Common symptoms||Sample questions (for child and/or parent)
to assess for symptomsa|
Have you lost interest in activities that used to be
Psychomotor retardation and/or fatigue
Do you feel tired more often or like you don't have
Limited social interactions
How often do you spend time with friends or classmates?
Recent rapid weight gain
Review medical history
Decline in academic performance
What are your current grades?
What were your grades last year?
Anxiety around eating
How do you feel when eating?
Worries regarding weight and body size
How do you feel about your body shape and size?
Use of food to cope with anxiety
When you feel worried, what helps you feel better?
Loss of control when eating
How do you feel when eating?
Use of diet pills, laxatives, purging, excessive exercise,
or tobacco to control weight
What methods have you used to change your weight?
Do you ever eat more than other kids your age in one
What have you tried to lose weight?
Eating in secret
How often do you eat when no one else is around, or
how often do you try to hide eating?
How often do you miss or skip breakfast, lunch, or
dinner in a given week?
How do you feel about yourself and your abilities?
How do you feel about your body? Do you wish that parts
of your body were different?
Peer victimization (teasing and/or bullying
Do you think that other students pick on you more frequently
than they pick on other students?
Limited peer relationships
Is it easy or more difficult for you to make friends?
Feeling stigmatized due to weight
Do you think that others treat you differently because
of your weight?
Poor coping skills, particularly use of food-based
When you feel bad, what helps you feel better?
Does food help you feel better if you are having a bad day?
Unusual or erratic behavior change or change in friendships
Have you noticed any recent changes in your child's
behavior or friendships?
Level of concern for youth weight status
How concerned are you about your child's weight?
Past attempts to manage child's weight
What have you tried in order to manage your child's
Who is in charge of meals and food in your home?
Do you have concerns about your weight?
Family dietary practices
Does your family eat together or "on the go"?
How frequently do you eat out at restaurants or get fast food?
Family physical activity practices
How does your family spend time together? Do family
members exercise or participate in sports or recreational activities?
Supports for adherence to an intervention program
Who will support you in your efforts to provide a healthier
environment for your family? Do all family members agree with making changes?
Cultural beliefs regarding weight, diet, and physical activity
Tell me about the meaning of food, activity, and weight
in your family.
Barriers to dietary or physical activity changes, such
as access to healthy and affordable foods, neighborhood safety,
and opportunities for safe and supervised physical activity
What things do you think may get in the way of making
lifestyle changes to the family diet or physical activity?