After two decades in Caribbean adolescent health, Dr Asha Pemberton says she’s now seeing medical complications in teens that were once unheard of, like Type 2 diabetes, hypertension and even menstrual irregularities.
She warns that the emotional fallout is just as alarming as the physical toll, with low self-esteem and social withdrawal becoming routine among overweight and obese youth.
Speaking during Thursday’s Healthy Caribbean Coalition webinar, Back to School, Back to Health: Nothing at School Should Encourage Unhealthy Choices, Dr Pemberton, Caribbean vice-president of the International Association for Adolescent Health, described a troubling shift in adolescent health across the region.
Conditions once considered adult-onset are now “standard” among Caribbean teens, she said, citing insulin resistance, hypertension and early signs of metabolic disease.
“I have been in the paediatric and adolescent space in the Caribbean for 20 years now, and I can say that at the beginning of my career, the medical complications we are now seeing were pretty much unheard of,” she explained.
But the crisis, she stressed, is not only physical. The psychological strain is mounting—often quietly, and with lasting consequences.
“It’s really important to recognise the silent effects on their health and well-being, which are often emotional and psychosocial,” she said. “At the end of the day, obese and overweight children and teens are aware that their bodies are not healthy. There is a difficulty moving through the world in a bigger body.”
That awareness, she noted, erodes confidence at a critical stage of development. Adolescents are especially vulnerable to social comparison and peer identification, and when their bodies feel out of sync with their environment, the fallout can be profound.
“So the low self-esteem, low self-confidence, and the low self-concept that overweight, obese children and adolescents develop by virtue of feeling has a spin-off effect in their behaviour,” she said.
Among the consequences: withdrawal from sports and physical activity, not out of disinterest but from pain and discomfort.
“While you might say, ‘just go to the gym’ or ‘just walk’, the reality is, it hurts to walk, it’s hard to walk, their cardiovascular tolerance is not normal,” Pemberton explained. “When we put interventions in place, we have to recognise that their bodies are not normal bodies, and they feel much more conspicuous.”
That sense of visibility and vulnerability, she added, can lead to troubling coping behaviours. “An adolescent or older child with low self-esteem is more likely to binge more, is more likely to recluse themselves from social activities, engage in high-risk behaviours, and often when you drill down, the root [cause] is low self-esteem due to body weight and shape.”
(SB)
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