Associations Between Obesity and Comorbid Mental Health, Developmental, and Physical Health Conditions in a Nationally Representative Sample of US Children Aged 10 to 17

Department of Health Services, School of Public Health, UCLA, Los Angeles, Calif
Academic pediatrics (Impact Factor: 2.01). 11/2012; 13(1). DOI: 10.1016/j.acap.2012.10.007
Source: PubMed


This large population-based study of US children considered the association of obesity with a broad range of comorbidities. This study examined relationships between weight status and health for US children.

We performed cross-sectional analysis of data on 43,297 children aged 10 to 17 from the 2007 National Survey of Children's Health. Weight status was calculated from parent report of child height and weight. Logistic regression models assessed associations between weight status and 21 indicators of general health, psychosocial functioning, and specific health disorders, adjusting for sociodemographic factors.

Using body mass index (BMI) percentiles for age and sex, 15% of US children were considered overweight (BMI 85th to <95th percentile), and 16% were obese (BMI ≥95th percentile). Compared with children classified as not overweight, obese children were more likely to have reported good/fair/poor health (adjusted odds ratio [AOR] 2.18, 95% confidence interval [CI] 1.76-2.69), activity restrictions (AOR 1.39, 95% CI 1.10-1.75), internalizing problems (AOR 1.59, 95% CI 1.04-2.45), externalizing problems (AOR 1.33, 95% CI 1.07-1.65), grade repetition (AOR 1.57, 95% CI 1.24-1.99), school problems, and missed school days. Attention deficit/hyperactivity disorder, conduct disorder, depression, learning disability, developmental delay, bone/joint/muscle problems, asthma, allergies, headaches, and ear infections were all more common in obese children.

Obese children have increased odds of worse reported general health, psychosocial functioning, and specific health disorders. Physicians, parents, and teachers should be informed of the specific comorbidities associated with childhood obesity to target interventions that could enhance well-being. Future research should examine additional comorbidities and seek to confirm associations using longitudinal data and clinical measures of height and weight.

Download full-text


Available from: Neal Halfon, Sep 02, 2014
1 Follower
307 Reads
  • Source
    • "Numerous variables that prior literature has associated with physical health and development were included as covariates to help address concerns of omitted variable bias and identify unique associations between health and development. Child characteristics included indicators for gender, being a twin or triplet, and diagnosis of autism or ADHD (included due to established associations between these conditions, physical health, and developmental competencies; Gurney et al., 2006; Halfon et al., 2013). Child race/ethnicity was coded as White, Black, Hispanic, Asian/Pacific Islander, or multiracial. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Extant research identifies associations between early physical health disparities and impaired functioning in adulthood, but limited research examines the emergence of these associations in the early years of children's lives. This study draws on data from the Early Childhood Longitudinal Study Birth Cohort (ECLS-B; N = 5900) to assess whether a host of early health indicators measured from birth to age five are associated with children's cognitive and behavioral skills at age five. After adjusting for child and family characteristics, results revealed that children's neonatal risks (prematurity or low birth weight) and reports of poor health and hospitalizations were associated with lower cognitive skills, and neonatal risks and poor health predicted lower behavioral functioning at age five. Some of the association between neonatal risks and school readiness skills were indirect, functioning through children's poor health and hospitalization. Analyses further found that associations between early physical health and children's school readiness skills were consistent across subgroups defined by family income and child race/ethnicity, suggesting generalizability of results. Findings emphasize the need for more interdisciplinary research, practice, and policy related to optimizing child well-being across domains of physical health and development in the early years of life. Copyright © 2015 Elsevier Ltd. All rights reserved.
    Social Science [?] Medicine 08/2015; 142:145-153. DOI:10.1016/j.socscimed.2015.08.030 · 2.89 Impact Factor
  • Source
    • "Lower health-related quality of life has been associated with obesity in preschoolers already [16]. Obesity has been shown to be a cause for teasing and bullying in children, and these in turn can contribute to the development of psychological consequences like a depression [23]. Depressive symptoms themselves contribute to lower quality of life [69], just as obesity itself too [16]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Aim. “The combined DAK therapy for obesity in children and adolescents” combines a 6-week inpatient with a 10.5-month outpatient treatment. The aim of the study is to evaluate whether the therapeutic achievements are maintained two and four years after intervention. Method. All subjects who had participated in the 12-month program in 2004/2005 were included in the follow-up study. Body weight, height, and physical fitness were assessed through direct measurements, behaviour, and quality of life by self-report questionnaires. Statistical analysis is based on an intention-to-treat analysis. Results. The response rate after three years was 63.4% and 42.2% after five years. Within three years, participants reduced their BMI-SDS significantly by 0.20 (SD 0.49) and by 0.15 (SD 0.51) within five years. Significant positive changes could be observed with respect to the participants eating behaviour. Similarly, the food intake, particularly the consumption of calorie-reduced beverages, increased significantly while that of nonrecommended foods decreased. Improvement was also seen in the subjective quality of life as well as several aspects of self-perception. Conclusion. Compared to baseline data, significant reduction of BMI-SDS and positive changes of health-related behaviours could be observed even three and five years after the start of the initial program.
    International Journal of Pediatrics 04/2013; 2013:856743. DOI:10.1155/2013/856743
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: To examine the association of overweight/obesity with health, health care utilization, and expenditures in a national sample of 10- to 17-year-old children and adolescents. Secondary analysis of 2005 to 2009 Medical Expenditure Panel Survey data (n = 17,224). Outcome measures included suboptimal health, emotional/behavioral problems, health care utilization, and expenditures. Overweight and obese children and adolescents had greater risk of suboptimal health (adjusted risk ratio [ARR], 1.4 and 1.7; P < .01), use of prescriptions (ARR, both 1.1; P = .01), and emergency department visits (ARR, 1.2 and 1.1; P = .01); overweight children/adolescents had lower mean out-of-pocket expenditures (∼$100, P < .01); and obese children/adolescents had greater risk of emotional/behavioral problems (ARR, 1.2; P < .01) and specialist visits (ARR, 1.1; P = .01). The most common specialty referral among obese children/adolescents was psychiatry. Overweight and obesity were not associated with office visits or total expenditures. A greater proportions of children and adolescents with suboptimal health and emotional/behavioral problems had health care expenditures, and those with suboptimal health were more likely to have out-of-pocket expenditures. Pediatric overweight and obesity affect child and adolescent health status, emotional/behavioral problems, and specific domains of health care utilization, but do not appear to be associated with total health care expenditures. Out-of-pocket expenditures are lower among overweight children and adolescents. These findings highlight the need for early intervention in overweight children/adolescents, when health care expenditures may not be greater, and suggest that it may prove useful to pay special attention to the health status and emotional/behavioral problems of overweight and obese children/adolescents in weight-management interventions.
    Academic pediatrics 05/2013; 13(3):251-8. DOI:10.1016/j.acap.2013.02.005 · 2.01 Impact Factor
Show more