Top

Published in:

01-12-2020 | Obesity | Research article

Psychosocial, behavioral and clinical correlates of children with overweight and obesity

Authors: Vidhu V. Thaker, Stavroula K. Osganian, Sarah D. deFerranti, Kendrin R. Sonneville, Jennifer K. Cheng, Henry A. Feldman, Tracy K. Richmond

Published in: BMC Pediatrics | Issue 1/2020

Abstract

Background

Psychological and behavioral correlates are considered important in the development and persistence of obesity in both adults and youth. This study aimed to identify such features in youth with severe obesity (BMI ≥ 120% of 95^thpercentile of sex-specific BMI-for-age) compared to those with overweight or non-severe obesity.

Methods

Youth with BMI ≥ 85^th percentile were invited to participate in a prospective research registry where data was collected on attributes such as family characteristics, eating behaviors, dietary intake, physical activity, perception of health and mental well-being, and cardiometabolic parameters.

Results

In a racially/ethnically diverse cohort of 105 youth (65% female, median age 16.1 years, range 4.62–25.5), 51% had severe obesity. The body fat percent increased with the higher levels of obesity. There were no differences in the self-reported frequency of intake of sugar sweetened beverages or fresh produce across the weight categories. However, the participants with severe obesity reported higher levels of emotional eating and eating when bored (p = 0.022), levels of stress (p = 0.013), engaged in fewer sports or organized activities (p = 0.044), and had suboptimal perception of health (p = 0.053). Asthma, depression and obstructive sleep apnea were more frequently reported in youth with severe obesity. The presence of abnormal HDL-C, HOMA-IR, hs-CRP and multiple cardiometabolic risk factors were more common among youth with severe obesity.

Conclusions

Youth with severe obesity have identifiable differences in psychosocial and behavioral attributes that can be used to develop targeted intervention strategies to improve their health.

Hales CM, Fryar CD, Carroll MD, Freedman DS, Ogden CL. Trends in obesity and severe obesity prevalence in US youth and adults by sex and age, 2007-2008 to 2015-2016. JAMA J Am Med Assoc. 2018;319(16):1723–5. https://doi.org/10.1001/jama.2018.3060.CrossRef

Skinner AC, Ravanbakht SN, Skelton JA, Perrin EM, Armstrong SC. Prevalence of obesity and severe obesity in US children, 1999–2016. Pediatrics. 2018;141(3):e20173459. https://doi.org/10.1542/peds.2017-3459.CrossRefPubMedPubMedCentral

Ogden CL, Fryar CD, Hales CM, Carroll MD, Aoki Y, Freedman DS. Differences in obesity prevalence by demographics and urbanization in US children and adolescents, 2013-2016. JAMA - J Am Med Assoc. 2018;319(23):2410–8. https://doi.org/10.1001/jama.2018.5158.CrossRef

Kelly AS, Barlow SE, Rao G, et al. Severe obesity in children and adolescents: identification, associated health risks, and treatment approaches: a scientific statement from the American Heart Association. Circulation. 2013;128(15):1689–712.CrossRef

Skinner AC, Perrin EM, Moss LA, Skelton JA. Cardiometabolic risks and severity of obesity in children and young adults. N Engl J Med. 2015;373(14):1307–17. https://doi.org/10.1056/NEJMoa1502821.CrossRefPubMed

Zabarsky G, Beek C, Hagman E, Pierpont B, Caprio S, Weiss R. Impact of severe obesity on cardiovascular risk factors in youth. J Pediatr. 2018;192:105–14. https://doi.org/10.1016/j.jpeds.2017.09.066.CrossRefPubMed

Barros R, Moreira P, Padrao P, Teixeira VH, Carvalho P, Delgado L. Obesity increases the prevalence and the incidence of asthma and worsens asthma severity. Clin Nutr. 2017;36:1068–74. https://doi.org/10.1016/j.clnu.2016.06.023.CrossRefPubMed

Dreber H, Reynisdottir S, Angelin B, Tynelius P, Rasmussen F, Hemmingsson E. Mental distress in treatment seeking young adults (18-25 years) with severe obesity compared with population controls of different body mass index levels: cohort study. Clin Obes. 2017;7(1):1–10. https://doi.org/10.1111/cob.12170.CrossRefPubMed

Kamath CC, Vickers KS, Ehrlich A, et al. Behavioral interventions to prevent childhood obesity: a systematic review and metaanalyses of randomized trials. J Clin Endocrinol Metab. 2008;93(12):4606–15. https://doi.org/10.1210/jc.2006-2411.CrossRefPubMed

10.

JaKa MM, French SA, Wolfson J, et al. Understanding outcomes in behavior change interventions to prevent pediatric obesity: the role of dose and behavior change techniques. Heal Educ Behav. 2019;46(2):312–21. https://doi.org/10.1177/1090198118798679.CrossRef

11.

Fox CK, Gross AC, Bomberg EM, et al. Severe obesity in the pediatric population: current concepts in clinical care. Curr Obes Rep. May 2019. https://doi.org/10.1007/s13679-019-00347-z.

12.

Gross AC, Fox CK, Rudser KD, Foy AMHH, Kelly AS. Eating behaviours are different in youth with obesity and severe obesity. Clin Obes. 2016;6(1):68–72. https://doi.org/10.1111/cob.12127.CrossRefPubMed

13.

Elberg J, Mcduffie JR, Sebring NG, et al. Comparison of methods to assess change in children ’ s body. Clin Res. 2004:64–9.

14.

Ginde SR, Geliebter A, Rubiano F, et al. Air displacement plethysmography: validation in overweight and obese subjects. Obes Res. 2005;13(7):1232–7. https://doi.org/10.1038/oby.2005.146.CrossRefPubMed

15.

Tanner JM. Normal growth and techniques of growth assessment. Clin Endocrinol Metab. 1986;15(3):411–51. https://doi.org/10.1016/S0300-595X(86)80005-6.CrossRefPubMed

16.

Troped PJ, Wiecha JL, Fragala MS, et al. Reliability and validity of YRBS physical activity items among middle school students. Med Sci Sports Exerc. 2007;39(3):416–25. https://doi.org/10.1249/mss.0b013e31802d97af.CrossRefPubMed

17.

Varni JW, Seid M, Kurtin PS. and Validity of the Pediatric Quality of PedsQLTM Version 4 . 0 Generic Core Scales in Healthy Life InventoryTM and Patient Populations. Med Care. 2001;39(8):800–12.CrossRef

18.

Varni JW, Limbers CA. The pediatric quality of life inventory: measuring pediatric health-related quality of life from the perspective of children and their parents. 2009;56:843–63. https://doi.org/10.1016/j.pcl.2009.05.016.

19.

Karlsson J, Persson L-O, Sjöström L, Sullivan M. Psychometric properties and factor structure of the Three-Factor Eating Questionnaire ( TFEQ ) in obese men and women . Results from the Swedish Obese Subjects ( SOS ) study. Int J Obes. 2000;24:1715–25.CrossRef

20.

Shisslak CM, Renger R, Sharpe T, et al. Development and evaluation of the McKnight risk factor survey for assessing potential risk and protective factors for disordered eating in preadolescent and adolescent girls. Int J Eat Disord. 1999;25(2):195–214. https://doi.org/10.1002/(SICI)1098-108X(199903)25:2<195::AID-EAT9>3.0.CO;2-B.CrossRefPubMed

21.

Choi J, Joseph L, Pilote L. Obesity and C-reactive protein in various populations: a systematic review and meta-analysis. Obes Rev. 2013;14(3):232–44. https://doi.org/10.1111/obr.12003.CrossRefPubMed

22.

Danesh J, Wheeler JG, Hirschfield GM, et al. C-reactive protein and other circulating markers of inflammation in the prediction of coronary heart disease. N Engl J Med. 2004;350(14):1387–97. https://doi.org/10.1056/NEJMoa032804.CrossRefPubMed

23.

Cifkova R, Frohlich J, Skodova Z, et al. C-Reactive Protein and the Risk of Developing Hypertension. a Population Study. J Hypertens. 2004;22(Suppl. 2):S149. https://doi.org/10.1097/00004872-200406002-00510.CrossRef

24.

Sesso HD, Buring JE, Rifai N, Blake GJ, Gaziano JM, Ridker PM. C-reactive protein and the risk of developing hypertension. JAMA J Am Med Assoc. 2003;290(22):2945–51. https://doi.org/10.1001/jama.290.22.2945.CrossRef

25.

Pearson TA, Mensah GA, Alexander RW, et al. Markers of inflammation and cardiovascular disease: application to clinical and public health practice: a statement for healthcare professionals from the centers for disease control and prevention and the American Heart Association. Circulation. 2003;107(3):499–511. https://doi.org/10.1161/01.CIR.0000052939.59093.45.CrossRefPubMed

26.

Kahn SE, Zinman B, Haffner SM, et al. Obesity is a major determinant of the association of C-reactive protein levels and the metabolic syndrome in type 2 diabetes. Diabetes. 2006;55(8):2357–64. https://doi.org/10.2337/db06-0116.CrossRefPubMed

27.

Han TS, Sattar N, Williams K, Gonzalez-Villalpando C, Lean MEHS. Prospective study of C-reactive protein in relation to the development of diabetes and metabolic syndrome in the Mexico City diabetes study. Diabetes Care. 2002;25(11):2016–21.CrossRef

28.

Papoutsakis C, Priftis KN, Drakouli M, et al. Childhood overweight/obesity and asthma: is there a link? A systematic review of recent epidemiologic evidence. J Acad Nutr Diet. 2013;113(1):77–105. https://doi.org/10.1016/j.jand.2012.08.025.CrossRefPubMed

29.

Gomez-Llorente MA, Romero R, Chueca N, Martinez-Cañavate A, Gomez-Llorente C. Obesity and asthma: a missing link. Int J Mol Sci. 2017;18(7):1–12. https://doi.org/10.3390/ijms18071490.CrossRef

30.

Kelsey MM, Zaepfel A, Bjornstad P, Nadeau KJ. Age-related consequences of childhood obesity. Gerontology. 2014;60(3):222–8. https://doi.org/10.1159/000356023.CrossRefPubMed

31.

Fox CK, Gross AC, Rudser KD, Foy AMH, Kelly AS. Depression, anxiety, and severity of obesity in adolescents: is emotional eating the link? Clin Pediatr (Phila). 2016;55(12):1120–5. https://doi.org/10.1177/0009922815615825.CrossRef

32.

Lazarevich I, Esther M, Camacho I, Del M, Vel Azquez-Alva C, Zepeda M. Relationship among obesity, depression, and emotional eating in young adults. Appetite. 2016;107:639–44. https://doi.org/10.1016/j.appet.2016.09.011.CrossRefPubMed

33.

Antoniou EE, Bongers P, Jansen A. The mediating role of dichotomous thinking and emotional eating in the relationship between depression and BMI. Eat Behav. 2017;26:55–60. https://doi.org/10.1016/j.eatbeh.2017.01.007.CrossRefPubMed

34.

Gowey MA, Reiter-purtill J, Becnel J, Mitchell JE, Zeller MH. Sciences H. HHS Public Access. 2017:211–8. https://doi.org/10.1016/j.appet.2016.01.020.Weight-Related.

35.

Zeller MH, Inge TH, Modi AC, et al. Severe Obesity and Comorbid Condition Impact on the Weight-Related Quality of Life of the Adolescent Patient. J Pediatr. 2014;166(3):651–9.e4. https://doi.org/10.1016/j.jpeds.2014.11.022.CrossRefPubMedPubMedCentral

36.

Kiecolt-Glaser JK, Fagundes CP, Andridge R, et al. Depression, daily stressors and inflammatory responses to high-fat meals: when stress overrides healthier food choices. Mol Psychiatry. 2017;22(3):476–82. https://doi.org/10.1038/mp.2016.149.CrossRefPubMed

37.

Powell EM, Frankel LA, Hernandez DC. The mediating role of child self-regulation of eating in the relationship between parental use of food as a reward and child emotional overeating. Appetite. 2017;113:78–83. https://doi.org/10.1016/j.appet.2017.02.017.CrossRefPubMed

38.

Aparicio E, Canals J, Arija V, De Henauw S, Michels N. The role of emotion regulation in childhood obesity: implications for prevention and treatment. Nutr Res Rev. 2016;29(01):17–29. https://doi.org/10.1017/s0954422415000153.CrossRefPubMed

39.

Taut D, Renner B, Baban A. Reappraise the situation but express your emotions: impact of emotion regulation strategies on ad libitum food intake. Front Psychol. 2012;3:359. https://doi.org/10.3389/fpsyg.2012.00359.CrossRefPubMedPubMedCentral

40.

Goossens L, Braet C, Van Vlierberghe L, Mels S. Loss of control over eating in overweight youngsters: the role of anxiety, depression and emotional eating. Eur Eat Disord Rev. 2009;17(1):68–78. https://doi.org/10.1002/erv.892.CrossRefPubMed

41.

Michels N, Sioen I, Braet C, et al. Stress, emotional eating behaviour and dietary patterns in children. Appetite. 2012;59(3):762–9. https://doi.org/10.1016/j.appet.2012.08.010.CrossRefPubMed

42.

Jääskeläinen A, Nevanperä N, Remes J, Rahkonen F, Järvelin MR, Laitinen J. Stress-related eating, obesity and associated behavioural traits in adolescents: a prospective population-based cohort study. BMC Public Health. 2014;14(1):321. https://doi.org/10.1186/1471-2458-14-321.CrossRefPubMedPubMedCentral

43.

Power TG, Olivera YA, Hill RA, et al. Emotion regulation strategies and childhood obesity in high risk preschoolers. Appetite. 2016;107:623–7. https://doi.org/10.1016/j.appet.2016.09.008.CrossRefPubMedPubMedCentral

44.

Herle M, Fildes A, Steinsbekk S, Rijsdijk F, Llewellyn CH. Emotional over- and under-eating in early childhood are learned not inherited. Sci Rep. 2017;7(1):9092. https://doi.org/10.1038/s41598-017-09519-0.CrossRefPubMedPubMedCentral

45.

Herle M, Fildes A, Llewellyn CH. Emotional eating is learned not inherited in children, regardless of obesity risk. Pediatr Obes. 2018;13(10):628–31. https://doi.org/10.1111/ijpo.12428.CrossRefPubMedPubMedCentral

46.

Koball AM, Meers MR, Storfer-Isser A, Domoff SE, Musher-Eizenman DR. Eating when bored: revision of the emotional eating scale with a focus on boredom. Health Psychol. 2012;31(4):521–4. https://doi.org/10.1037/a0025893.CrossRefPubMed

47.

Moynihan AB, van Tilburg WAP, Igou ER, Wisman A, Donnelly AE, Mulcaire JB. Eaten up by boredom: Consuming food to escape awareness of the bored self. Front Psychol. 2015;6(APR):1–10. https://doi.org/10.3389/fpsyg.2015.00369.CrossRef

48.

Braden A, Musher-Eizenman D, Watford T, Emley E. Eating when depressed, anxious, bored, or happy: are emotional eating types associated with unique psychological and physical health correlates? Appetite. 2018;125:410–7. https://doi.org/10.1016/j.appet.2018.02.022.CrossRefPubMed

49.

Boutelle KN, Braden A, Knatz-Peck S, Anderson LK, Rhee KE. An open trial targeting emotional eating among adolescents with overweight or obesity. Eat Disord. 2018;26(1):79–91. https://doi.org/10.1080/10640266.2018.1418252.CrossRefPubMed

50.

Olvera N, Dempsey A, Gonzalez E, Abrahamson C. Weight-related teasing, emotional eating, and weight control behaviors in Hispanic and African American girls. Eat Behav. 2013;14(4):513–7. https://doi.org/10.1016/j.eatbeh.2013.06.012.CrossRefPubMed

51.

van der Valk ES, Savas M, van Rossum EFC. Stress and obesity: are there more susceptible individuals? Curr Obes Rep. 2018;7(2):193–203. https://doi.org/10.1007/s13679-018-0306-y.CrossRefPubMedPubMedCentral

52.

Stalder T, Steudte-Schmiedgen S, Alexander N, et al. Stress-related and basic determinants of hair cortisol in humans: a meta-analysis. Psychoneuroendocrinology. 2017;77:261–74. https://doi.org/10.1016/j.psyneuen.2016.12.017.CrossRefPubMed

53.

Wester VL, Staufenbiel SM, Veldhorst MAB, et al. Long-term cortisol levels measured in scalp hair of obese patients. Obesity. 2014;22(9):1956–8. https://doi.org/10.1002/oby.20795.CrossRefPubMed

54.

Noppe G, Van Den Akker ELT, De Rijke YB, Koper JW, Jaddoe VW, Van Rossum EFC. Long-term glucocorticoid concentrations as a risk factor for childhood obesity and adverse body-fat distribution. Int J Obes. 2016;40(10):1503–9. https://doi.org/10.1038/ijo.2016.113.CrossRef

55.

Griffiths LJ, Parsons TJ, Hill AJ. Self-esteem and quality of life in obese children and adolescents: a systematic review. Int J Pediatr Obes. 2010;5(4):282–304. https://doi.org/10.3109/17477160903473697.CrossRefPubMed

56.

Easterlin MC, Chung PJ, Leng M, Dudovitz R. Association of Team Sports Participation with Long-term Mental Health Outcomes among Individuals Exposed to adverse childhood experiences. JAMA Pediatr. May 2019. https://doi.org/10.1001/jamapediatrics.2019.1212.

Title: Psychosocial, behavioral and clinical correlates of children with overweight and obesity
Authors: Vidhu V. Thaker
Stavroula K. Osganian
Sarah D. deFerranti
Kendrin R. Sonneville
Jennifer K. Cheng
Henry A. Feldman
Tracy K. Richmond
Publication date: 01-12-2020
Publisher: BioMed Central
Keywords: Obesity
Obesity
Overweight
Published in: BMC Pediatrics / Issue 1/2020
Electronic ISSN: 1471-2431
DOI: https://doi.org/10.1186/s12887-020-02145-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Psychosocial, behavioral and clinical correlates of children with overweight and obesity

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 1/2020

Incidence and predictors of neonatal mortality among neonates admitted in Amhara regional state referral hospitals, Ethiopia: prospective follow up study

A 8- year Bangladeshi girl with disseminated histoplasmosis, presented as chronic liver disease with portal hypertension: a rare case report

Bainbridge-ropers syndrome caused by loss-of-function variants in ASXL3: Clinical abnormalities, medical imaging features, and gene variation in infancy of case report

Effects of Body Mass Index (BMI), demographic and socioeconomic factors on organized physical activity (OPA) participation in children aged 6-15 years: a cross-sectional study comparing primary and secondary school children in Greece

Impact of rapid enterovirus polymerase chain reaction testing on management of febrile young infants < 90 days of age with aseptic meningitis

Study protocol: functioning curves and trajectories for children and adolescents with cerebral palsy in Brazil – PartiCipa Brazil