Child Overweight, Associated Psychopathology, and Social Functioning: A French School‐based Survey in 6‐ to 11‐year‐old Children

Abstract

The aim of this study was to estimate the prevalence of child overweight in a regional sample of primary school‐aged children, and to examine the relationships among child overweight, psychopathology, and social functioning. A cross‐sectional survey was conducted in 2004 in 100 primary schools of a large French region, with 2,341 children aged 6–11 randomly selected. Child weight and height, lifestyle variables (leisure‐time physical activity (LTPA), watching television (TV), playing video games), and socioeconomic characteristics were collected in parent‐administered questionnaires. Child psychopathology outcomes were assessed using child‐ and parent‐reported instruments (Dominic Interactive (DI) and Strengths and Difficulties Questionnaire (SDQ)). Overweight and obesity were estimated according to the International Obesity Task Force (IOTF) definition. Response rates to the parent questionnaire and DI were 57.4 and 95.1%, respectively. Final sample size was 1,030 children. According to the IOTF, 17.3% of the children were overweight, of whom 3.3% were obese. In univariate analysis, correlates of overweight were low parental education, low monthly income, Disadvantaged School Areas (DSAs), self‐reported generalized anxiety, parent‐reported conduct disorders, emotional problems, and peer difficulties. High monthly income was less frequently associated with overweight. In multivariate analysis, parent‐reported peer difficulties (odds ratio (OR) = 2.06; 95% confidence interval = 1.27–3.35) and DSAs (1.88; 1.03–3.44) were independent factors significantly associated with child overweight. There was a trend of being overweight with elevated TV times (P for trend = 0.02). The psychosocial burden of excess weight appears to be significant even in young children. Findings should be considered for preventing strategies and public health interventions. School‐based overweight prevention programs should be implemented first in disadvantaged areas together with information about weight stigmatization and discrimination.

Behavioral and Psychosocial Factors in Childhood Obesity

“…This contrasts with those studies using clinical samples that generally show a clear positive association between overweight and levels of depressive symptoms and anxiety disorders (Pine et al, 2001;Van Vlierberghe et al, 2009;Vila et al, 2004), and oppositional defiant disorders (Mustillo et al, 2003). One possible explanation is that people who suffer mentally from their elevated weight status, significantly more often seek professional help than those who do not, and thereby bias the clinical samples toward higher levels of psychopathology (Pitrou et al, 2010). Prospective studies in the literature also found an association between obesity and psychopathology.…”

“…The understanding of the relationship between obesity and common mental health disorders in children and adolescents is less advanced, and results are inconsistent (Gatineau & Dent, 2011). In addition, it must be noted that research in this area is subjected to many limitations (Costello et al, 2005;Pitrou et al, 2010, Vila et al, 2004Wardle et al, 2005) such as the use of clinical samples that may not reflect the general population, the infrequent inclusion of structured clinical interviews based on diagnostic criteria, the lack of use of control groups in the study design, etc. Despite these limitations, there are a number of interesting findings about childhood obesity in relation to mental health problems.…”

“…The psychosocial burden of excess weight appears to be significant even in young children. A cross-sectional survey conducted in 100 primary schools of a large French region, with 2,341 children aged 6-11 randomly selected (Pitrou et al, 2010) found that overweight was strongly associated with poor social functioning and with higher rates of peer difficulties. Other studies, however, have different findings to those already mentioned in relation to childhood obesity and psychological well-being.…”

Comorbilidad psicopatológica en obesidad

“…Por otro lado, en Francia en 2010 16 se publicó una encuesta realizada a 1.030 niños de 6 a 11 años y a sus familiares, de la que se concluyó que el exceso de peso estaba asociado no solo a ciertas variables psicosociales, como bajos ingresos mensuales, sino también con variables psicopatoló-gicas como mayores niveles de ansiedad generalizada, trastornos de conducta informados por los padres, problemas emocionales y dificultades con los compañeros.…”

Beyond Pharmacotherapy: Understanding the Links between Obesity and Chronic Mental Illness

“…A population study of 1429 Chinese adolescents also found that people with ADHD symptoms were 40% more likely to be obese than lean, 88 but the literature is not conclusive as negative findings in a nonclinical French sample of children has also been reported. 89 Several potential mechanisms to explain ADHD-obesity comorbidity have been proposed, many of which are of primary importance to obesity work in general. Impulsivity is a key component of both overeating and ADHD, and is likely to play a key role in their comorbidity.…”