Childhood overweight and elementary school outcomes

Abstract

Objective: To examine the link between childhood overweight status and elementary school outcomes. Design: Prospective study design: multivariate regression models examining the association between changes in overweight status and school outcomes between kindergarten entry and end of third grade, after controlling for various child, family and school characteristics. Subjects: Nationally representative sample of US children who entered kindergarten in 1998, with longitudinal data on body mass index (BMI) and school outcomes at kindergarten entry and end of third grade. Measurements: Wide range of elementary school outcomes collected in each wave including academic achievement (math and reading standardized test scores); teacher reported internalizing and externalizing behavior problems (BP), social skills (selfcontrol, interpersonal skills) and approaches to learning; school absences; and grade repetition. Measurements of height and weight in each wave were used to compute BMI and indicators of overweight status based on CDC growth charts. A rich set of control variables capturing child, family, and school characteristics. Results: Moving from not-overweight to overweight between kindergarten entry and end of third grade was significantly associated (Po0.05) with reductions in test scores, and teacher ratings of social-behavioral outcomes and approaches to learning among girls. However, this link was mostly absent among boys, with two exceptions -boys who became overweight had significantly fewer externalizing BPs (Po0.05), but more absences from school compared to boys who remained normal weight. Being always-overweight was associated with more internalizing BP among girls but fewer externalizing BPs among boys. Conclusion: Change in overweight status during the first 4 years in school is a significant risk factor for adverse school outcomes among girls but not boys. Girls who become overweight during the early school years and those who start school being overweight and remain that way may need to be monitored carefully. IntroductionThe dramatic rise in childhood overweight in recent years has sparked numerous research studies that have examined the consequences of overweight at young ages on health and socioeconomic outcomes in adulthood.1-4 A number of studies have also examined health consequences in childhood and adolescence, in particular, psychological outcomes such as self-esteem and depression. [5][6][7][8][9] Less is known, however, about how childhood overweight might affect children's school outcomes. As children spend a significant amount of time in school daily it is possible that the effects of being overweight are felt in various aspects of school-life, including academic achievement, social skills, and attendance. There are multiple pathways through which this effect might transfer. First, being overweight may lower self-esteem and body image and make it harder for children to concentrate or be attentive in class, thereby preventing them from learning in school. This psychosocial aspect has be...

Teasing and social rejection among obese children enrolling in family-based behavioural treatment: effects on psychological adjustment and academic competencies

“…46 In community samples of children and adolescents, an association between overweight and obesity and lower academic competencies has repeatedly been observed. [6][7][8] In concordance to those studies, a higher likelihood of low academic competencies would have been expected in this clinical sample of obese children as compared to the general population of Icelandic children. As no other studies of academic competencies among obese children in a clinical sample were found, these findings require replication.…”

“…[1][2][3][4][5] In community samples of children and adolescents, overweight and obesity has also been associated with lower academic competencies, [6][7][8] although this association has, to our knowledge, not been studied in a clinical sample of obese children.…”

“…However, a higher degree of overweight has not been associated with an increased risk of psychological maladjustment in clinical samples of obese children, 2,9-11 although this association has been commonly observed among community-based samples. [17][18][19] Few studies have been published about the moderators and mediators of the association between childhood obesity and academic competencies, but suggested factors include parental education and SES, child's gender, school absenteeism, 6,7,17,20 diet and physical activity, 17 psychological adjustment 17 and most recently weight-based stigma, teasing and social rejection. 8 Among children in general, approximately 17-30% report experiencing teasing and social rejection.…”

Associations between obesity and developmental functioning in pre-school children: a population-based study

“…7,8 Findings from population-based studies do suggest that associations between obesity and impairment in children's psycho-social functioning may be mediated by age and gender, with greater impairment in older children and in females. 7,10 Few studies have addressed the possible effects of childhood obesity on other aspects of developmental functioning. A recent study of first-grade children in Germany (mean age ¼ 6.7 years) 11 found that obesity was associated with impairment in motor development in both boys and girls, whereas Datar and Sturm (2004), 12 in a large and nationally representative sample children beginning kindergarten in the US, found that obesity was associated with higher levels of teacher-and parent-reported behavior problems in girls, but not boys, after controlling for socio-demographic, lifestyle and family variables.…”

“…15 Impairment in developmental functioning during childhood may have adverse effects on self-esteem, psycho-social functioning more generally, and academic performance, as well as increasing the risk of obesity later in life. 10,12 To date, the vast majority of studies that have examined associations between childhood overweight and impairment in specific aspects of functioning have been conducted in adolescents. Hence, where associations have been observed, it is unclear whether these effects were apparent earlier in the child's development and, if so, at what point.…”