Factors associated with depression and anxiety symptoms among children seeking treatment for obesity: A social‐ecological approach

Abstract

Summary Background Children with overweight/obesity are more likely to exhibit symptoms of depression and anxiety than are their peers without overweight/obesity; however, the rates and correlates of depression and anxiety symptoms among children seeking obesity treatment remain unclear. Objectives Examine the prevalence and associated factors of depression and anxiety symptoms among treatment‐seeking children with overweight/obesity. Methods Children 7 to 11 years old (N = 241) and their parents completed assessments before beginning family‐based behavioral weight‐loss treatment. Disorder‐specific self‐report questionnaires assessed child depression and anxiety. The social‐ecological model served as a framework for examining factors associated with depression and anxiety symptoms. Results Among our sample, 39.8% (96/241) met clinical cutoffs for depression and/or anxiety symptomatology. Specifically, of these 96, 48 met criteria for both depression and anxiety, 24 for depression only, and 24 for anxiety only. Child eating disorder pathology, parents' use of psychological control (ie, a parenting style characterized by emotional manipulation), and lower child subjective social status were significantly associated with greater child depression symptomatology. Child eating disorder pathology and parent psychological control were significantly associated with greater child anxiety symptomatology. Conclusion Nearly 40% of children exhibited psychopathology symptoms, and a variety of correlates were found. Thus, pediatric weight‐loss providers may consider screening for and addressing mental health concerns (and associated factors) prior to and during treatment.

A brief session‐by‐session measure of eating disorder psychopathology for children and adolescents: Development and psychometric properties of the Eating Disorder‐15 for Youth (ED‐15‐Y)

“…Community norms for youth ages 12–14 are available (Carter, Stewart, & Fairburn, 2001), but psychometric properties of the EDE‐A have not been examined. In contrast, the YEDE‐Q has been used primarily in overweight populations (Balantekin et al, 2017; Eichen et al, 2019; Kass et al, 2017; Sheinbein et al, 2019; Skjåkødegård et al, 2016). Only one study of eating disorders was identified that used the YEDE‐Q, which demonstrated some evidence of convergent validity in adolescent inpatients with AN (Noetel et al, 2016).…”

Development of RisObIn.Com, a Screening Tool for Risk of Childhood Obesity in the Community

“…In reaction to anxiety, emotional eating acts as a biological response that provides temporary feelings of gratification/satisfaction [57]. The intervention approach for children with anxiety symptoms and emotional eating should be adapted to address the negative emotions underlying eating behaviors as well as teaching healthy coping strategies for these emotions [58]. Parents and their own perception of the child's dietary habits is one of the most important factors for the dietary habits of children [59].…”

Body mass index and peer victimization: A transactional model

“…Body mass index (BMI) is the weight‐to‐height ratio, where an increased BMI, specific to growth standards of a population, is indicative of overweight and obesity in the population (WHO, 2018). Being obese or overweight among youth are associated with a plethora of adverse physical, psychosocial, and psychological consequences (Li et al, 2020; Sheinbein et al, 2019), one of them being increased risk of being bullied (Van Geel et al, 2014; Waasdorp et al, 2018). However, these results were mostly based on cross‐sectional designs that do not allow for analysis of directionality of relations, and the few longitudinal studies that have examined the direction of links have reported inconsistent results (Adams & Bukowski, 2008; Baldwin et al, 2016; Lee et al, 2018; Lumeng et al, 2010).…”