Obesity and its association with mental health among Mexican children and adolescents: systematic review

Abstract

Context Obesity and mental health issues increasingly affect children and adolescents, but whether obesity is a risk factor for mental health issues is unclear. Objective To systematically review the association between obesity and mental health issues (ie, anxiety and/or depression) among Mexican children and adolescents. Data sourcing, extraction, and synthesis A literature search of 13 databases and 1 search engine was conducted. Population, exposure, comparison, outcomes, and study design data were extracted, analyzed, and narratively synthesized. The JBI critical appraisal tool was used to evaluate evidence quality. Results A total of 16 studies with 12 103 participants between 8 and 18 years old were included. Four studies focused on anxiety outcomes, 10 on depression, and 2 on both (ie, anxiety and depression). Evidence is unclear about the association of obesity with anxiety. However, most evidence shows that Mexican children and adolescents with overweight or obesity are more likely to have depression or report a higher number of depressive symptoms than normal-weight participants. Such likelihood is greater for females. Conclusion Health promotion interventions to treat or prevent obesity could also consider mental health outcomes. Systematic Review Registration PROSPERO registration no. CRD42019154132

Dose-Dependent Association Between Body Mass Index and Mental Health and Changes Over Time

“…The increase in obesity is often attributed to today’s obesogenic environment of unhealthy family and community lifestyles, aggressive marketing of unhealthy foods, promotion of sedentary behaviors, widespread availability of energy-dense foods, and increased screen time. This environment worsens obesity and the mental health challenges experienced by adolescents . Our findings, consistent across time, sex, and grades, confirm this U-shaped pattern, underscoring its relevance for public health policies.…”

“…Additionally, the surge in depression among adolescent girls might diminish the relative impact of BMI z scores, as their overall mental distress is already high. This could also explain the stronger BMI z score–body dissatisfaction association in girls, who often report greater body dissatisfaction . These findings highlight the need to consider various influences on adolescent mental health, including social and environmental factors, not just BMI z scores metrics.…”

“…Individuals with underweight often experience a sense of insufficiency, negative body image, and societal or peer pressures, affecting mental health . Biological factors, like genetics, can make healthy weight maintenance challenging for some adolescents . Conversely, adolescents with overweight or obesity often experience stigmatization and bullying, contributing to mental health issues .…”

“…We considered several confounders that previous literature has identified as relevant to both BMI and mental health. These included sociodemographic variables, like age, sex, and family affluence of adolescents . Family affluence was measured using the validated Family Affluence Scale, a proxy for socioeconomic status, with scores ranging from 0 to 9, where higher scores indicate greater affluence …”

“…1,2 In 2016, 340 million children and adolescents had overweight or obese globally. 3 Higher weight not only carries risks of physical diseases, like cardiovascular disease and type 2 diabetes, but also affects current and future mental health. [4][5][6] This issue is increasingly critical as the growing rates of overweight and obesity in adolescence often extend into early adulthood.…”