The relationship between family functioning and child and adolescent overweight and obesity: a systematic review

Abstract

There is mounting evidence that family functioning is linked to childhood overweight and obesity, and that both of these are associated with health-related behaviours and adverse health outcomes in children and adolescents. This paper systematically examines the peer-reviewed evidence regarding the relationship between child and adolescent overweight and obesity and family functioning. Peer-reviewed literature published between 1990 and 2011 hosted in Scopus, Pub Med or Psyc INFO were searched, in addition to the reference lists of included papers. Twenty-one studies met the selection criteria. Of the 17 identified cross-sectional and longitudinal studies, 12 reported significant associations between family functioning and childhood overweight and obesity. The instruments used to measure family functioning in the identified studies were heterogeneous. Poor family functioning was associated with increased risk of obesity and overweight in children and adolescents, and obese children and adolescents were more likely to come from families with poor family functioning. Aspects of family functioning which were associated with increased risk of child and adolescent obesity included poor communication, poor behaviour control, high levels of family conflict and low family hierarchy values. Half (2/4) of the identified intervention studies showed a significant relationship between family functioning and changes in child weight. The results demonstrate that family functioning is linked to obesity; however, higher level evidence and greater understanding of the mechanisms behind this relationship are required. The results indicate a need for a standardised family functioning measure applicable across populations. The results provide evidence of the value of considering family functioning in childhood obesity research and intervention.

Relationships of family conflict, cohesion, and chaos in the home environment on maternal and child food‐related behaviours

“…High levels of family cohesion provide a social environment that promotes positive emotional, mental, and physical health, whereas high family conflict typically diminishes health. The limited research examining family functioning vis‐à‐vis food‐related behaviours indicates that compared to children and teens living in high functioning families, those in lower functioning families tend to eat fewer fruits/vegetables (Berge et al, ; Renzaho, Kumanyika, & Tucker, ), consume more fast food (Berge et al, ), have poorer eating habits (Mellin, Neumark‐Sztainer, Story, Ireland, & Resnick, ; Renzaho, Dau, Cyril, & Ayala, ), and increased obesity risk (Cyril, Halliday, Green, & Renzaho, ; Halliday, Palma, Mellor, Green, & Renzaho, ; Zeller et al, ). Women in low functioning families demonstrate more obesity risk behaviours (i.e., more screen time and more soft drink, fast food, chips, and processed meat consumption; Wen, Simpson, Baur, Rissel, & Flood, ).…”

‘I just don't want to get bullied anymore, then I can lead a normal life’; Insights into life as an obese adolescent and their views on obesity treatment

“…When discussing overweight and obesity in relation to young people, psychosocial functioning relates to factors such as self‐esteem, self‐identity, perceptions of physical appearance, athletic skills and social functioning, all of which have been associated with a lower quality of life . A range of studies show that poor family functioning, poor communication, poor behavioural control and high levels of conflict are associated with higher obesity levels . Additionally, adolescents living with obesity can experience a heterogeneous range of problems reinforcing their obesity, including poor family food practices, patterns of physical inactivity and sedentary behaviours, insufficient boundary setting around habits at home such as the use of technology and behaviours at mealtimes, whilst more complex issues around psychological well‐being and sexual or physical abuse also exist …”

Maternal correlates of body mass index in American Indian/Alaska Native and White adolescents: Differences between mother/son and mother/daughter pairs

“…Twenty percent of AI/ANs aged 10-17 years are obese, compared to 12% of non-Hispanic Whites in the same age range (1). Adolescent obesity is a multifactorial disorder (2), and parental factors have been found to play a critical role in adolescent obesity outcomes (3, 4). Given parents’ role in establishing dietary habits (5-7), sedentary behaviors (8-11), and distorted perceptions of body mass index (BMI) (5, 12, 13), interventions to prevent obesity in AI/ANs have often included parents (7, 14, 15).…”