Is obesity associated with emotional and behavioural problems in children? Findings from the Millennium Cohort Study

We examined cross-sectional and longitudinal associations between obesity and emotional and behavioural problems in a nationally representative sample of young children.

Data were available from 11 202 children (50% boys) participating in the UK's Millennium Cohort Study. Height and weight were measured at 3 and 5 years and children defined as obese using IOTF cut-offs for body mass index (BMI). Emotional and behavioural problems were parentally assessed using the Strengths and Difficulties Questionnaire. Adjusted linear and multinomial regression analyses were conducted separately for boys and girls.

At age 3, obese boys had more conduct problems, and obese girls had more prosocial behaviours, than their normal weight counterparts. At age 5, obese boys had more conduct problems, hyperactivity and inattention problems, peer relationship problems and total difficulties. Obese girls only had more peer relationship problems. Obese 3-year-olds were not at increased risk of abnormal scores; in contrast, obese 5-year-old boys were significantly more likely to have abnormal scores for conduct problems, hyperactivity and inattention problems, peer relationship problems, prosocial behaviours and total difficulties. Obesity, at age 3, was also predictive of peer relationship problems at age 5 in boys (95% CI: 0.26 [0.01, 0.52]).

Childhood obesity is associated with emotional and behavioural problems from a very young age. Obese boys are at particular risk. Further research is required to examine effect modifiers and mediating factors in these associations. Recognition and response to these mental health problems should be a goal of pediatric obesity interventions and policies.