Association Between Obesity/Overweight and Functional Gastrointestinal Disorders in Children

Although emerging data indicate that obese/overweight children are more likely to develop functional gastrointestinal disorders (FGIDs) than normal-weight peers, contrasting results have been reported. The present observational, case-control study aimed at estimating the prevalence of FGIDs in obese/overweight children compared to normal-weight peers.

Consecutive obese and overweight children aged 4 to 18 years attending the obesity outpatient clinic were enrolled as study cases. Normal-weight children were enrolled as comparison group. All the enrolled patients received a thorough health examination from both a pediatric endocrinologist and gastroenterologist. Moreover, they were asked to fill out the Rome III questionnaire for the diagnosis of FGIDs. Data were analyzed to compare the prevalence of FGIDs between cases and controls.

Throughout the study period we enrolled 103 cases and 115 controls. No significant age and sex differences were found between the 2 groups. FGIDs were significantly more prevalent in obese/overweight compared to normal-weight children (47.57% vs 17.39%; P < 0.0001). Increased prevalence was observed for functional constipation (18.44% vs 7.82%; P = 0.025), functional dyspepsia (23.33% vs 6.95%; P = 0.001), and irritable bowel syndrome (10.67% vs 2.60%; P = 0.024), whereas no difference was observed for functional abdominal pain (1.94% vs 2.60%; P = 1.00).

Our data suggest that there is a link between excess body fat and FGIDs in children. This finding may offer a model of patients in which the effects of food and nutritional substances, the gut microbial environment, and psychosocial factors are fitting well with the emerging biopsychosocial conceptual model for FGIDs.