Associations Between Obesity and Comorbid Mental Health, Developmental, and Physical Health Conditions in a Nationally Representative Sample of US Children Aged 10 to 17

doi:10.1016/j.acap.2012.10.007

Academic Pediatrics

Volume 13, Issue 1, January–February 2013, Pages 6-13

https://doi.org/10.1016/j.acap.2012.10.007 Get rights and content

Abstract

Objective

This large population-based study of US children considered the association of obesity with a broad range of comorbidities. This study examined relationships between weight status and health for US children.

Methods

We performed cross-sectional analysis of data on 43,297 children aged 10 to 17 from the 2007 National Survey of Children’s Health. Weight status was calculated from parent report of child height and weight. Logistic regression models assessed associations between weight status and 21 indicators of general health, psychosocial functioning, and specific health disorders, adjusting for sociodemographic factors.

Results

Using body mass index (BMI) percentiles for age and sex, 15% of US children were considered overweight (BMI 85th to <95th percentile), and 16% were obese (BMI ≥95th percentile). Compared with children classified as not overweight, obese children were more likely to have reported good/fair/poor health (adjusted odds ratio [AOR] 2.18, 95% confidence interval [CI] 1.76–2.69), activity restrictions (AOR 1.39, 95% CI 1.10–1.75), internalizing problems (AOR 1.59, 95% CI 1.04–2.45), externalizing problems (AOR 1.33, 95% CI 1.07–1.65), grade repetition (AOR 1.57, 95% CI 1.24–1.99), school problems, and missed school days. Attention deficit/hyperactivity disorder, conduct disorder, depression, learning disability, developmental delay, bone/joint/muscle problems, asthma, allergies, headaches, and ear infections were all more common in obese children.

Conclusions

Obese children have increased odds of worse reported general health, psychosocial functioning, and specific health disorders. Physicians, parents, and teachers should be informed of the specific comorbidities associated with childhood obesity to target interventions that could enhance well-being. Future research should examine additional comorbidities and seek to confirm associations using longitudinal data and clinical measures of height and weight.

Section snippets

Sample

The 2007 NSCH was conducted by the National Center for Health Statistics as a module of the State and Local Area Integrated Telephone Survey. The NSCH used a stratified random-digit-dial sampling design to achieve a nationally representative sample of 91,642 parents of children 0 to 17 years of age. One child was randomly selected from each household, and a detailed telephone interview was conducted with the parent or guardian who knew the most about the child’s health and health care.

Prevalence of Overweight and Obesity

The estimated prevalence of overweight based on parent-reported height and weight for all children aged 10 to 17 was 15% (95% confidence interval [CI] 14–16), and prevalence of obesity was 16% (95% CI 15–17). Wide social differentials in rates of overweight and obesity are apparent (Table 1). Obesity rates were nearly 3 times higher for children in poor families versus those at 400% FPL or greater (27% vs 10%), and nearly 2 times higher for black and Hispanic children versus white non-Hispanic

Discussion

Overweight and obesity were associated with poorer health status, lower emotional functioning, and school-related problems. Greater weight was also associated with higher rates of specific comorbid conditions, including ADHD, conduct disorders, depression, learning disabilities, developmental delay, good/fair/poor teeth, bone/joint/muscle problems, asthma, allergies, headaches, and ear infections. Although controlling for social status dampened the magnitude of these associations, most

Conclusions

The past 20 years have shown dramatic increases in the prevalence of childhood obesity, with recent studies showing that obesity has almost doubled between 1988 and 2006.3, 61 This same time period has also shown large increases in the prevalence of other childhood-onset health conditions such as ADHD, conduct problems, learning difficulties, and asthma.62, 63 The finding that comorbid conditions tend to cluster within individuals and that there are common social risk factors that might

Acknowledgments

Supported in part by funding from the Maternal and Child Health Bureau of the Health Resources and Services Administration Interdisciplinary Maternal and Child Health Training Program (2 T76M600014:11) (Dr Halfon) and NIH LRP (Dr Larson). We also thank Dena Herman, PhD, for her comments; Louba Aaronson, who assisted with data analysis; and Amy Graber, who assisted with document preparation.

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Children at RiskAssociations Between Obesity and Comorbid Mental Health, Developmental, and Physical Health Conditions in a Nationally Representative Sample of US Children Aged 10 to 17

Abstract

Objective

Methods

Results

Conclusions

Section snippets

Sample

Prevalence of Overweight and Obesity

Discussion

Conclusions

Acknowledgments

J Nutr

Soc Sci Res

Psychiatr Clin N Am

J Pediatr Nurs

J Pediatr

J Adolesc Health

Ann Epidemiol

Prevalence and trends in overweight among US children and adolescents, 1999–2000

JAMA

Prevalence of overweight and obesity in the United States, 1999–2004

JAMA

The increase of childhood chronic conditions in the United States

JAMA

A potential decline in life expectancy in the United States in the 21st century

N Engl J Med

How much should we invest in preventing childhood obesity?

Health Aff (Millwood)

Health consequences of obesity

Arch Dis Child

Chemical toxins: a hypothesis to explain the global obesity epidemic

J Altern Complement Med

The obesity epidemic: from the environment to epigenetics—not simply a response to dietary manipulation in a thermoneutral environment

Front Genet

Overweight, obesity, and health-related quality of life among adolescents: the National Longitudinal Study of Adolescent Health

Pediatrics

Health status and health care expenditures in a nationally representative sample: how do overweight and healthy-weight children compare?

Pediatrics

Comorbidities of obesity in school children: a cross-sectional study in the PIAMA birth cohort

BMC Public Health

Health-related quality of life of overweight and obese children

JAMA

Overweight and basal metabolic rate in boys with attention-deficit/hyperactivity disorder

Eat Weight Disord

Childhood obesity and attention deficit/hyperactivity disorder: a newly described comorbidity in obese hospitalized children

Int J Eat Disord

Overweight in children and adolescents in relation to attention-deficit/hyperactivity disorder: results from a national sample

Pediatrics

Mental health problems and overweight in a nationally representative sample of adolescents: effects of race and ethnicity

Pediatrics

Physician-diagnosed obesity in German 6- to 14-year-olds. Prevalence and comorbidity of internalising disorders, externalising disorders, and sleep disorders

Obes Facts

Asthma and obesity in children

Curr Opin Pediatr

Association between asthma symptoms and obesity in preschool (4–5 year old) children

J Asthma

Healthy for now? A cross-sectional study of the comorbidities in obese preschool children in the United States

Clin Pediatr (Phila)

Orthopedic complications of overweight in children and adolescents

Pediatrics

Obesity and paediatric migraine

Cephalalgia

Headaches in overweight children and adolescents referred to a tertiary-care center in Israel

Obesity (Silver Spring)

Relationship between pediatric obesity and otitis media with effusion

Arch Otolaryngol Head Neck Surg

Attention-deficit/hyperactivity disorder (ADHD) and obesity: a systematic review of the literature

Crit Rev Food Sci Nutr

Children at Risk
Associations Between Obesity and Comorbid Mental Health, Developmental, and Physical Health Conditions in a Nationally Representative Sample of US Children Aged 10 to 17