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Factors associated with depression and anxiety symptoms among children seeking treatment for obesity: A social-ecological approach.

ABSTRACT: BACKGROUND:Children with overweight/obesity are more likely to exhibit symptoms of depression and anxiety than are their peers without overweight/obesity; however, the rates and correlates of depression and anxiety symptoms among children seeking obesity treatment remain unclear. OBJECTIVES:Examine the prevalence and associated factors of depression and anxiety symptoms among treatment-seeking children with overweight/obesity. METHODS:Children 7 to 11 years old (N = 241) and their parents completed assessments before beginning family-based behavioral weight-loss treatment. Disorder-specific self-report questionnaires assessed child depression and anxiety. The social-ecological model served as a framework for examining factors associated with depression and anxiety symptoms. RESULTS:Among our sample, 39.8% (96/241) met clinical cutoffs for depression and/or anxiety symptomatology. Specifically, of these 96, 48 met criteria for both depression and anxiety, 24 for depression only, and 24 for anxiety only. Child eating disorder pathology, parents' use of psychological control (ie, a parenting style characterized by emotional manipulation), and lower child subjective social status were significantly associated with greater child depression symptomatology. Child eating disorder pathology and parent psychological control were significantly associated with greater child anxiety symptomatology. CONCLUSION:Nearly 40% of children exhibited psychopathology symptoms, and a variety of correlates were found. Thus, pediatric weight-loss providers may consider screening for and addressing mental health concerns (and associated factors) prior to and during treatment.

SUBMITTER: Sheinbein DH

PROVIDER: S-EPMC7081722 | biostudies-literature | 2019 Aug

REPOSITORIES: biostudies-literature

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Factors associated with depression and anxiety symptoms among children seeking treatment for obesity: A social-ecological approach.

Sheinbein Daniel H DH Stein Richard I RI Hayes Jacqueline F JF Brown Mackenzie L ML Balantekin Katherine N KN Conlon Rachel P Kolko RPK Saelens Brian E BE Perri Michael G MG Welch R Robinson RR Schechtman Kenneth B KB Epstein Leonard H LH Wilfley Denise E DE

Pediatric obesity 20190416 8

<h4>Background</h4>Children with overweight/obesity are more likely to exhibit symptoms of depression and anxiety than are their peers without overweight/obesity; however, the rates and correlates of depression and anxiety symptoms among children seeking obesity treatment remain unclear.<h4>Objectives</h4>Examine the prevalence and associated factors of depression and anxiety symptoms among treatment-seeking children with overweight/obesity.<h4>Methods</h4>Children 7 to 11 years old (N = 241) an ...[more]

PMID: 30990254

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Project description:BACKGROUND:Obesity is a well-known risk factor for elevated inflammation and insulin resistance. Social anxiety may moderate this relationship, such that individuals who areboth obese and socially anxious may have an even greater risk for elevated inflammation and insulin resistance than those who are obese but not socially anxious; the combination of obesity and social anxiety is markedly stressful. METHODS:The current paper reports secondary analyses from the Biomarker wave of the Mid-Life in the United States (MIDUS) study (N?=?1255), a publicly available dataset of American adults. Participants completed a standard scale measuring social anxiety symptoms and had their waist circumference, height, and weight measured by a staff member. They also provided a fasting blood sample that was assayed for CRP, IL-6, HOMA-IR, glucose, and insulin. RESULTS:The interaction between obesity and social anxiety symptoms was significant. People with a larger waist circumference and more social anxiety symptoms had greater inflammation and insulin resistance relative to those with a larger waist circumference but less social anxiety symptoms. These results were similar for both measures of inflammation and were robust across both the unadjusted and adjusted models. The results were also largely replicated in models using body mass index (BMI) rather than waist circumference as the measure of obesity. CONCLUSIONS:The current findings build on existing work about the health risks of obesity, extending it in an important new direction by demonstrating that these health risks are stronger among those who are also socially anxious. In fact, the magnitude of the relationship between obesity and metabolic function is 1.5 times stronger among those with more social anxiety symptoms. Thus, knowing whether a person is obese only provides one piece of the puzzle; knowing information about both obesity and social anxiety symptoms is critical for understanding who is most at risk for obesity-related health problems. Thus, a critical next step is for intervention scientists to examine health programs tailored to people who are both obese and socially anxious.

Dataset Information

Factors associated with depression and anxiety symptoms among children seeking treatment for obesity: A social-ecological approach.

Publications

Factors associated with depression and anxiety symptoms among children seeking treatment for obesity: A social-ecological approach.

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