Is obesity associated with depression in children? Systematic review and meta-analysis
Abstract
Objectives: To compare the odds of depression in obese and overweight children with that in normal-weight children in the community. Design: Systematic review and random-effect meta-analysis of observational studies. Data sources: EMBASE, PubMed and PsychINFO electronic databases, published between January 2000 and January 2017. Eligibility criteria for selecting studies: Cross-sectional or longitudinal observational studies that recruited children (aged <18 years) drawn from the community who had their weight status classified by body mass index, using age-adjusted and sex-adjusted reference charts or the International Obesity Task Force age-sex specific cut-offs, and concurrent or prospective odds of depression were measured. Results: Twenty-two studies representing 143 603 children were included in the meta-analysis. Prevalence of depression among obese children was 10.4%. Compared with normal-weight children, odds of depression were 1.32 higher (95% CI 1.17 to 1.50) in obese children. Among obese female children, odds of depression were 1.44 (95% CI 1.20 to 1.72) higher compared with that of normal-weight female children. No association was found between overweight children and depression (OR 1.04, 95% CI 0.95 to 1.14) or among obese or overweight male subgroups and depression (OR 1.14, 95% CI 0.93 to 1.41% and 1.08, 95% CI 0.85 to 1.37, respectively). Subgroup analysis of cross-sectional and longitudinal studies separately revealed childhood obesity was associated with both concurrent (OR 1.26, 95% CI 1.09 to 1.45) and prospective odds (OR 1.51, 95% CI 1.21 to 1.88) of depression. Conclusion: We found strong evidence that obese female children have a significantly higher odds of depression compared with normal-weight female children, and this risk persists into adulthood. Clinicians should consider screening obese female children for symptoms of depression. Background: Childhood mental illness is poorly recognised by healthcare providers and parents, despite half of all lifetime cases of diagnosable mental illness beginning by the age of 14 years. 1 Globally, depression is the leading cause of disease burden, as measured by disability-adjusted life years, in children aged 10–19 years. 2 Untreated, it is associated with poor school performance and social functioning, substance misuse, recurring depression in adulthood and increased suicide risk, which is the second leading cause of preventable death among young people. 3–6 The resulting cost to the National Health Service of treating depression is estimated at over £2 billion, and the wider social and economic impact of depression is likely to be considerable. 7
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Overweight and underweight adolescents have an increased risk of psychological problems and reduced quality of life.
“Overweight and underweight adolescents have an increased risk of psychological problems and reduced quality of life.”
From Psychopathological symptoms and well-being in overweight and underweight adolescents: A network analysis (2021) · cites this paper as [1]
School-aged children and adolescents who have high BMIs and excessive body weights are known to be at high risk of developing depression.
“as well as depression.26”
From Physical activity and health in Chinese children and adolescents: expert consensus statement (2020) (2020) · cites this paper as [26]
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“26 Despite the importance of regular physical activity and compelling evidence from the growing body of scientific literature regarding its health benefits for children and adolescents, there has been a lack of research-driven, evidence-based, culturally relevant consensus on physical activity and…”
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- Authors
- Sutaria, S., Devakumar, D., Yasuda, S. S., Das, S., & Saxena, S.
- Affiliations
- Imperial College London (GB)
- University College London (GB)
- Corresponding author
- Sutaria, Shailen
- Venue
- Archives of Disease in Childhood
- Publisher
- BMJ
- Published
- 2018-06-29
- Volume
- 104
- Issue
- 1
- Pages
- 64-74
- ISSN
- 0003-9888 (ISSN-L)
- 1468-2044
- OpenAlex
- W2811190164
- Cited by
- 240
- References
- 60
- Citations by year
- 2026: 28 · 2025: 28 · 2024: 35 · 2023: 41 · 2022: 44 · 2021: 22 · 2020: 26 · 2019: 13 · 2018: 3
- FWCI
- 2.91
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Archives of Disease in Childhood (publishedVersion)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (publishedVersion)
- HighWire Press Open Archive (submittedVersion)
- Spiral (Imperial College London) (submittedVersion)
- Funders
- National Institute for Health and Care Research (CL-2015-18-004)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
- Keywords
- childhood obesity, depression, overweight, sex differences, body mass index, depression prevalence, depression screening, child mental health
- MeSH terms
- Child Health, Suicide Prevention, Child, Depression, Humans, Mental Health, Suicide, Pediatric Obesity, Observational Studies as Topic
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