Pediatric Obesity Research Update | Psychiatric Disorders and Obesity in Childhood and Adolescence-A Systematic Review of Cross-Sectional Studies

Each month, the OMA Pediatric Committee reviews a pediatric-focused obesity research update to help keep you up to date about the latest findings. This month’s update addresses psychiatric disorders and obesity.

Psychiatric Disorders and Obesity in Childhood and Adolescence-A Systematic Review of Cross-Sectional Studies

Article Summary

Obesity and psychiatric disorders are major contributors to the global disease burden. This study aims to assess what we know currently about the association between these disease categories and identify gaps in knowledge. Read the full article.

Article Review

Both obesity and psychiatric disorders are considered major contributors to our global disease burden. Global obesity rates among almost 130 million children, adolescents and adults have tripled since 1975. In 2020, the World Health Organization reported that more than 30 million minors had obesity. In addition to the myriad of physical impacts of obesity, a significant body of evidence suggests that obesity is linked to lower social and physical indicators of quality of life. Mental health illness is also on the rise. A recent study that assessed the prevalence of mental health illnesses among 204 countries and various age groups found that between 1990 and 2019 the disability-adjusted life years due to mental health illnesses increased from 80.8 million to 125.3 million constituting mental health illness among the top 10 leading causes of diseases. Mental health illnesses such as anxiety, eating disorders, and depression often co-occur with risk factors for poor physical health such as obesity. Previous research also suggests that individuals with persistent chronic mental health illness are more susceptible to weight gain.

Based on the Prisma guidelines, this review includes cross-sectional studies published within the last decade. The authors looked at the relationship between psychiatric disorders (i.e. anxiety, mood disorders, and psychoses) and obesity in youth. In total, the authors reviewed 14 cross-sectional studies that included 23, 442 youth (<19 years). Nine of the studies reported a significant relationship between obesity and the psychiatric disorder examined. Most of the included studies reported a significant association between obesity and affective disorders such as depression. The review has showed that these diseases (obesity and psychiatric disorders) share a common genetic profile and similar behavioral patterns. For example, both bipolar disorder and depression affect and distort energy, motivation, attitude towards eating, and need for sleep – rendering patients more vulnerable to weight gain.

The relationship between obesity and disorders in the spectrum of psychosis was examined in one study, possibly due to the fact that psychosis emerges during late adolescence and early adulthood which limits evidence based on the inclusion criteria for this review. It must be noted that studies have suggested that psychosis itself is responsible for glucose deregulation, even though evidence is scarce. Although it must be considered across the board, atypical antipsychotics are well documented to have an effect on weight gain and metabolic disturbances, further exacerbating the risk of obesity in susceptible populations. Another of the included studies investigated the connection between social anxiety and obesity, with results indicating that social anxiety and body mass index (BMI) were significantly correlated. In one study, researchers included 150 adolescents aged between 14 and 18, and found that social anxiety and obesity had a positive relationship.

The authors identified several limitations of this review, including the cross-sectional design of most studies reviewed. In addition, many of the studies used self-report tools as identifiers of psychiatric disease rather than validated clinical or diagnostic assessments. Lastly, the review is limited by the overall lack of research looking at these associations – obesity and psychiatric disorders. Despite the limitations, this review highlights the association between mental health illnesses and obesity, and reveals an important opportunity for future studies.

Additional Resources

Find more resources, curated by OMA’s Pediatric Committee, on our Pediatric Resources page. There you’ll find additional article reviews on various topics related to obesity as well as public resources for clinicians and families.