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I call Charlotte Hardman. I am a Lecturer in Psychology at the University of Liverpool in the UK. And I am here at the European Congress on Obesity in Glasgow to present our latest research on childhood obesity and mental health symptoms.
How did you do your study?
We used data from the Millennium Cohort Study. It is a large cohort based on the population of the United Kingdom. They are children born between 2000 and 2002, and they are followed since. This provides a very rich source of data. We used data from just over 17,000 children in this cohort and reviewed badessments from 3 to 14 years of age. What interested us was their level of obesity, as well as their level of mental health symptoms, which we call internalisation symptoms – it's basically symptoms related to mental health, to Anxiety, depression and weaning.
We were interested in the extent to which obesity and internalization of symptoms could occur and develop together. Because we know that mental health issues and obesity are increasing in children and adolescents, we do not know much about how they might be badociated and how they might develop together.
This is the primary objective of our study: to answer this question and also to examine the temporal precedents of these two results for health during childhood and adolescence.
So we tried to answer the following question: what comes first? Does obesity precede mental health or is it the opposite?
What were your discoveries?
The main conclusion is that we did not find much badociation between mental health and obesity before the age of 7 years. Once children reached the age of 7, we found that obesity and internalized symptoms were more likely to occur together, and there was also an badociation in their rate of development. Thus, increases in one over time were badociated with an increase in the other. And what we also saw emerge from age 7 was a bidirectional badociation. We found that obesity predicted a subsequent risk of developing elevated internalizing symptoms, but that high internalizing symptoms were also a risk factor for later obesity.
This indicates that what we are seeing here is a two-way badociation where one is badociated with the other.
Did you expect children to be affected at such a young age?
It was quite surprising. We know that the rate of obesity increases with age and adolescence. And it's the same for mental health. An earlier study similar to the one we found suggests that badociations began to emerge later in childhood.
And there are a lot of reasons for that. We could not tell from our study. But it could be that as children grow older they become a little more aware of body weight. Unfortunately, having a higher body weight is highly stigmatized in our society. Other studies have also shown that the more children grew up, the more they became aware of it. And they begin to internalize this bias, this bias on weight and this can affect self-esteem and can potentially lead to depressive symptoms. So you can see how they could potentially be linked by this particular mechanism.
Were some groups of children more at risk than others?
It's a very interesting question. What we did with the data was that we looked at the factors that might explain the badociation, one of the most obvious being the socio-economic position.
Previous research has shown that children from disadvantaged backgrounds are more likely to suffer from obesity and mental health problems.
It is therefore possible that the socio-economic position can explain and even confuse all the relations that we might encounter. So this is an important part of our study: we controlled the socio-economic position. And when we did that, we found that the badociations between obesity and the internalization of symptoms have weakened a bit.
But we still found that there were unique badociations, even after controlling the socio-economic position. And it's important because it suggests that there are other factors at play here. And these factors can be psychological, social or physiological. So the essentially socio-economic position partly explains part of the badociation, but that's not the only factor.
How could your results be used in practice?
We therefore believe that our study highlights the complexity of obesity. So I think some people might think that obesity is just eating less and getting more exercise, and that could be easier. And I think our study really disputes that and shows that there is a connection with mental health.
And this link starts to develop from 7 years old. And I think it's very important for anyone working with obese children to fully understand this connection with mental health. So, if a child is struggling with his weight, he is also more and more likely to struggle with his mental health. And that has implications for the types of treatment that we could use, and I really think it's important to stress that weight should be treated with extreme sensitivity when we work with young people.
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