More on Childhood Obesity and Quality of Life


As yesterday’s Childhood Obesity News post noted, quality of life has been a subject of concern for quite a long time in the study of youth obesity. Sometimes, in the midst of all the journal articles and lab results and optimistically designed programs, it’s easy to lose sight of the fact that millions of children and teenagers are not just too big for last month’s clothes, they are abysmally miserable. The discomfort felt by obese kids is both physical and psychological, and it can be extreme. It starts at a very young age, and it hits boys just even harder, at least in the early years.

When London’s MRC Centre of Epidemiology for Child Health and UCL Institute of Child Health researched self-esteem in overweight kids, they wanted to assess exactly how far into the matter previous studies had delved. As they eloquently expressed it, “the psychological morbidities associated with obesity are not well established.” The team found 17 studies on the relation between obesity and self-esteem and 25 quality-of-life studies, which collectively suggested that physical competence, appearance and social functioning were all adversely affected.

The knowledge gained from this and other studies regarding psychosocial risks and mental health disorders was summed up by a British public health website:

There is strong evidence to suggest that by adolescence, there is increased risk of low self-regard and impaired quality of life in obese individuals. Factors associated with mental health problems in obese children include lower levels of physical activity, low self esteem, body dissatisfaction, eating disorders and weight-based teasing. Recent findings from the Millennium Cohort Study suggest that childhood obesity may be associated with emotional and behavioural problems from a very young age, with obese boys at particular risk.

The Millenium Cohort Study is a longitudinal study, of which there are many in both Britain and the United States. The British one referred to here started out with 19,000 babies born in 2000. The basic idea of any study of this kind is to recruit a very large group so the numbers are large enough to be meaningful, especially as time goes on and members of the cohort drop out or die. Such a study follows the course of the subjects’ lives for decades, periodically collecting data in what are called “sweeps.” Only a cohort study has the strength to describe long-term health outcomes, particularly when the answers that are sought concern more than one person. Only a longitudinal study can, for instance, make connections between a pregnant woman’s habits and the formative result they have on her child.

When scientists in 2011 looked for evidence of correspondence between childhood obesity and emotional and behavioral problems, the available data covered just over 11,000 children, evenly divided between the sexes. This particular study looked at the subjects as 3-year-olds and again as 5-year-olds. Here is what it found:

At age 3, obese boys had more conduct problems, and obese girls had more prosocial behaviors, than their normal weight counterparts. At age 5, obese boys had more conduct problems, hyperactivity and inattention problems, peer relationship problems and total difficulties. Obese girls only had more peer relationship problems. Obese 3-year-olds were not at increased risk of abnormal scores; in contrast, obese 5-year-old boys were significantly more likely to have abnormal scores for conduct problems, hyperactivity and inattention problems, peer relationship problems, prosocial behaviors and total difficulties.

Engaging in prosocial behavior is not a bad thing, because it makes the world go round. What this research suggests is that chubby 3-year-old girls are people-pleasers, trying harder than their slender friends to win acceptance and affection. But by age 5, overweight female children are already experiencing more interpersonal relationship problems than the skinnier girls. And that is sad.

Your responses and feedback are welcome!

Source: “Self-esteem and quality of life in obese children and adolescents: a systematic review.,”, August 2010
Source: “Health risks of childhood obesity,”
Source: “Is obesity associated with emotional and behavioural problems in children?,” June 2011
Image by Craig Nagy


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OVERWEIGHT: What Kids Say explores the obesity problem from the often-overlooked perspective of children struggling with being overweight.

About Dr. Robert A. Pretlow

Dr. Robert A. Pretlow is a pediatrician and childhood obesity specialist. He has been researching and spreading awareness on the childhood obesity epidemic in the US for more than a decade.
You can contact Dr. Pretlow at:


Dr. Pretlow’s invited presentation at the American Society of Animal Science 2020 Conference
What’s Causing Obesity in Companion Animals and What Can We Do About It

Dr. Pretlow’s invited presentation at the World Obesity Federation 2019 Conference:
Food/Eating Addiction and the Displacement Mechanism

Dr. Pretlow’s Multi-Center Clinical Trial Kick-off Speech 2018:
Obesity: Tackling the Root Cause

Dr. Pretlow’s 2017 Workshop on
Treatment of Obesity Using the Addiction Model

Dr. Pretlow’s invited presentation for
TEC and UNC 2016

Dr. Pretlow’s invited presentation at the 2015 Obesity Summit in London, UK.

Dr. Pretlow’s invited keynote at the 2014 European Childhood Obesity Group Congress in Salzburg, Austria.

Dr. Pretlow’s presentation at the 2013 European Congress on Obesity in Liverpool, UK.

Dr. Pretlow’s presentation at the 2011 International Conference on Childhood Obesity in Lisbon, Portugal.

Dr. Pretlow’s presentation at the 2010 Uniting Against Childhood Obesity Conference in Houston, TX.

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