Being overweight when entering kindergarten linked to behavior problems in girls

August 02, 2004

CHICAGO — Overweight is associated with behavior problems among girls entering kindergarten, but not boys, according to an article in the August issue of The Archives of Pediatrics & Adolescent Medicine, a theme issue on mental health and one of the JAMA/Archives journals.

According to the article, psychological problems are among the consequences of being overweight during childhood, and overweight children may be teased and ridiculed, leading to low self-esteem. However, most research on overweight and mental health has focused on adolescents and adults.

Ashlesha Datar, Ph.D., of RAND, Santa Monica, Calif., and colleagues investigated the relationship between overweight and behavior problems among 9,949 children as young as 5 years old entering kindergarten in the 1998-1999 school year. Information on height, weight and parent- and teacher-reported behavior problems were collected three times over the children's first two years in school.

The researchers found that among overweight girls, but not boys, there was an 81 percent increased risk of teacher-reported externalizing behavior problems (including problems paying attention and aggressive behavior), a 54 percent increased risk of teacher-reported internalizing behavior problems (including depression and withdrawal), and a 49 percent greater risk of parent-reported internalizing behavior problems. The researcher also found that overweight status did not predict the onset of new behavior problems over time for either girls or boys, but low family income and maternal depression were strong predictors for these problems.

"Childhood overweight is already associated with behavior problems when girls start school, but not boys," write the researchers. "In contrast to common belief, overweight status does not predict the onset of new internalizing or externalizing behavior problems during the first two years of school," the authors conclude.
(Arch Pediatr Adolesc Med. 2004;158:804-810. Available post-embargo at Editor's Note: This study was supported by the National Institute for Health Care Management, Washington, D.C.

For more information, contact JAMA/Archives Media Relations at 312-464-JAMA (5262) or e-mail

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