Associations between Anxiety Symptoms and Child and Family Factors in Pediatric Obesity

Objective: This study compared child weight status, social skills, body dissatisfaction, and health-related quality of life (HRQOL), as well as parent distress and family functioning in youth who are overweight or obese (OV/OB) with versus without clinical anxiety symptoms. Method: Participants included 199 children 7 to 12 years of age (mean age = 9.88 years) who were OV/OB, and their parents. Children completed social skills, body dissatisfaction, and HRQOL questionnaires. Parents completed the Child Behavior Checklist (CBCL) and child HRQOL, parent distress, family functioning, and demographic questionnaires. Children were placed in 2 groups based on CBCL anxiety problems scale scores: the OV/OB + clinical anxiety group included children with T scores ≥65 (n = 23) and children with T scores ≤59 comprised the OV/OB group (n = 176). Results: After controlling for covariates, children in the OV/OB + clinical anxiety group reported more body dissatisfaction (F[1,198] = 5.26, p = .023, partial η2 = .027) and lower total HRQOL (F[1,198] = 8.12, p = .005, η2 = .041) and had parents who reported higher psychological distress (F[1,198] = 5.48, p = .020, η2 = .028) and lower child total HRQOL (F[1,198] = 28.23, p < .001, η2 = .128) compared with children in the OV/OB group. Group differences were not significant for child weight status, social skills, or family functioning. Conclusion: Clinically significant anxiety among children who are OV/OB is associated with increased body dissatisfaction and parent psychological distress, as well as decreased HRQOL. Findings have implications for the assessment and treatment of anxiety symptoms in pediatric obesity.