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Family conflict, financial strain linked to childhood obesity


Diet and exercise may present an incomplete picture when it comes to kids becoming overweight or obese. A new study suggests family-related factors also play a role, particularly for girls.

The study, published in the journal Preventive Medicine last month, examined three types of family stress to understand which, when experienced repeatedly, are linked to being overweight or obese at age 18. They included family disruption and conflict — events such as a mother divorcing or remarrying, a parent being sent to jail, the death of someone close, or the child suffering violence; financial strain, measured in part by living below the poverty line or a mother's long period of unemployment; and maternal poor health, which included a mother's binge drinking, drug use, and depression.


Analyzing longitudinal survey data on nearly 4,800 adolescents, the researchers found that girls who experienced family disruption and conflict or financial strain repeatedly between their birth and age 15 were more likely to be overweight or obese at age 18. For boys, maternal poor health was linked to being overweight or obese at 18.

The study did not explore the reason for the gender differences. Yet the findings align with those from earlier research showing that family instability and economic adversity seem to place girls — but not boys — at greater risk of obesity during young adulthood.

Eating to alleviate stress seems to be more common among females than males, and there may be hormonal factors at work, says lead author Daphne Hernandez, assistant professor in the health and human performance department at the University of Houston and the Texas Obesity Research Center. Repeated or chronic stress can lead to an increase in secretion of cortisol, which may stimulate food intake and suppress satiety. "When people eat because they're stressed, they're reaching for comfort food, not the carrot or the apple," Hernandez says.


Obesity remains a stubborn health issue in the United States. Around 17 percent of kids ages 2-19 and 35 percent of adults age 20 or older are obese, according to Centers for Disease Control and Prevention data. Obesity is linked to health conditions including heart disease, stroke, type 2 diabetes, and some types of cancer.

A study of mealtime interactions published in Pediatrics last fall found another family-related link to obesity. Compared with normal weight children's family meals, overweight or obese kids' family meals tended to include more hostile or critical behavior, more lecturing about food or eating (comments such as "children in other countries are starving while you waste food"), and other negative interactions.

School-based obesity intervention programs that focus on diet and exercise could benefit from including family-related factors, Hernandez says. For instance, they could help reduce family-related stress through access to counseling and financial aid services.

"At the end of the day, kids are going home to their family environment," Hernandez says. "So it would be beneficial for these programs to help kids manage stress."

US obesity - Children and adolescents
The percentages of US children and adolescents (ages 2-19) meeting the criteria for overweight or obese over time. "Overweight" is defined as having a body mass index (BMI) between the 85th and 95th percentiles (by sex and age) from the 2000 CDC Growth Charts. "Obese" is defined as having a BMI greater than or equal to the 95th percentile.
Survey period Sample Overweight Obese
1971–1974 7,041 10.2% 5.2%
1976–1980 7,351 9.2% 5.5%
1988–1994 10,777 13% 10%
1999–2000 4,039 14.2% 13.9%
2001–2002 4,261 14.6% 15.4%
2003–2004 3,961 16.5% 17.1%
2005–2006 4,207 14.6% 15.4%
2007–2008 3,249 14.8% 16.8%
2009–2010 3,408 14.9% 16.9%
2011–2012 3,355 14.9% 16.9%
SOURCE: Centers for Disease Control and Prevention/National Center for Health Statistics, National Health and Nutrition Examination Surveys
Globe Staff
US obesity - Adults
The percentages of US adults (ages 20 and older) meeting the criteria for overweight, obese, and extremely obese over time. "Overweight" is defined as having a body mass index (BMI) between 25 and 29.9; obese is defined as having a BMI of 30 or higher; extremely obese is defined as having a BMI of 40 or higher. 
Survey period Sample Overweight Obese Extremely obese
1988–1994 16,235 33.1% 22.9% 2.8%
1999–2000 4,117 34% 30.5% 4.7%
2001–2002 4,413 35.1% 30.5% 5.1%
2003–2004 4,431 34.1% 32.2% 4.8%
2005–2006 4,356 32.6% 34.3% 5.9%
2007–2008 5,550 34.3% 33.7% 5.7%
2009–2010 5,926 33% 35.7% 6.3%
2011–2012 5,181 33.6% 34.9% 6.4%
SOURCE: Centers for Disease Control and Prevention/National Center for Health Statistics, National Health and Nutrition Examination Surveys
Globe Staff

Ami Albernaz can be reached at ami.albernaz@gmail.com.