New research suggests that maternal mental health is a significant influence on childhood obesity. In particular, maternal depression seems to correlate with overweight in young children.
Childhood obesity continues to be a serious issue. According to the Centers of Disease Control (CDC), the prevalence of childhood overweight has doubled in the past 30 years and adolescent obesity has tripled.
While much research has focused on the obvious considerations– readily available high-calorie foods, the fast pace of modern life, and lack of physical activity—a growing number of researchers are looking at other factors that may impact a child’s weight in less-obvious but more pervasive ways.
A Significant Correlation
Investigators from Children’s Hospital at Montefiore in New York undertook a cross-sectional study of 401 mother/child pairs to assess depression among mothers and their children’s weight. The children were all five years old. Of the 78.3% of mothers who responded, 23.4% reported having symptoms of depression. Of these, 15.7% said their symptoms were mild and 7.7% percent were moderate to severe (Gross R.S. Academic Pediatrics 2013; 13(4): 356-363 ) .
The researchers were able to obtain complete child body mass index (BMI) for 288 children. Of these, 200 had mothers with no depressive symptoms, 47 with mild symptoms, and 21 with moderate to severe. However, 12 of the 21 children whose mothers had moderate to severe depression (57.2%) were overweight or obese. Twenty of the children with moderate depression (42.6%) were overweight or obese, while only 75 children of mothers who were not depressed (34.1%) were overweight or obese.
The Montefiore study is definitely not the first to look at possible correlations between maternal mental health and childhood weight problems. In 2007, an Australian research team came to a different conclusion. They concluded that maternal health, including depression, did not affect childhood obesity rates (Gibson L Y, Med J Aust 2007; 186 (11): 591-595. )
The Australian study included children who were a mean age of 9.51 years and the investigators questioned the mothers about life events (List of Threatening Experiences) and their self-esteem (Rosenberg Self-Esteem Scale). In their discussion, the authors stated that family instability may have played a role in childhood obesity in the past, when it was not a common problem. The authors wrote, however, that obesity has become so prevalent that the issue “is not confined to families with these problems.”
The Australian authors also noted that previous studies linking family dysfunction and obesity did not look at confounders such as lower education and income. The recent Montefiore study looked at families from a low-income area in the Bronx, and the authors listed this as a limitation on the study.
The parenting styles between depressed and non-depressed mothers also differed, said the investigators from Montefiore. They believe this may have also influenced weight differences among the children. Mothers who were depressed were less likely to provide structured meal environments for their children, including structured meals or healthy food options. These mothers did not have as much hands-on interaction with their children, nor did they model healthy eating habits.
Permissive parenting added to the problem. The authors defined permissive parenting as a lack of setting limits on behavior and placing few demands on a child. Children who had few limits around eating and meal times and/or were given food as rewards were also more likely to be overweight.
Interestingly, although a study published in The American Journal of Clinical Nutrition (2008) found that families in lower socio-economic brackets ate less nutritiously than their more economically advantaged peers, another study published in 2009 in the Journal of Public Health Nutrition, found that it was depressed and permissive mothers in higher income groups who had more obese children than similarly depressed, permissive mothers in lower socioeconomic brackets (Darmon N, Am J Clin Nutr, May 2008; 87 (5): 1107-1117. Topham G.L. Journal of Public Health Nutrition 13(8):1237-1244)
The authors of this study concluded that, “Permissive mothers with higher [socioeconomic status] may have more food available for their children, but may not regulate the portion and type of food eaten by their children.”
Though the jury is still out on the precise role of maternal psychological health on childhood weight, this line of research does suggest that tackling the epidemic of childhood obesity will involve more than just addressing childhood diets or levels of exercise. The issue warrants a family-centered approach that looks at the mother’s mental health and provides the necessary support.