A new, in-depth study of New Zealand children and teenagers seeking help with weight issues has found their emotional health and wellbeing is, on average, markedly worse than that of children without weight issues.

Researchers found a concerning level of emotional and behavioural problems, and say these findings highlight how important it is that obesity programmes involve psychologists.

The 233 children in the study were assessed when they enrolled in a community-based, 12-month intervention programme in Taranaki called Whānau Pakari. Aged 4-16, the participants had BMIs in the clinically obese range, and many had weight-related health problems.

Both parents and children filled out separate versions of a questionnaire that measures “health-related quality of life”. Parents (or the child if aged more than 11 years) filled out a second questionnaire to screen for behavioural and emotional difficulties, such as anxiety, sleep issues and aggression.

Researchers found:

• Over four in 10 (44 percent) of children in the study had scores indicating a high likelihood of emotional and behavioural problems, six times the rate typically found in young people
• Nearly three in 10 (28 percent) had scores indicating a high likelihood of psychological difficulties serious enough to warrant intervention
• On average, the children’s quality of life as reported by their parents was comparable to that for children and teens diagnosed with cancer, and  lower than a comparison group of Taranaki children living with a chronic health condition, Type 1 diabetes, which requires daily testing and treatment
• The greater the participants’ BMI, the lower their quality of life scores
• Reported quality of life was lowest in participants who experienced breathing pauses (linked to a sleep condition called obstructive sleep apnoea), headaches, difficulty getting to sleep, and/or developmental problems
• Obesity itself, rather than ethnicity or financial hardship, appeared to be the main contributing factor for young people’s lower quality of life in this cohort

“This study highlights that a large proportion of children and teens struggling with weight issues are also highly likely to be affected by psychological problems, and in turn, lower quality of life,” says Dr Yvonne Anderson, Liggins Institute researcher, Taranaki paediatrician and co-author of the study.

“However, it is important to note that these results come from a group that were seeking help with their weight, so these findings cannot be generalised to all who have obesity,” she says.

“We hope these findings serve as a reminder that we all need to work to reduce the stigma associated with obesity. It is really important that we do not see obesity as a single condition. It has many contributing factors, can affect individuals in many ways, and undertaking respectful, non-judgemental, and individualised assessments is critical for any type of meaningful engagement.”

The study was a collaboration between the Liggins Institute based at the University of Auckland, Taranaki District Health Board and Sport Taranaki, with funding from the Health Research Council.

Almost three in 10 of the children in the study came from households in the most deprived household areas of Taranaki. Māori and Pakeha each made up 45 percent of the group, with the remaining 10 percent from other ethnicities.

Nationally, an estimated 85,000 children aged 2-14 years are obese, and about 4,500 in Taranaki, according to the New Zealand Health Survey.

Whānau Pakari means “Healthy self-assured whānau who are fully active”. The programme, which is still running, involves regular home visits and support from a multi-disciplinary team of health professionals to help whānau make healthy lifestyle changes.

The study was published in BMJ Open.