Obesity and Psychopathology From Childhood to Adolescence: A Systematic Review of Prospective Studies

Abstract

Background: Obesity and psychological symptoms often coexist during childhood and adolescence. Understanding the long-term associations between these conditions is essential for designing effective prevention and intervention strategies. The study presented here aimed to examine recent evidence concerning the longitudinal relationship between obesity and commonly comorbid psychopathologies such as depression, anxiety, and eating disorders during childhood and adolescence.

Methods: A systematic review of prospective observational studies was conducted using the PubMed, Scopus, and EBSCOhost databases, covering publications from 2010 to 2025. Twenty-one high-quality studies met the inclusion criteria, especially of participants aged six to 18 years and follow-up periods of at least two years.

Results: A narrative synthesis of 21 prospective studies reveals key longitudinal associations between obesity and psychological symptoms throughout childhood and adolescence, with gender-specific patterns becoming more evident during the teenage years. The collective evidence suggests a bidirectional relationship between eating disorders and obesity. Furthermore, there is evidence indicating a potential prospective association between elevated weight trajectories and depressive symptoms, a connection that appears to be influenced by gender. Specifically, the association from depression to obesity may be more pronounced in older children, particularly girls. Due to the limited number of studies focusing on anxiety symptoms, definitive conclusions regarding their relationship with obesity remain elusive.

Conclusions: This systematic review points to the scarcity of prospective studies that extend beyond two years of follow-up to explore the bidirectional association between obesity and psychological symptoms in youth. While the findings of the present study indicate mutual influences, particularly for eating disorders and depressive symptoms, further research involving longer follow-up periods and diverse populations is warranted. The present study's results emphasise the importance of early, integrated prevention efforts that address common risk factors.