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Maternal Depression Linked to Childhood Obesity

Mothers who experience depressive symptoms often display obesity-promoting practices and have children who are overweight or obese, according to a new study by investigators at The Children’s Hospital at Montefiore (CHAM). These data recently were published in Academic Pediatrics.

The study compared moms’ self-reported depressive symptoms, such as loss of interest, fatigue, low energy, and poor concentration, with their children’s body mass index (BMI) at age five, as documented in their medical records. Mothers reported depressive symptoms 23.4% of the time, with those reporting moderate to severe depressive symptoms more likely to have an overweight or obese five-year-old child compared with mothers without depressive symptoms.

“We see a high prevalence of both depression and obesity in our practice and previous studies have shown a correlation,” says Rachel S. Gross, MD, MS, FAAP, attending pediatrician at CHAM, assistant professor of pediatrics in the department of pediatrics at Albert Einstein College of Medicine of Yeshiva University, and lead study author. “We wanted to formally investigate the link and expand our current understanding of maternal depression, the mother–child relationship and associated outcomes.”

The study cohort included 401 mother-child pairs, of which 288 children had documented height/weight status at age five in their medical records. Researchers conducted a 30 minute interview with moms (primarily low-income, Hispanic and black mothers in the Bronx) whose children had received care at Montefiore’s Comprehensive Family Care Center, asking questions about mom’s mental health and their children’s eating habits including mealtime practices and feeding styles.

Data shows that mothers with depressive symptoms, who are likely to have less than a high school education and be unemployed, tend to display permissive parenting where they place fewer demands on their children. They are less responsive to their child’s needs, choosing parenting strategies for coping that require less cognitive effort and often neglect to set limits on the child’s behavior. They were more likely to have children who consumed more sweetened drinks, infrequently had family meals, more commonly ate at restaurants and had fewer regular breakfasts, than children with mothers without depressive symptoms. Depressed moms also were less likely to model healthy eating than non-depressed mothers.

Feeding practices, such as preparing daily breakfast, modeling healthy eating, and setting limits on the child’s diet, all require active maternal involvement, possibly explaining why these practices were less common among depressed mothers.

Researchers also investigated the activity levels and sleep patterns of all 401 children and found that children of mothers with depressive symptoms slept fewer hours per day and had less outdoor play time than those with mothers without depressive symptoms. Inadequate sleep has been linked to increased risk of child obesity and limited daily outdoor play time can also impact weight.

“Our findings suggest that maternal depression plays a role in childhood obesity and supports the need for educational resources for low-income families to encourage active engagement and positive feeding practices,” Gross says. “In order to reverse the national obesity trend, we believe that providing access to mental health specialists in the pediatric primary care setting may represent an opportunity for early childhood obesity prevention. This could have a long term impact on the obesity epidemic, especially among ethnic minority, low-income families, who are known to be at the highest risk for both early child obesity and maternal depression.”

— Source: Montefiore Medical Center