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J Okla State Med Assoc. 2018 Oct;111(8):802-805.

Identifying Differences in the Prevalence of Psychological Symptoms between Underweight, Normal Weight, Overweight, and Obese Children in Primary Care.

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Department of Psychiatry and Behavioral Sciences, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma.
Department of Pediatrics, Ohio State University, Columbus, Ohio.
Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma.



The prevalence of childhood obesity continues to be a major public health problem. Nearly one-third of children in the United States can be classified as overweight or obese, which is particularly concerning given that obesity is associated with a number of physical and mental health problems. Past studies have examined childhood obesity and psychological symptoms using samples of referred children who have already been identified as overweight or obese, leaving out children who are classified as underweight or healthy weight. This study aims to bridge this gap in the literature by evaluating differences in psychological symptoms among children who fall within all weight ranges within primary care.


Data was obtained from a systematic chart review using EMR (Electronic Medical Record) for children ages 6 to 16 years from two primary care health clinics. Differences between weight groups regarding reported internalizing and externalizing symptoms were evaluated utilizing data from the Pediatric Behavioral Health Screen (PBHS).


Significant overall psychological symptoms (internalizing and externalizing) were endorsed for 13.2% of the sample (p > .01). Chi-Square analyses determined that the relationship between internalizing symptoms and weight category were significant. Specifically, children who were classified as overweight or obese were more likely to report significant internalizing symptoms than underweight or healthy weight children.


Children who fall into the overweight and obese weight categories may need to be screened for psychological symptoms and referred for mental health services following overweight/obese classification in primary care.


obesity; overweight; pediatric primary care


Conflict of interest statement

Conflicts of Interest and Disclosures The authors have no pertinent conflict of interest and did not receive funding for this project.

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