NEW YORK (Reuters Health) ? Children who are heavier than their peers at ages four and five are more likely to struggle in their relationships with other kids several years later, an Australian study suggests.
After following more than 3,300 children for about four years, researchers found that the heavy kids were up to 20 percent more likely at age eight or nine to be described by their parents as having social difficulties and by teachers as having emotional problems.
"It's interesting that we're seeing these problems at an early age," said Christina Calamaro, a professor at the University of Maryland School of Nursing, who did not participate in the research.
"I think this speaks to the fact that health care providers need to take weight into consideration at an earlier age, so we can cut it off at the pass before they hit middle school," she told Reuters Health.
The researchers surveyed the parents and teachers of 3,363 Australian children participating in a large national health study. The interviews were conducted first when the kids were four or five, and again four years later.
The questions involved measures of children's mental and behavioral health, such as emotional problems, hyperactivity and social skills.
Children also had their weight and height checked at each age.
At ages four and five, 222 boys (13 percent) and 264 girls (16 percent) were determined to be overweight, while 77 boys (4.5 percent) and 87 girls (5.2 percent) were obese.
Those kids with a body mass index (BMI -- a measure of weight relative to height) at least 1.6 points greater than their normal-weight peers at a young age were more at risk of having social problems, including isolation or teasing, later on.
For a five year old boy who is 40 inches tall and 40 pounds, for instance, a 1.6-point increase in BMI would translate into a weight gain of about two pounds.
At ages eight and nine, the heavier kids were 15 percent more likely to receive an evaluation of "concerning," based on parents' and teachers' responses about social interactions with peers. The heavy kids were also 20 percent more likely to get a "concerning" score from teachers on emotional development.
Lead author Michael Sawyer, a professor at the University of Adelaide, said it's important to evaluate children's social life in grade school because this is the age at which it starts to increase in importance.
"The quality of peer relationships during this period of time has the potential to have a significant impact on children's later mental health," Sawyer wrote in an email to Reuters Health.
In the study, published in the journal Pediatrics, the authors write that the stigma of being overweight can translate into social struggles for these children, and the kids might withdraw themselves from social activities because they fear teasing.
Obese children are more likely to be bullied (see Reuters Health story of May 3, 2010).
Sawyer's group did not find any differences between the heavy kids and the normal weight kids in their risk of mental health problems, such as hyperactivity or conduct disorders.
Other studies have found that later in life, however, obesity puts adults at greater risk of developing a mental illness like depression or anxiety.
Sawyer said he'd like to continue following the children to see whether the social problems his study revealed might be precursors to later mental health problems.
SOURCE: http://bit.ly/qBd85l Pediatrics, online September 19, 2011.
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