Childhood obesity's influence on socioeconomic disparities in young adolescents’ mental health

Maria Gueltzow*, Joost Oude Groeniger, Maarten J. Bijlsma, Pauline W. Jansen, Tanja A.J. Houweling, Frank J. van Lenthe

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review



We investigated whether socioeconomic inequalities in young adolescents’ mental health are partially due to the unequal distribution of childhood obesity across socioeconomic positions (SEP), i.e. differential exposure, or due to the effect of obesity on mental health being more detrimental among certain SEPs, i.e. differential impact. 


We studied 4660 participants of the Generation R study, a population-based study in the Netherlands. SEP was estimated by mother's education and household income at age five of the child. We estimated the contribution of the mediating and moderating effects of high body fat percentage to the disparity in mental health. This was done through a four-way decomposition using marginal structural models with inverse probability of treatment weighting. 


Comparing children with the least to most educated mothers and the lowest to highest household income, the total disparity in emotional problems was 0.98 points (95%CI:0.35–1.63) and 1.68 points (95%CI:1.13–2.19), respectively. Of these total disparities in emotional problems, 0.50 points (95%CI:0.15–0.85) and 0.24 points (95%CI:0.09–0.46) were due to the differential exposure to obesity. Obesity did not contribute to disparities in behavioural problems. 


Addressing the heightened obesity prevalence among children in low SEP families may reduce inequalities in emotional problems in early adolescence.

Original languageEnglish
Pages (from-to)19-26
Number of pages8
JournalAnnals of Epidemiology
Publication statusPublished - Jun 2024

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