{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T18:09:16Z","timestamp":1779300556605,"version":"3.51.4"},"reference-count":57,"publisher":"Public Library of Science (PLoS)","issue":"5","license":[{"start":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T00:00:00Z","timestamp":1779235200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosglobalpublichealth.org"],"crossmark-restriction":false},"short-container-title":["PLOS Glob Public Health"],"abstract":"<jats:p>\n                    Adverse childhood mental health outcomes have emerged as a significant public health concern, with an increasing body of evidence linking children\u2019s obesity with increased risk of mental health outcomes. This is a cross-sectional study of 40,820 U.S. children aged 6\u201317 used survey-weighted logistic regression on the 2021\u201322 National Survey of Children\u2019s Health (NSCH) data. The study examined whether interpersonal factors such as bullying, poor mothers\u2019 or fathers\u2019 mental health, poor family resilience and greater difficulty in making or keeping friends modified the associations between BMI category and parent-reported lifetime depression (LDD) or anxiety (LDA) mental health outcomes, using interaction terms and adjusting for age, sex, race\/ethnicity and federal poverty levels. Obesity was significantly associated with higher odds of both\n                    <jats:bold>LDD<\/jats:bold>\n                    and\n                    <jats:bold>LDA<\/jats:bold>\n                    in children aged 6\u201317 years. Obese children had\n                    <jats:bold>2.08 times higher odds<\/jats:bold>\n                    of LDD (aOR 2.08; 95% CI: 1.64-2.64) and\n                    <jats:bold>1.48 times higher odds<\/jats:bold>\n                    of LDA (aOR 1.48; 95% CI: 1.25-1.76) compared to normal-weight peers. Significant effect modification in the statistical model was observed for\n                    <jats:bold>LDD:<\/jats:bold>\n                    never bullied (aOR = 2.12; 95% CI: 1.45-3.11), mother\u2019s mental health (aOR = 1.70; 95% CI: 1.70- 2.70), and father\u2019s mental health (aOR = 2.54; 95% CI: 1.51-4.29). For\n                    <jats:bold>LDA<\/jats:bold>\n                    , effect modification in the statistical model was seen for\n                    <jats:bold>making friends<\/jats:bold>\n                    (aOR = 1.91; 95% CI: 1.13-3.22) and\n                    <jats:bold>father\u2019s mental health<\/jats:bold>\n                    (aOR = 2.14; 95% CI: 1.34-3.41). In this cross-sectional sample, obesity was associated with higher LDD and LDA, with associations varying by interpersonal and family factors. Given parent-reported, cross-sectional data, findings are associative and not causal. The results emphasize integrating mental health screening into obesity programs, strengthening anti-bullying efforts, and adopting family-centered approaches; future research should use longitudinal, multi-informant designs to establish temporal relationships and reduce bias.\n                  <\/jats:p>","DOI":"10.1371\/journal.pgph.0006462","type":"journal-article","created":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T17:35:05Z","timestamp":1779298505000},"page":"e0006462","update-policy":"https:\/\/doi.org\/10.1371\/journal.pgph.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Between the scales and the scars: The interpersonal moderators of the association between Body Mass Index and parent-reported depression\/anxiety diagnoses in U.S. children: Evidence from the 2021\u201322 National Survey of Children\u2019s Health (NSCH)"],"prefix":"10.1371","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7971-0237","authenticated-orcid":true,"given":"Fnu","family":"Kajal","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bin","family":"Suh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chen","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maia","family":"Ingram","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Scott","family":"Carvajal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karl","family":"Krupp","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7818-3394","authenticated-orcid":true,"given":"Purnima","family":"Madhivanan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2026,5,20]]},"reference":[{"key":"pgph.0006462.ref001","first-page":"76","author":"World Health Organization [WHO]","year":"2024"},{"key":"pgph.0006462.ref002","author":"CDC US Government","year":"2024"},{"issue":"1","key":"pgph.0006462.ref003","doi-asserted-by":"crossref","first-page":"212","DOI":"10.1186\/s12916-019-1449-8","article-title":"The epidemiological burden of obesity in childhood: a worldwide epidemic requiring urgent action","volume":"17","author":"M Di Cesare","year":"2019","journal-title":"BMC Med"},{"key":"pgph.0006462.ref004","first-page":"125","article-title":"Psychological consequences of childhood obesity: psychiatric comorbidity and prevention","volume":"7","author":"J Rankin","year":"2016","journal-title":"Adolesc Health Med Ther"},{"key":"pgph.0006462.ref005","author":"H Choi","year":"2025"},{"key":"pgph.0006462.ref006","author":"NIHCM Foundation","year":"2023"},{"issue":"7","key":"pgph.0006462.ref007","doi-asserted-by":"crossref","first-page":"742","DOI":"10.1111\/obr.12535","article-title":"Exploring the association between childhood and adolescent obesity and depression: a meta-analysis","volume":"18","author":"Y-H Quek","year":"2017","journal-title":"Obes Rev"},{"key":"pgph.0006462.ref008","doi-asserted-by":"crossref","first-page":"111867","DOI":"10.1016\/j.jpsychores.2024.111867","article-title":"Parent-reported LDD, parent-reported LDA, and development of obesity from childhood to young adulthood in China","volume":"185","author":"Y Fan","year":"2024","journal-title":"J Psychosom Res"},{"issue":"2","key":"pgph.0006462.ref009","doi-asserted-by":"crossref","DOI":"10.1111\/cch.13237","article-title":"Obesity and risk of depressive disorder in children and adolescents: A meta-analysis of observational studies","volume":"50","author":"Y Chen","year":"2024","journal-title":"Child Care Health Dev"},{"issue":"1","key":"pgph.0006462.ref010","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1136\/archdischild-2017-314608","article-title":"Is obesity associated with depression in children? 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