A study in 2005 concluded that within a subgroup of children who were hospitalized for obesity, 57.7% had co-morbid ADHD. This relationship between obesity and ADHD may seem counter-intuitive, as ADHD is typically associated with higher level of energy expenditure, which is thought of as a protective factor against obesity. However, these studies determined that children exhibited more signs of predominantly inattentive-type ADHD rather than combined-type ADHD. It is possible, however, that the symptoms of hyperactivity typically present in individuals with combined-type ADHD are simply masked in obese children with ADHD due to their decreased mobility. The same correlation between obesity and ADHD is also present in adult populations. Existing underlying explanations for the relationship between ADHD and obesity in children include but are not limited to abnormalities in the hypo-dopaminergic pathway, ADHD creating abnormal eating behaviors which leads to obesity, or impulsivity associated with binge eating leading to ADHD in obese patients. A systematic review of the literature on the relationship between obesity and ADHD concluded that all reviewed studies reported ADHD patients were heavier than expected. However, the same systematic review also claimed that all the evidence supporting this connection was still limited and further research is still necessary to learn more about this connection. Given the prevalence rates of both obesity and ADHD in children, understanding the possible relationship between the two is important for public health, particularly when exploring treatment and management options. Direct intervention for psychological treatment of childhood obesity has become more prevalent in recent years.
Over a three-week period researchers studied the relationship of socioeconomic status (SES) to body composition in 194 children, ages 11–12. They measured weight, waist girth, stretch stature, skinfolds, physical activity, TV viewing, and SES; researchers discovered clear SES inclines to upper class children compared to the lower class children.Childhood inactivity is linked to obesity in the United States with more children being overweight at younger ages. In a 2009 preschool study 89% of a preschoolers day was found to be sedentary while the same study also found that even when outside, 56 percent of activities were still sedentary. One factor believed to contribute to the lack of activity found was little teacher motivation, but when toys, such as balls were made available, the children were more likely to play. Home environment
Childrens food choices are also influenced by family meals. Researchers provided a household eating questionnaire to 18,177 children, ranging in ages 11–21, and discovered that four out of five parents let their children make their own food decisions. They also discovered that compared to adolescents who ate three or fewer meals per week, those who ate four to five family meals per week were 19% less likely to report poor consumption of vegetables, 22% less likely to report poor consumption of fruits, and 19% less likely to report poor consumption of dairy foods.