Objectives: The purpose of this study was to investigate mental health problems in obese child and adolescent patients. We assess the frequency of mental health problems and their differences according to sex, school grade and severity of obesity.

Methods: The sample consisted of 106 children and adolescents aged 8-16 years (61 boys with mean age 10.98±2.26, 45 girls with mean age 9.74±1.96, p=.004) who were diagnosed with obesity and recruited at the Department of Pediatrics of Jeju National University Hospital. The participants completed the Korean-Child Behavior Checklist (K-CBCL), Children’s Depression Inventory (CDI), Korean version of the Eating Attitude Test-26 (KEAT-26), and somatotype drawings.

Results: The percentage of participants having a T-score in clinical range on one or more CBCL subscale was 37.7%. The percentage of participants in the high risk group for depression (CDI score above 17) was 20.8% and that in the high risk group for eating disorder (EAT-26 score above 20) was 6%. The girls showed significantly lower CBCL T-scores in social competence (48.39±15.66 vs. 38.91±22.04, p=.011), adjustment function (49.51±17.35 vs. 40.38±22.58, p=.020) and school competence (53.34±10.47 vs. 48.22±15.11, p=.042) than the boys, but the percentages of boys and girls in clinical range were not significantly different. The middle school students showed (significantly) higher CBCL T-scores in somatic symptoms (60.86±9.44 vs. 55.74±6.76, p=.005), aggressive behavior (58.81±6.74 vs. 54.68±6.22, p=.009), total problems (59.86±9.91 vs. 54.88±9.76, p=.039) and externalizing problems (57.90±10.57 vs. 52.44±9.38, p=.022) than the elementary school students. The severe obesity group showed significantly higher CBCL T-scores in attention problems (59.18±9.45 vs. 54.15±5.34, p=.001), social problems (59.25±8.59 vs. 55.96±6.50, p=.038), delinquent behavior (58.07±6.97 vs. 54.73±6.00, p=.017) and total problems (59.21±11.65 vs. 54.67±9.03, p=.037) than the mild to moderate obesity group.

Conclusion: Significant proportions of obese children and adolescents suffer from mental health problems. Clinicians need to pay attention to the mental health risk, especially in obese adolescents and severely obese children and adolescents.