Executive function phenotypes in pediatric obesity

Pediatr Obes. 2020 Sep;15(9):e12655. doi: 10.1111/ijpo.12655. Epub 2020 Jun 7.


Objective: To comprehensively examine the behavioral phenotypes of children with and without executive function (EF) impairments in a clinical sample of youth with obesity.

Methods: Youth aged 8 to 17 years (Mean age = 12.97) attending a medical clinic for obesity and their caregivers (N = 195 dyads) completed a battery of behavioral questionnaires. Caregiver-proxy report of EF was assessed using the Behavior Rating Inventory of Executive Function. Latent Class Analysis was conducted to identify EF groupings. Analysis of variance and chi-square tests were conducted to examine associations between EF groups and behavioral phenotypes.

Results: Four latent classes of EF impairment were identified (No/Low Impairment; Behavioral Regulation Impairment; Metacognition Impairment; Global Impairment). There was an overall positive pattern of associations between these EF groups and behavioral/emotional symptoms, such that behavioral/emotional symptoms tended to increase with EF impairment.

Conclusions: Children with obesity and EF impairment demonstrate a dysregulated behavioral phenotype ranging from internalizing to externalizing behavioral and weight-related symptoms. This phenotype framework may be clinically beneficial for utilizing screening/assessment results to develop, tailor, and/or match treatment approaches in pediatric obesity.

Keywords: adolescents; children; executive function; obesity; parents; phenotypes.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Caregivers
  • Child
  • Child Behavior Disorders / diagnosis
  • Child Behavior Disorders / epidemiology
  • Child Behavior Disorders / physiopathology
  • Emotions
  • Executive Function / physiology*
  • Female
  • Humans
  • Male
  • Neuropsychological Tests
  • Pediatric Obesity / physiopathology
  • Pediatric Obesity / psychology*
  • Phenotype*
  • Surveys and Questionnaires