Executive Function and Pediatric Overweight: A Problem-Solving Framework

Pediatric overweight has become a topic of interest primarily due to the severity of potential physical and socioemotional consequences and escalating rates of weight status in children. Legislative initiatives have called for the creation of intervention and prevention programs; however, the efficacy and effectiveness of most of these programs have either not been established or are limited. The limited effect programs have on pediatric obesity may be due to a lack of understanding of the complexity of risk and protective factors associated with weight status. Pediatric overweight occurs when social, familial, psychological, and biological factors interact to disrupt the balance of energy intake and energy expenditure. In order to impact weight status, it is important to understand specific factors that are associated with overweight and obesity. Research has started to examine social, familial, and psychological factors that can be addressed in prevention and intervention programs. The present study examines potential relations between aspects of executive function and pediatric weight status as well as obesity-prone eating behaviors. Executive function is operationally defined as a problem-solving construct with four steps that work together to solve a problem: recognizing the problem, planning a course of action, executing the action, and evaluating the success of the action. Participants (78 children and their caregivers) between the ages of four and seven had their heights and weights measured, completed language-appropriate receptive language assessments, and were engaged in four tasks that theoretically correspond to the four aspects of problem-solving. Caregivers of the participating children completed demographic, economic hardship, child eating behaviors, and child daily executive functioning measures. No significant findings were indicated between problem-solving phases of executive function and current weight status. Using multiple linear regression analyses, findings indicated that children who have high general appetites for food demonstrated deficits in the problem recognition and plan execution phases of executive function on caregiver-report measures even when accounting for racial/ethnic membership and socioeconomic hardship. In addition, children who cope with their emotions through eating (i.e., Emotional Overeating) rather than through other means also exhibit deficits in problem recognition, problem analysis, and plan execution on caregiver-report measures even when accounting for racial/ethnic membership and socioeconomic hardship. The findings presented in this study are discussed in light of the current literature and their implications for the future direction of intervention and prevention programs for pediatric overweight and obesity