Maria Dellenmark Blom: Children with both obesity and neurodevelopmental disorders need tailored support

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MARIA DELLENMARK BLOM
Dissertation defense: 11 June 2026 (click for details)
Doctoral thesis: The importance of considering neurodevelopmental disorders in childhood obesity care
Research area: Pediatrics 
Sahlgrenska Academy, The Institute of Clinical Sciences

In Sweden, approximately 4 percent of children aged 5 to 19 are estimated to live with obesity*. The condition is associated with medical complications, and with increasing age, the risk of depression and anxiety may also increase. Research has shown that children with obesity more often experience difficulties in school and face a higher risk of not completing upper secondary education.

Against this background, early and effective interventions are crucial. At the same time, an increased prevalence of neurodevelopmental disorders (NDDs), such as ADHD and autism, has been observed. However, the links are not yet fully understood in children with obesity, and there is a need to study additional factors related to children having a neurodevelopmental comorbidity.

“For example, cognitive functioning as well as family-related factors such as parental educational level and family structure need to be examined more closely in order to better understand how healthcare can adapt lifestyle education,” says Maria Dellenmark Blom, licensed psychologist, specialist at Sahlgrenska University Hospital, Regional Child and Adolescent Psychiatry Assessment Unit, and doctoral student at the Institute of Clinical Sciences.

In addition, there is a lack of studies highlighting families’ own experiences of how children cope with stress related to obesity.

Figure 1 from thesis: The intertwined network illustrates the complexity of child development and how different factors interact within a multifactorial perspective. The image also symbolizes how comorbidity and various diagnostic difficulties can be closely interconnected and influence one another on multiple levels.

Many children with obesity also have neurodevelopmental diagnoses

The research in the thesis mapped the proportion of children with both diagnosed and undiagnosed neurodevelopmental disorders, such as ADHD and autism, and investigated factors that may be associated with  these coexisting conditions.

“In interviews with parents, we also explored the patient perspective by examining which stress factors the children experience and how they cope with them. This can provide knowledge about how healthcare services need to adapt.”

Up to half of the children participating in obesity treatment had at least one neurodevelopmental diagnosis, with ADHD being the most common, followed by autism. One in three children who participated in a neurodevelopmental screening had, two years after the study ended, been assessed by child and adolescent psychiatry services as meeting the criteria for an ADHD diagnosis.

“These are important findings. But even children with obesity who did not have a neurodevelopmental diagnosis were reported to have a high prevalence of difficulties related to motor skills, perception, learning, and behavior.”

Children diagnosed with neurodevelopmental disorders also tended to perform lower on cognitive tests, particularly in areas related to attention. Higher levels of depressive symptoms were also found among children who had received a neurodevelopmental diagnosis before participating in the research project. As a group, these children more often had overlapping neurodevelopmental diagnoses, such as coexisting ADHD and autism.

One of the sub-studies also suggests that children with both obesity and neurodevelopmental disorders are more likely to live in separated or single-parent family structures compared with children with obesity who do not have such diagnoses, underlining the need for additional support.

Research strengthens family-centered care

“Within both healthcare and schools, we need to be aware of the neurodevelopmental comorbidity associated with obesity, since it can affect the child’s and the family’s development and health, including how lifestyle changes — which form the foundation of childhood obesity treatment — are understood and implemented.”

The analysis of parents’ descriptions of their children showed that passive coping strategies, such as avoidance or affect-driven behaviors, were often described in relation to eating, weight, and body image. Active coping strategies were more often described in connection with obesity treatment and visits to pediatric clinics. Several parents described difficulties in knowing how to talk to their child about why they attend pediatric healthcare services.

“This type of research can strengthen a more family-centered approach to care. Knowledge about how children and families manage the situation can be used to better support active coping strategies, which in turn may improve treatment outcomes and children’s health.”

Parents’ and children’s perspectives deepened understanding of a complex situation

What has been the most rewarding and the most challenging aspect of the doctoral project?
“This research would not have been possible without the contributions made by the families. It has also been rewarding to gain a deeper understanding of what comorbidity involving neurodevelopmental disorders actually means. Listening to parents’ and children’s own perspectives has contributed greatly to a more nuanced understanding of what it is like to live in a family with a child affected by obesity — complementing quantitative studies,” says Maria Dellenmark Blom, continuing:

“What has been most challenging is the complexity involved and ensuring that this complexity can be captured through the chosen methods and measurement tools. I am grateful for all what I have learned from the families and the project, and for the opportunity to contribute additional valuable pieces to this relatively new field of research.”

Text: Susanne Lj Westergren