Toddler Self-Regulation and Subsequent Obesity Differs Between Boys and Girls

An overweight child on a scale
An overweight child on a scale
Patterns of self-regulation of toddlers and risk for obesity and whether they differ between boys and girls were examined.

Sex differences were observed in associations between self-regulation at 24 months and subsequent obesity at 5.5 years, according to findings published in JAMA Pediatrics.

Poor self-regulation during childhood has been associated with a variety of long-term health issues in adulthood, including obesity. Thus, it is most likely that self-regulation is shaped at an early stage of brain development. In this study, researchers examined data from the Early Childhood Longitudinal Study, Birth Cohort to evaluate how different levels of toddler self-regulation were associated with the prevalence of obesity by the time they reached kindergarten, and whether patterns of associations differed between boys and girls.

The cohort included 6400 children (3250 [50.6%] boys and 3200 [49.4%] girls) in the analytic sample, with a median age of 24.1 months at baseline and 64.5 months at the self-regulation and body mass index assessments. The follow-up period ranged from 30.3 to 49.1 months (mean, 40.3 months).

Boys had lower mean self-regulation scores vs girls (13.7 [95% CI, 13.4-13.9] vs 14.9 [95% CI, 14.7-15.1], respectively), and the lowest self-regulation quartile included a larger number of boys than girls (weighted percentages, 66.5% vs 33.5%). Obesity prevalence at 5.5 years was 19.2% for boys vs 16.5% for girls. The pattern of association between toddler self-regulation and obesity at 5.5 years differed between sexes (P =.008 for interaction). The adjusted prevalence of obesity for boys was 19.7%, 18.3%, 20.3%, and 15.9% from the lowest to the highest quartile of self-regulation, whereas for girls, a U-shaped association was observed: from lowest to highest self-regulation quartile, adjusted prevalence of obesity was 17.0%, 10.3%, 10.7%, and 15.0%.

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In addition, investigators also determined that lower socioeconomic status, maternal smoking, maternal obesity, and nonwhite race/ethnicity were associated with increased obesity and lower levels of self-regulation.

Researchers wrote, “[o]besity prevention efforts aimed at improving self-regulation may have different results for girls and boys.”


Anderson SE, Whitaker RC. Association of self-regulation with obesity in boys vs girls in a US national sample [published online July 16, 2018]. JAMA Pediatr. doi: 10.1001/jamapediatrics.2018.1413