The Association Between Affect and Adiposity in Childhood and Adolescence: A Systematic Review

Background The relationship between adiposity and psychological health is complex, with much of the current research focused on adult or adolescent psychopathology. Affect, a facet of psychological well-being observable from infancy, appears to influence energy balance behaviors, but relationships with adiposity are not fully understood. This review examined the association between affect and adiposity across childhood and adolescence to further understand the nature of these relationships.

Methods Six electronic databases were searched in February 2024. Studies that reported an association between measures of adiposity and affect were included and synthesized narratively. Study quality was assessed using an adapted version of the Newcastle–Ottawa Scale.

Results One hundred and sixty-seven studies were retrieved from the search. Studies overwhelmingly focused on negative affect (n = 75) rather than positive affect (n = 14) or both (n = 21). Thirty-three studies focused on adiposity and emotional functioning, and 24 on emotional regulation. Negative affect was more consistently associated with adiposity in adolescence. There was little evidence of bidirectionality, whereby higher adiposity generally preceded negative affect. Positive affect was also related to adiposity, although these relationships were mixed, with prospective associations found with higher and lower adiposity across development. Mechanisms of associations were infrequently examined but varied when reported.

Conclusions Positive and negative affect both appear to be associated with adiposity, and these relationships may be dynamic across development. Longitudinal research to elucidate these associations across development is necessary to confirm whether these trends are a true developmental phenomenon or a function of sample differences in baseline affect.