Assessing how the edmonton obesity staging system for pediatrics (EOSS-P) in childhood relates to mental health outcomes 7 years later: findings from the quality cohort

Iulia Bolnavu; Emma Blackburn; Alexa Nunziato; Soren Harnois-Leblanc; Vicky Drapeau; Lisa Kakinami; Jennifer mgrath; Hulst Andraea Van; Misha Dolmatov; Stasia Hadjiyannakis; Melanie Henderson

doi:10.1530/endoabs.110.P658

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Endocrine Abstracts (2025) 110 P658 | DOI: 10.1530/endoabs.110.P658

ECEESPE2025 Poster Presentations MTEabolism, Nutrition and Obesity (125 abstracts)

Assessing how the edmonton obesity staging system for pediatrics (EOSS-P) in childhood relates to mental health outcomes 7 years later: findings from the quality cohort

Iulia Bolnavu^{1, 2}, Emma Blackburn^{2, 3}, Alexa Nunziato^{1, 2}, Soren Harnois-Leblanc⁴, Vicky Drapeau⁵, Lisa Kakinami⁶, Jennifer mgrath⁷, Andraea Van Hulst⁸, Misha Dolmatov⁹, Stasia Hadjiyannakis^{10, 11} & Mélanie Henderson^{2 3 12}

Author affiliations

¹Faculty of Medecine, Université de Montréal, Montreal, QC, Canada; ²Research Center of Sainte Justine Hospital University Center, Montreal, QC, Canada; ³School of Public Health, Université de Montréal, Montreal, QC, Canada; ⁴Department of Population Medicine, Harvard Pilgrim Health Care Institute/Harvard Medical School, Boston, MA, United States; ⁵Department of Physical Education, Université de Laval, Quebec, QC, Canada; ⁶Department of Mathematics and Statistics, Concordia University, Montreal, QC, Canada; ⁷Department of Psychology, Concordia University, Montreal, QC, Canada; ⁸Ingram School of Nursing, mgill University, Montreal, QC, Canada; ⁹Department of Epidemiology and Biostatistics, mgill University, Montreal, QC, Canada; ¹⁰Children’s Hospital of Eastern Ontario, Ottawa, ON, Canada; ¹¹Department of Pediatrics, Faculty of Medecine, Ottawa University, Ottawa, ON, Canada; ¹²Department of Pediatrics, Faculty of Medecine, Université de Montréal, Montreal, QC, Canada

JOINT1127

Introduction: The EOSS-P (Edmonton Obesity Staging System for Pediatrics) is a comprehensive tool that defines obesity severity beyond traditional anthropometric measures (weight or body mass index). It assesses obesity burden across four domains: metabolic, mechanical, mental health, and milieu. We previously demonstrated that EOSS-P scores at 8-10 years were associated with adverse cardiometabolic health outcomes at 15-17 years. Given strong evidence between living with excess weight and poorer mental health outcomes, we aimed to study associations between EOSS-P staging at 8-10 years and mental health outcomes at 15-17 years.

Methods: Data were obtained from the QUALITY cohort, a prospective study of Quebec children with a parental history of obesity. This analysis focused on the children with obesity at ages 8-10 and 15-17 years (n = 72). EOSS-P was staged at 8-10 years, ranging from Stage 0 (no abnormalities across domains) to Stage 3 (significant impairment across domains). Participants reported on mental health symptoms at 15-17 years old using two validated questionnaires, the Composite International Diagnostic Interview for anxiety (CIDI-A) and for depression (CIDI-D). We estimated the associations between the EOSS-P stage at 8-10 years and mental health at 15-17 years using multivariable linear regression models adjusted for age and sex. Multiple imputation and inverse probability of censoring weighting addressed missing data and selection bias due to loss to follow-up, respectively. We log-transformed CIDI-A and expressed results in sympercents.

Results: At 8-10 yrs, 0. 6% of the sample belonged to EOSS-P Stage 0, 33. 0% to Stage 1, 40. 0% to Stage 2, and 26. 0% to Stage 3. Compared to Stage 1, belonging to Stage 2 at 8-10 years was associated with an increase in CIDI-D of 2. 39 points [CI: -0. 65; 5. 32] but no meaningful association with CIDI-A at 15-17 years. Belonging to Stage 3 at 8-10 years was associated with an increase in CIDI-D of 2. 04 points [CI: -1. 97; 5. 87] and a 17. 92% [CI: -24. 20%; 79. 33%] increase in CIDI-A at 15-17 years compared to belonging to Stage 1.

Conclusion: A higher EOSS-P stage at age 8-10 years showed a trend towards less favourable mental health at age 15-17 years, independent of baseline mental health staging within the EOSS-P. Notably, although modest, the increase in depressive and anxiety symptoms in late adolescence suggests a potentially clinically meaningful association, despite the small sample size. Results need to be confirmed in a larger sample.