Inflammatory markers and self-regulation improvements in children and adolescents with obesity during inpatient treatment.
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Obesity, self-regulation, and inflammation interact through complex physiological and psychological pathways. Inflammation may not only impair self-regulation in youth with obesity but could also interfere with their ability to develop these skills, thereby hindering positive changes in unhealthy obesity-related behaviors. Given the limited research on this topic in youth with obesity, the current study explored the associations between inflammatory markers and self-regulation in children and adolescents with obesity undergoing multidisciplinary obesity treatment (MOT) in an inpatient setting. Three pre-registered research questions (https://osf.io/yavbf) were addressed: (1) the concurrent relationship between inflammatory markers (hs-CRP, IL-6 and TNFα) and self-regulation before treatment, (2) the predictive value of those baseline inflammatory markers for self-regulation improvements over the ten months of MOT, and (3) associations between changes in inflammatory markers and concurrent changes in self-regulation during treatment. The sample consisted of 143 children and adolescents (7-18 years; M = 14, SD = 2.2; 40.6 % boys) with obesity (Adjusted BMI1 Range = 134-288 %; M = 193.6, SD = 27.6), who participated in a double-blind randomized controlled trial. Using latent change score models, results showed that higher TNFα was associated with poorer self-reported self-regulation at pre-treatment. Reductions in TNFα were related to less improvement in parent-reported self-regulation during treatment. Results with hs-CRP and IL-6 were not significant. These finding provide partial support for the association between inflammation, particularly TNFα, and self-regulation, and underscore their complex, nuanced interplay in a clinical sample of youth with obesity.