Prevalence and Risk factors of Obesity and Its Impact on Academic Performance Among School-age Children in Mosul, Iraq

Background : Childhood obesity is a serious health condition that is escalating into a global pandemic. Obese children are more likely to remain obese into adulthood, increasing their risk of morbidity and mortality. Preventing childhood obesity is, therefore, a critical public health priority. The causes of childhood obesity are multifactorial, encompassing genetic, familial, behavioral, and environmental influences. Factors such as increased availability and affordability of high-calorie fast food, larger portion sizes, excessive consumption of sugar sweetened beverages, and sedentary lifestyles have all been linked to rising obesity rates. Aim: This study aims to determine the prevalence of overweight and obesity among school-age children in Mosul, and to evaluate its correlation with risk factors such as dietary habits, parental obesity, daily activity, screen time, parental income, and education level, as well as the impact of obesity on the academic school performance. Participants and methods : The study employed a cross-sectional design involving a total of 2,304 school-age children (1,194 boys and 1,110 girls) from four primary schools, conducted between December 2024 and May 2025. Anthropometric measurements, including height, weight, and BMI, were recorded. Among them, 139 students were identified as overweight or obese. These children were compared with 200 healthy-weight peers, who served as controls. A questionnaire-based interview with their parents was conducted to explore associated risk factors. A comparison of final mathematics scores was carried out between overweight and obese children from Stage 5 (n = 34) and Stage 6 (n = 53), each matched with 100 healthy-weight peers from the corresponding stage. Statistical analysis included the calculation of the relative risk ratio (RR) to evaluate associated risk factors and a t-test to assess significant differences in mean scores. Results : The overall prevalence of overweight and obesity was 6%, with boys (7.7%) being more affected than girls (4.2%). The vast majority of overweight and obese children (n = 111, 80%) were from urban areas. Significant contributing factors included parental obesity, high family income, prolonged screen time and sedentary behavior, excessive consumption of sugary beverages and fast food, and low levels of physical activity. Academic performance was found to be significantly lower among overweight and obese children in both Stage 5 and Stage 6 of primary school compared to their healthy-weight peers (Stage 5: mean score: 65.8 ± 10.4 vs. 78.9 ± 9.9); stage 6: (68.5 ± 11.3 vs. 77.0 ± 10.9). Conclusion : high household income, parental obesity, excessive high energy diets, poor activity and less sharing in school sports, as well as long screen time are possible contributing factors of overweight and obesity. Significant association of overweight and obesity with the poor academic school performance was noticed.