# The Impact of Psychological Health on Childhood Obesity: A Cross-Developmental Stage Analysis
## 2 Materials and Methods  
This is an ongoing cross-sectional study of a pediatric clinical population conducted by the Child and Adolescent Psychiatric Department in collaboration with the Endocrinology Outpatient Clinic and the Pediatric Clinic of Penteli General Children's Hospital. This study explored the links between psychological well-being and body weight among a diverse cohort of children aged 5-16 years. Our participants were divided into two groups based on their Body Mass Index (BMI): one consisting of overweight and obese children (experimental group) and the other comprising children with a BMI within the normal range (control group). Recruitment was conducted across hospital outpatient and inpatient settings to ensure representation across a broad demographic and health spectrum. Before their participation, detailed information about the study's aims and procedures was provided to both the children and their guardians by our research team. This briefing highlighted the investigation's focus on the interconnections between psychological factors and body weight. Ethical adherence was a cornerstone of our methodology, with informed consent and child assent obtained in alignment with established ethical standards. Precise measurements of height, weight, and BMI complemented comprehensive documentation of each participant's medical history. To delve deeper into the psychological landscape, participants were asked to complete a sequence of self-report questionnaires. These tools were selected for their robustness in assessing critical psychological dimensions:  
* Strengths and Difficulties Questionnaire (SDQ) by [PERSON] (1997), which provides insight into emotional and behavioral problems. (Emotional Problems Scale, Conduct Problems Scale, Hyperactivity Scale, Peer Problems Scale, Prosocial Scale, Total Difficulties score, Externalizing and Internalizing Scores) [14]. * The Adolescent Anxiety and Avoidant Attachment Inventory (AAAAI) by [PERSON] (2015) examines the nuances of adolescent attachment (attachment anxiety, attachment avoidance) [15]. * The Affect Regulation Checklist (ARC) by [PERSON] (2003) focuses on Affect Dysregulation and its roles in behavior (Affect Dysregulation, Affect Suppression, Adaptive Reflection) [16]. These instruments allowed for a multifaceted assessment of attachment quality, emotional regulation, and emotional or behavioral issues. By integrating these psychological constructs with biometric data, our study was poised to perform an in-depth analysis of the potential contributions of these factors to increased body weight among pediatric populations. To address potential concerns related to the use of self-report questionnaires among participants across diverse developmental stages (8-10, 11-12, and 12-16 years), our study implemented specific methodological safeguards. Recognizing the critical challenge of ensuring accurate comprehension among younger cohorts, the questionnaires were carefully designed with age-appropriate wording and structured to facilitate understanding across the specified age ranges. To further mitigate risks associated with self-reporting and to enhance the reliability of our findings, a qualified specialist was made available during the administration of the questionnaires. This specialist was equipped to provide necessary clarifications tailored to the developmental level of the participants, ensuring that all questions were comprehended correctly without introducing bias. Such proactive measures underscore our commitment to methodological integrity, aiming to strengthen the validity of the responses obtained and to address potential limitations inherent in questionnaire-based research involving younger populations. The collected data set the stage for a rigorous analysis aimed at unraveling the intricate dynamics between psychological health and obesity in children and adolescents.