Opinion
Parental Neglect and Childhood Obesity Amidst COVID-19: A
Developmental Psychopathology Perspective on Health and
Developmental Risks
Silvia Cimino
Citation: Cimino, S. Parental Neglect
and Childhood Obesity Amidst
COVID-19: A Developmental
Psychopathology Perspective on
Health and Developmental Risks.
Nutrients 2024, 16, 2162. https://
doi.org/10.3390/nu16132162
Academic Editors: Hubertus
Himmerich and Maria Luz
Fernandez
Received: 30 April 2024
Revised: 14 June 2024
Accepted: 5 July 2024
Published: 7 July 2024
Copyright: © 2024 by the authors.
Licensee MDPI, Basel, Switzerland.
This article is an open access article
distributed under the terms and
conditions of the Creative Commons
Attribution (CC BY) license
(https://creativecommons.org/license
s/by/4.0/).
Nutrients 2024, 16, 2162. https://doi.org/10.3390/nu16132162
Department of Dynamic, Clinic and Health Psychology, Faculty of Psychology and Medicine,
Sapienza University of Rome, 00185 Rome, Italy; silvia.cimino@uniroma1.it; Tel.: +39-064991
Abstract: The COVID-19 pandemic has profoundly impacted the mental health and developmental
trajectories of children and adolescents, catalyzing a range of psychological and behavioral issues
due to enforced lockdowns and other restrictions. This text explores these impacts through the lens
of developmental psychopathology, which integrates clinical psychology and developmental
science to examine the emergence and evolution of psychological disorders across a lifespan. This
paper highlights how pandemic-related disruptions have exacerbated conditions such as anxiety
and depression and, notably, increased childhood obesity due to changes in lifestyle and reductions
in physical activity. The analysis includes a discussion of how isolation has not only restricted access
to educational and psychological resources but also increased the risk of parental mental illness and
related familial stress, thereby intensifying issues of neglect and their consequent impact on child
health. By employing a developmental psychopathology framework, this paper argues for the
necessity of targeted interventions that address these complex interplays of genetic, environmental,
and psychological factors. Such interventions aim to support children through structured
educational and health-oriented strategies, ensuring their well-being amidst the ongoing challenges
posed by the pandemic. This approach underscores the importance of early, multifaceted strategies
involving parents, educators, and healthcare providers to foster healthier developmental outcomes
for children facing unprecedented global health crises.
Keywords: COVID-19 pandemic; developmental psychopathology; childhood obesity; mental
health interventions
The COVID-19 pandemic and the measures implemented to limit its spread have had
significant unintended consequences, particularly on the mental health and development
of children and adolescents. Research highlights that the mental health impacts of the
pandemic on children and adolescents are profound and potentially long-lasting.
Lockdowns and other restrictions have led to increased reports of anxiety, depression,
and other mental health issues among young populations. A systematic review by
Panchal et al. [1] noted that anxiety and depression symptoms were notably prevalent,
affecting a significant percentage of children during the lockdown periods. These
psychological issues were compounded by irritability, anger, and a general increase in
mental distress, as posited by Fegert et al. [2], who emphasized that the isolation measures
not only limited access to regular educational and psychological support systems but also
heightened the risk of parental mental illness, domestic violence, and child maltreatment.
This was particularly challenging for children with special needs or pre-existing mental
health conditions, who found the pandemic period especially disruptive [2]. The narrative
review by Miranda et al. [3] also pointed out that while some supportive strategies
emerged during the pandemic, their effectiveness remains uncertain, particularly in
addressing long-term mental health outcomes. Children respond to stress differently
www.mdpi.com/journal/nutrients
Nutrients 2024, 16, 2162 2 of 7

depending on their developmental stage, and high rates of post-traumatic symptoms were
identified, suggesting a critical area for targeted mental health interventions. Throughout
the COVID-19 crisis, an intricate relationship between parental neglect and the escalating
issue of childhood obesity emerged and was examined through the lens of developmental
psychopathology.
Developmental psychopathology [4,5] is an interdisciplinary field that examines the
development of psychological disorders within a life-span framework. This field
integrates principles from clinical psychology and developmental science to understand
how certain maladaptive behaviors or mental health issues can arise and change
throughout a person’s life. Originating in the late 20th century, developmental
psychopathology emerged from the realization that adult psychopathology could often
be traced back to developmental processes that went awry during childhood. Scholars like
Norman Garmezy, Michael Rutter, and Dante Cicchetti were pivotal in its foundation,
focusing on risk factors, resilience, and the interplay between nature and nurture in the
development of psychopathological conditions. This theoretical–clinical framework
places significant emphasis on understanding how different trajectories of development
can lead to mental health outcomes. It considers the influence of biological, psychological,
and socio-environmental factors that interact at various stages of a person’s development.
By focusing on these interactions, the field seeks to identify why individuals diverge from
typical developmental pathways, which can lead to the onset of disorders. For instance,
Rutter [4] highlighted the importance of sensitive periods in development, where certain
experiences have profound effects on developmental outcomes, suggesting that timing of
risk exposure can significantly affect mental health.
A core principle of this field is that maladaptive and adaptive developments are not
distinct pathways but are interwoven across the lifespan. This concept is reflected in the
work of Cicchetti and Cohen [5], who articulate that adaptability and vulnerability to
mental illness are influenced by earlier developmental processes and subsequent
experiences. Their work underscores the importance of a dynamic approach to studying
psychopathology, one that accounts for changes across time and differing contexts.
Furthermore, developmental psychopathology focuses on resilience and risk factors.
It examines how certain environments, genetic predispositions, and coping mechanisms
influence one’s ability to handle stress or overcome adversity. For example, research by
Masten et al. [6] into resilience in development provides a framework for studying how
children overcome adversities, emphasizing the role of protective factors that help
mitigate risk.
In short, developmental psychopathology is a vital field that contributes to our
understanding of how psychological disorders can develop and change throughout a
person’s life. It integrates findings from various disciplines to offer a comprehensive
approach to mental health, emphasizing the necessity of considering a wide range of
influences and their interaction over time. This perspective not only helps in diagnosing
and treating mental disorders but also offers a blueprint for preventive measures that can
be implemented at critical stages of development.
This viewpoint sheds light on how the pandemic’s compounded pressures amplified
health and developmental risks. The upheaval caused by the pandemic has reshaped
children’s social and educational environments, emphasizing the influence of varied
forms of parental neglect—emotional, educational, or physical—on the health outcomes
of children, with a notable impact on the prevalence of overweight and obesity issues.
Studies indicate a rise in children’s screen time, diminished physical activity, and irregular
sleep patterns during the pandemic, highlighting the role of changed environmental
conditions on children’s health behaviors [7]. Furthermore, the pandemic’s influence on
nutritional habits and the increased likelihood of excessive weight gain in children
underscore the drastic alterations in daily routines that favor a sedentary lifestyle and
unhealthy eating habits [8]. In fact, many studies observed an increase in the consumption
of home-cooked meals, snacks, sweets, and bakery products, while the intake of fast food
Nutrients 2024, 16, 2162 3 of 7

and soft drinks decreased. These dietary changes were mixed in their health implications;
while home-cooked meals might be healthier, the increase in snacks and sweets can lead
to adverse health outcomes. For example, the increased intake of snacks and sweets is
associated with higher risks of obesity and related metabolic disorders, which in turn can
exacerbate mental health issues such as anxiety and depression [9]. Additionally,
emotional eating driven by stress and anxiety during confinement was linked to the
increased consumption of sugary and fatty foods, contributing to weight gain and poor
mental health outcomes [10]. The altered eating patterns, combined with reduced physical
activity and increased screen time, further amplified these negative health effects,
underscoring the need for targeted interventions to promote healthy eating and physical
activity during such periods [11]. School closures are pinpointed as a significant factor for
weight gain in children, removing the structured support for regular exercise and
nutritious eating habits [12]. These elements collectively present a complex challenge,
where neglect in various forms, intensified by pandemic conditions, significantly affects
the increasing trends in childhood overweight and obesity.
In the wake of COVID-19, public health, mental health, and child development face
intersecting challenges, notably the surge in rates of overweight and obesity among
children during the pandemic. Viewing this issue through a developmental
psychopathology framework emphasizes neglect’s pivotal role in intensifying these
challenges, affecting children’s physical, emotional, and developmental well-being. The
lockdown period has notably led to significant increases in body weight and BMI among
school-aged children and adolescents, underscoring the negative effects of the pandemic
on children’s physical health [13]. Additionally, as said above, the closure of schools
during the pandemic was directly linked to a heightened risk of weight gain in children,
reflecting the direct impact of disrupted regular school activities on obesity rates [14]. This
complex scenario underscores the need for comprehensive strategies to address the multi-
dimensional aspect of neglect and its influence on children’s health amidst the ongoing
pandemic.
The pandemic has heightened parental stress levels, possibly leading to both physical
and emotional neglect. Physical neglect, manifested as poor nutrition and inadequate
structured physical activity due to lockdown measures, directly heightens the risk of
children becoming overweight. Emotional neglect, seen through a lack of emotional
support and engagement, may intensify stress-related eating and inactive behaviors in
children, contributing to weight gain. The COVID-19 pandemic’s disruption to daily life
has significantly affected health behaviors, stress levels, and the financial and food
security of families with young children, indicating the wider scope of physical and
emotional neglect’s potential effects on child nutrition and activity patterns [15,16].
Parental stress and perceived risk during the pandemic negatively correlated with
children’s physical activity and well-being, highlighting emotional neglect’s indirect
effects on children’s lifestyle choices and mental health [17]. These observations
underscore the linkage between parental stress, neglect, and the negative outcomes on
children’s physical and emotional well-being during the COVID-19 pandemic.
The transition to remote learning and the subsequent lack of physical education and
extracurricular activities embody educational neglect, directly affecting children’s
physical health. The diminished opportunities for structured physical activity contribute
to a sedentary lifestyle, raising the risk of becoming overweight. The global shift to remote
learning has significantly affected children’s physical activity and mental health
outcomes, with school-aged children experiencing notable reductions in physical activity
since the transition, highlighting the challenge of providing adequate physical activity
opportunities during this period [18–20]. Moreover, studies during the pandemic
confirmed the diminished quality and duration of physical education classes in remote
schooling, revealing a significant decline in children’s physical/sports activity and motor
functions, which underscores the inadequate conditions for children’s healthy
development during remote schooling [21,22]. These findings emphasize the need to
Nutrients 2024, 16, 2162 4 of 7

bridge the gap in physical activity and health education for children during remote
learning periods to mitigate sedentary lifestyle-associated risks.
The developmental psychopathology perspective brings to light the significance of
intergenerational transmission within the context of neglect and obesity [23]. Parents who
have endured neglect or obesity in their youth might unintentionally pass on behaviors
that elevate their children’s risk of becoming overweight, particularly amid the
pandemic’s heightened stress and disruptions. Research on intergenerational stress
illustrates that stress during pregnancy can result in social deficits and depressive-like
behaviors in offspring, suggesting a dual-hit stress mechanism involving both prenatal
and early-life parenting environments. These insights affirm the intricate relationship
between genetic, environmental, and behavioral factors in the intergenerational
transmission of stress and behaviors related to obesity [24,25]. Furthermore, the link
between maternal lifetime stressors and the depressive symptoms of high-risk adolescent
daughters through the daughters’ lifetime stressors underscores stress transmission and
its implications for subsequent generations, especially in terms of neglect and the
heightened risk of obesity [26,27]. These observations highlight the necessity for
interventions that tackle the foundational causes of stress and obesity, taking into account
the intergenerational patterns that may intensify these issues.
In addressing these issues, a developmental psychopathology lens underscores the
criticality of early, targeted interventions to disrupt the cycle of neglect and obesity.
Potential strategies include providing support to parents and caregivers, enhancing access
to resources, delivering mental health interventions, and initiating educational initiatives.
These evidence-based approaches underscore the multifaceted strategy required to
navigate the interconnected issues of neglect and childhood obesity, emphasizing the
importance of early, comprehensive interventions involving parents, caregivers,
educators, and healthcare providers in the pursuit of healthier developmental trajectories
for children amidst unprecedented challenges [28–30].
Addressing the complex interplay between neglect and overweight in children,
especially during the COVID-19 pandemic, necessitates a comprehensive approach that is
responsive to the multifaceted nature of these challenges. The pandemic has not only
disrupted the lives of children and families but also presented an opportunity to
reevaluate and reinforce the systems of support that can prevent and mitigate the effects
of neglect and contribute to healthier outcomes for children.
Parental and caregiver support is paramount in addressing physical and emotional
neglect. By providing resources and education on stress management, nutrition, and the
importance of physical activity, we can empower parents and caregivers to foster
environments that support healthy development. This involves not only direct
educational efforts but also support systems that reduce the stressors contributing to
neglect, such as financial assistance programs, access to mental health services, and
community support networks [31].
Improving access to nutritious food and physical activity opportunities is critical,
particularly in communities where these resources are scarce. This can involve initiatives
like community gardens, subsidized healthy meal programs for children, and safe,
accessible spaces for physical activity. During the pandemic, when traditional avenues for
physical education and activity were disrupted, creative solutions such as virtual exercise
classes or socially distanced outdoor activities helped fill the gap.
The psychological well-being of both children and their parents or caregivers plays a
critical role in addressing neglect and its consequences. Offering mental health services,
including psychological support and therapy, can provide families with the tools to
manage stress, address emotional neglect, and foster healthier relationships. These
services can be delivered through telehealth platforms to increase accessibility, especially
during times when in-person services may be limited [32–34].
Schools are also crucial in supporting children’s physical and mental health. Beyond
providing education, they can offer structured physical activities, nutrition programs, and
Nutrients 2024, 16, 2162 5 of 7

mental health resources. Ensuring that remote or hybrid learning models include
components that address physical education and social–emotional learning can help
mitigate the impacts of educational neglect.
At a broader level, policy changes and community actions can support the systemic
changes needed to address neglect and its impacts on child health. This includes
advocating for policies that support family well-being, such as paid parental leave,
affordable healthcare, and accessible mental health services. Community efforts to raise
awareness and create supportive networks can also play a vital role in preventing neglect
and promoting healthy development [35–37].
The COVID-19 pandemic has highlighted and intensified the challenges of parental
neglect and its impact on childhood overweight and obesity. By adopting a
comprehensive approach that addresses the needs of children and families from a
developmental psychopathology perspective, we can work towards mitigating these
issues. This requires the collaboration of healthcare providers, educators, policymakers,
and communities to create a supportive environment that promotes the well-being and
healthy development of all children [38,39]. Through targeted interventions, support for
parents and caregivers, and systemic changes, we can strive to ensure that children have
the opportunity to thrive, even in the face of unprecedented challenges.

Funding: This research received no external funding.

Conflicts of Interest: The authors declare no conflict of interest.

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