Mapping the Dynamic Interplay of Mental Health and Weight Across Childhood: Data-Driven Explorations Using Causal Discovery

Childhood weight development, especially overweight and obesity, has been associated with mental health, but their dynamic, causal relationships, and whether these differ by sex, remain unclear. We applied causal discovery to data from the Danish National Birth Cohort (n=67,593) spanning six periods from pregnancy to late adolescence and considering 67 variables related to child and parental weight, mental health, lifestyle, and socio-economic factors. We found no statistically significant difference between the causal graphs for boys and girls (P=0.079). The data-driven models found causal influence of childhood weight on subsequent weight status. Mental health pathways were exclusively within or across adjacent periods and centered on early adolescent stress. We examined the interplay between a subset of mental health variables, containing information on externalizing and internalizing problems, and weight, and found no direct causal pathway between the two processes. These findings suggest that observed links between weight and these mental health measures may be attributable to confounding. Our findings demonstrate the value of data-driven causal discovery in large cohort studies and how to test for differences in causal mechanisms across subgroups. Results are available in an interactive application, enabling future research to further explore the interplay between weight and mental health.