Abstract
PURPOSE: Childhood obesity is a growing public health concern, associated with severe physical and psychological consequences. This study investigates the relationship between self-conscious emotions, specifically shame and guilt, and their impact on eating behaviors, physical activity levels, and screen time in children aged 10-18 years. Understanding these relationships may help design more effective obesity management strategies. METHODS: The study included 100 children with obesity and 90 children without obesity. Participants were evaluated using the Test of Self-Conscious Affect for Adolescents (TOSCA-A), the Dutch Eating Behavior Questionnaire (DEBQ), the Physical Activity Questionnaire for Children (PAQ-C), and the Revised Children's Anxiety and Depression Scale (RCADS). Comparative analysis was conducted between the two groups to assess emotional and behavioral patterns. RESULTS: Children with obesity reported higher levels of anxiety, depression, emotional eating, and restrictive eating, along with lower physical activity levels and increased screen time compared to children without obesity. While guilt was positively correlated with emotional eating in both groups, shame was significantly associated with problematic eating patterns only in children without obesity. The relationship between physical activity and these emotions was minimal, with only guilt showing a modest negative association with school-based activity in the control group. CONCLUSIONS: These findings highlight the need to address emotional well-being as part of childhood obesity interventions. Psychological approaches focusing on guilt and emotional eating may improve the effectiveness of treatment strategies. Future research is warranted to explore developmental variations in the impact of shame and guilt on children's behaviors. LEVEL OF EVIDENCE: Level III, well-designed cross-sectional analysis.