Nearly one in three children in Italy live with excess weight. Numbers from the OKkio alla Salute surveillance system of the Istituto Superiore di Sanità speak of 29.7 percent being overweight and obese, with 10.7 percent having overt obesity. These percentages remain among the highest in Europe and tell a more complex phenomenon than the simple equation “too many calories, not enough exercise.”
Thousands of children with weight problems come to the outpatient clinics of the Bambino Gesù Children’s Hospital every year. But alongside the scale today, other indicators are observed: sleep quality, working memory, and the ability to handle frustration and impulses. It is on these less visible factors that RESILIENT, a project coordinated by the Roman hospital and funded by the PNRR, focuses.
When sleep alters hunger
Poor sleep does not just mean being tired. At a developmental age, sleep deprivation alters the circuits that regulate appetite and satiety. The brain, still maturing between the ages of 6 and 11, is particularly sensitive to imbalances in circadian rhythms. International studies show that chronic sleep deprivation is associated with increased search for energy-dense foods and decreased control of food impulses.
In the sample of 120 children involved in RESILIENT, overweight and obesity were often accompanied by sleep disturbances and difficulties with self-regulation. Intervening in these aspects produced improvements not only in weight, but also in quality of rest and hunger management.
Emotions and metabolism, a unique circuit
Childhood obesity is a multidimensional condition. Stress, anxiety, and relationship difficulties affect eating behaviors and the neuroendocrine mechanisms that regulate metabolism. Emotional regulation, that is, the ability to recognize and modulate one’s reactions, is intertwined with executive functions: memory, attention, planning.
In the project, a group of children underwent computerized cognitive training to enhance attention and memory. The most interesting result was not only cognitive: those who worked on these skills showed an additional benefit on sleep and self-control. Strengthening executive functions means providing tools to maintain new eating and motor habits over time.
The window of plasticity
Between the ages of 6 and 11, the brain is still highly plastic. Acting in this window allows intervention in the central circuits that regulate appetite and energy expenditure. The five-month course integrated nutrition education, structured physical activity and active parental involvement, with an initial intensive online phase and a subsequent consolidation phase.
The results speak of improved body composition, muscle strength, metabolic parameters and behavioral aspects. An approach that goes beyond the logic of diet alone and recognizes that metabolism, emotions and sleep are part of the same system.
