Household chaos, defined as a lack of organization, structure, and predictability, has been linked to a number of deleterious childhood health outcomes. However, few studies have examined the relationship between household chaos and obesity-related health outcomes in children. The present study examined the association of household chaos and psychological functioning in a sample of youth being treated for obesity.


Participants were 715 patients (61.8% girls; M = 12.3 yrs; 68.7% Black; M = 146.9% of the 95th BMI %-ile) enrolled in a pediatric weight management clinic in the Mid-South U.S. Caregiver report of household chaos was measured using the Confusion, Hubbub and Order Scale (CHAOS). Psychological functioning was measured with the Pediatric Symptom Checklist (PSC-17), a caregiver-completed mental health screen that assesses domains of psychological functioning. The Wilcoxon Rank Sum Test was used to test differences in household chaos scores for each PSC-17 subscale and Spearman correlations were used to assess associations between household chaos and psychological functioning.


Results indicated that caregivers reporting clinical levels of child internalizing, externalizing, attention, and global dysfunction reported significantly higher levels of household chaos. Additionally, Spearman correlations revealed significant associations between household chaos and internalizing (rho = .24), externalizing, (rho = .28), attention (rho = .24), and global (rho = .31) psychological functioning.


Traditional management of pediatric obesity calls for changes across multiple health domains (e.g., dietary, exercise, and sleep), and such change is facilitated by structure and consistency. Conversely, household chaos may hinder attempts to initiate and maintain healthy lifestyle changes. These findings suggest that psychological resources within pediatric weight management settings should address both individual patient-level factors as well as household functioning.