Objective: To examine associations between obesity and impairment in developmental functioning in a general population sample of pre-school children.

Method: Standardized medical examinations were conducted in nine consecutive cohorts of male and female children (n ¼ 9415) aged between 4.4 and 8.6 years (mean ¼ 6.0, s.d. ¼ 0.37) residing in the Lower Bavaria region of Germany. Tests designed to assess performance in subdivisions representing four broad developmental domains, namely, motor development, speech development, cognitive development and psycho-social development, were completed by all participants.

Results: Boys had significantly higher rates of impairment than girls. The prevalence of obesity in boys was 2.4%, whereas in girls it was 4.3% (w2 ¼ 21.51, Po 0.01). After controlling for age, gender, year of recruitment and other potential covariates, the prevalence of impairment in gross motor skills was higher among obese male children than normal-weight male children (adjusted odds ratio ¼ 1.76, 95% confidence interval (CI) ¼ 1.02, 3.01, Po 0.05), whereas the prevalence of impairment in the ability to focus attention was higher in obese female children than normal-weight female children (adjusted odds ratio ¼ 1.86, 95% CI ¼ 1.00, 3.44, Po 0.05).

Conclusions: The findings suggest that gender-specific associations between obesity and impairment in specific aspects of developmental functioning may be evident in younger children.