*2.3. Procedure*

New patients arriving at the Obesity Risk Units were considered potential candidates to participate in this study. At their first appointment at the Unit, participants were weighed and measured to calculate BMIz. Once the patients were diagnosed with obesity, parents were offered the possibility for their children to voluntarily participate in the study. All parents of participants signed the informed consent documents before starting the assessment, in accordance with the Declaration of Helsinki. The study was approved by the Ethics Committee at CHGUV (reference number: 4/2019) and the Research Ethics Committee of the Autonomous Community of Aragon (CEICA) (reference number: PI19/269). Then, patients who agreed to participate were scheduled to come to the hospital in a second session. In this session, participants underwent a blood test to measure biomarkers, and one hour later (after having breakfast), they completed several psychological measures in the context of the Eat4HealthyLife project, including the DEBQ-C, assisted by a trained psychologist. Specifically, the assessment protocol of this project included some neurocognitive measurements, including the Kaufman Brief Intelligence Test Second Edition [60] and the Digit span subtest of the Wechsler Intelligence Scale for Children [61]. However, they are not reported herein because they are not relevant for the objective of this study.

It should be noted that recruitment of participants was stopped during the lockdown period (between March and June 2020), as well as during the third wave of COVID-19 in Spain (between January and March 2021) when the incidence of cases was very high. From the beginning of the pandemic, the study sessions took place with appropriate safety measures, such as mask and ventilation in the room. None of the participants presented symptoms compatible with an infectious process either at the time of the evaluation or in the previous week.
