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63 Functional constipation and overweight 2 INTRODUCTION Childhood overweight and obesity are challenging problems faced by pediatricians worldwide. 1 In 2013, in developed countries, the prevalence of overweight and obesity was 23.8% in boys and 22.6% in girls. 1 Although the prevalence of overweight and obesity is traditionally lower in developing countries, it has increased strikingly between 1980 and 2013; from 8.1% to 12.9% for boys and from 8.4% to 13.4% in girls. 1 Obesity in children is commonly known to be a risk factor for a wide variety of severe chronic diseases, including type 2 diabetes and fatty liver disease, and is associated with increased healthcare costs. 2 In developed countries, several pediatric studies have revealed an association between excessive bodyweight and functional constipation in children. 3–7 Functional constipation is a common pediatric healthcare problem worldwide, with a reported prevalence ranging from 0.7%-29.6%. 8 The diagnosis is based on the Rome III criteria, and symptoms may include infrequent, painful defecation, hard stools, and fecal incontinence. 9 These bothersome symptoms are known to have a significant impact on the quality of life of affected children. 10–13 Despite its common occurrence, the pathophysiology of functional constipation is still incompletely understood. 14 The underlying mechanisms behind the suggested association between functional constipation and overweight also remain unidentified. Factors such as dietary intake, physical activity, the gut microbiota, psychological factors, and socioeconomic status may play a role in the pathophysiology of both disorders and could account for their commonly reported co-occurrence. Studies regarding the association between functional constipation and excessive bodyweight have mostly been conducted in developed countries. Since pathophysiological factors may differ between developing and developed countries, it is of key importance to conduct such studies also in developing countries, to evaluate if results from studies from developed countries are indeed applicable to the pediatric population in developing countries. The primary aim of this population-based, cross-sectional observational study was to assess the prevalence of functional constipation, overweight, and obesity in children across multiple regions of Colombia and to assess the association between excessive bodyweight and functional constipation. Secondary aim was to assess whether other factors such as socioeconomic factors or family composition are associated with functional constipation or excessive bodyweight in children.