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69 Functional constipation and overweight 2 other hand, the association between lifestyle factors and the prevalence of overweight and obesity has been well established. 26–30 Because these lifestyle factors are likely related to both overweight and functional constipation, they might explain the previously reported association between functional constipation and overweight in studies conducted in developed countries, where these factors are likely to be more prevalent than in developing countries. One of the limitations of this study is that we did not obtain detailed information about possible influencing factors such as dietary intake, physical activity, and sedentary time. This might have been useful in identifying possible factors that may have contributed to the regional differences in both functional constipation and overweight. Also, no information was obtained regarding medication that influences gastrointestinal motility, which may have biased our results. Furthermore, functional constipation was diagnosed based on a Spanish translation of the QPGS-RIII and did not include a physical examination with a digital rectal examination. According to the most recent guidelines 31 , in children who meet one of the Rome III criteria based on medical history, a physical examination may provide evidence that a child fulfils two Rome III criteria, by detection of a fecal mass in the rectum. However, performing a physical examination with digital rectal examination in a population-based study among mostly healthy children is not ethically acceptable. Furthermore, there is a risk of selection bias in this study; because the response rate of the study was extremely high (90.3%), the risk of selection bias because of children declining to participate seems small. The total number of children excluded for being underweight was relatively small compared with the total amount of children, and, therefore, the risk of bias seems acceptable. In conclusion, functional constipation, overweight, and obesity are common disorders among children in Colombia. This study did not provide evidence for an association between functional constipation and overweight and/or obesity in Colombian children. The results of our study differ from previous studies conducted in developed countries that found an association between functional constipation and excessive bodyweight in children. Future studies should be performed to confirm our findings and investigate the different factors that could explain the differences found between our study and previous studies and the differences between studies conducted in developed and developing countries. We found great variability in prevalence of functional constipation, overweight, and obesity across different regions. Studies aimed at investigating the different socioeconomic, ethnic, dietary, and lifestyle variables of each region may provide important insights into the possible influence of each of these factors in the pathogenesis of functional constipation, overweight and obesity.