Background: The prevalence of obesity is increasing and many countries are struggling with its high rate and serious complications. As a result of distinct diet in obese children, they may be susceptible to nutritional deficiencies in particular, iron deficiency. This study aimed to examine the relationship between obesity and iron indices.

Methods: In this cross-sectional study, 206 elementary school students were selected by stratified random sampling. Anthropometric parameters (waist circumference and body mass index) were measured, and fasting venous blood was collected to test serum iron, ferritin, transferrin saturation and complete blood count. To recognize the association between obesity and anemia, data were entered to SPSS and Lisrel software and analyzed using appropriate related test.

Results: It was revealed that waist circumference was negatively associated with levels of serum iron and transferrin saturation (p<0.05). In contrast, the highest waist circumference was positively and significantly related to higher levels of TIBC (p<0.05) compared to normal-weight children. Generally, it was concluded that waist circumference was significantly related to total iron binding capacity and serum iron levels (p<0.05). Similar negative significant associations were observed among children with an increase in body mass index and transferring saturation. Central and general obese children were more likely to have iron deficiency with and without anemia.

Conclusion: This study suggests that the higher levels of total and central obesity should be taken into account when assessing the children’s body iron status and should be treated before providing dietary recommendations to correct anemia.