Sixty-eight percent of U.S. adults are overweight/obese, and this epidemic has physical, psychosocial, and behavioral consequences. An internet sample of adults (N = 2997) perceiving themselves as larger than ideal in clothing size reported their body mass index (BMI), relative clothing size (RS; discrepancy between current and ideal size), and avoidance behaviors. Exploratory factor analysis of 10 avoid-ance items produced social avoidance and body display avoidance factors. A relative importance analysis revealed RS as a better predictor than BMI for avoidance. A hierarchical multivariate analysis of covariance found RS to predict both avoidance constructs. The relationship between RS and both avoidance con-structs was stronger for women than men, and for younger as compared to older participants. Caucasians reported more body display avoidance than African Americans. This suggests that personal dissatisfac-tion with body size may deter involvement in varied life events and that women are especially avoidant of activities that entail displaying their bodies.

Objective: To quantitatively characterize change in health-related quality of life (HRQoL) in the context of behavioral (n= 16), surgical (n=5), and pharmacological (n=1) interventions for pediatric overweight and obesity. A secondary goal was to examine the relationship between change in HRQoL and change in weight status (ΔBMI) by treatment type. The amount of weight loss necessary to observe a minimally clinically important difference (MCID) in HRQoL was determined. Methods: Data were gathered from studies reporting on weight change and ΔHRQoL over the course of obesity interventions (N = 22) in youths (N=1,332) with average ages between 7.4 and 16.5 years (M = 12.2). An overall effect size was calculated for ΔHRQoL. Moderation analyses were conducted using ANOVA and weighted regression. MCID analyses were conducted by converting HRQoL data to SEM units. Results: The overall effect size for ΔHRQoL in the context of pediatric obesity interventions was medium (g = 0.51). A significant linear relationship was detected between ΔBMI and ΔHRQoL (R 2 = 0.87). This relationship was moderated by treatment type, with medical (i.e., surgical) interventions demonstrating a stronger relationship. Results indicated that it takes a change of 0.998 BMI units to detect true change in HRQoL. Conclusions: This study provides the first known quantitative examination of changes in HRQoL associated with weight loss in pediatric interventions. Medical interventions appear to offer a more substantial increase in HRQoL per unit of BMI change. These results offer a concrete weight loss goal for noticing positive effects in daily life activities.

Background: Health-related quality of life (HRQoL) has been recognized as an important target and health outcome in obesity research. The current study aimed to examine HRQoL in overweight or obese children after a 10-week primary-care-based weight management program, Parent-Led Activity and Nutrition for Healthy Living, in southern Appalachia.Methods: Sixty-seven children (ages 5-12 years) and their caregivers were recruited from four primary care clinics, two of which were randomized to receive the intervention. Caregivers in the intervention groups received two brief motivational interviewing visits and four group sessions led by providers as well as four phone follow-ups with research staff. Caregivers completed the PedsQL and demographic questionnaires at baseline and at 3, 6, and 12 months postintervention. Child height and weight were collected to determine standardized BMI.Results: Caregivers of children receiving the weight control intervention reported no statistically significant improvements in child total HRQoL, as compared to the control group, across the course of treatment (b = 0.178; 95% confidence interval, -0.681, 1.037; p = 0.687). Additionally, no statistically significant improvements were found across other HRQoL domains.Conclusions: Future studies examining HRQoL outcomes in primary care may consider treatment dose as well as methodological factors, such as utilization of multiple informants and different measures, when designing studies and interpreting outcomes.