Health-Related Quality of Life of Severely Obese Children and Adolescents

Abstract

Objective To examine the health-related QOL of obese children and adolescents compared with children and adolescents who are healthy or those diagnosed as having cancer.Design, Setting, and Participants Cross-sectional study of 106 children and adolescents (57 males) between the ages of 5 and 18 years (mean [SD], 12.1 [3] years), who had been referred to an academic children's hospital for evaluation of obesity between January and June 2002. Children and adolescents had a mean (SD) body mass index (BMI) of 34.7 (9.3) and BMI z score of 2.6 (0.5). Main Outcome MeasuresChild self-report and parent proxy report using a pediatric QOL inventory generic core scale (range, 0-100). The inventory was administered by an interviewer for children aged 5 through 7 years. Scores were compared with previously published scores for healthy children and adolescents and children and adolescents diagnosed as having cancer.Results Compared with healthy children and adolescents, obese children and adolescents reported significantly (PϽ.001) lower health-related QOL in all domains (mean [SD] total score, 67 [16.3] for obese children and adolescents; 83 [14.8] for healthy children and adolescents). Obese children and adolescents were more likely to have impaired health-related QOL than healthy children and adolescents (odds ratio [OR], 5.5; 95% confidence interval [CI], 3.4-8.7) and were similar to children and adolescents diagnosed as having cancer (OR, 1.3; 95% CI, 0.8-2.3). Children and adolescents with obstructive sleep apnea reported a significantly lower health-related QOL total score (mean [SD], 53.8 [13.3]) than obese children and adolescents without obstructive sleep apnea (mean [SD], 67.9 [16.2]). For parent proxy report, the child or adolescent's BMI z score was significantly inversely correlated with total score (r=−0.246; P = .01), physical functioning (r=−0.263; PϽ.01), social functioning (r=−0.347; PϽ.001), and psychosocial functioning (r=−0.209; P = .03). ConclusionsSeverely obese children and adolescents have lower health-related QOL than children and adolescents who are healthy and similar QOL as those diagnosed as having cancer. Physicians, parents, and teachers need to be informed of the risk for impaired health-related QOL among obese children and adolescents to target interventions that could enhance health outcomes.

Association of nutritional status and health-related quality of life in children with chronic kidney disease

“…Despite previous reports from other cohorts of children [ 50 ], these data do not demonstrate a lower HRQoL in those with markers of obesity (BMI SDS, waist circumference-to-height ratio). The reason for this may be a shift of the perceived normal body shape and “accepted” adiposity in children.…”

Association of nutritional status and health-related quality of life in children with chronic kidney disease

“…Despite previous reports from other cohorts of children [ 50 ], these data do not demonstrate a lower HRQoL in those with markers of obesity (BMI SDS, waist circumference-to-height ratio). The reason for this may be a shift of the perceived normal body shape and “accepted” adiposity in children.…”

Health‐related quality of life in children and adolescents: Current normative data, determinants and reliability on proxy‐report

“…Also a cause for attention is the fact that children, as well as parents, reported no association of HrQoL to BMI. Those findings stands in contrast to many other reports and might be caused by sampling or the fact that only 25 children in our group were obese. However, if this lacking awareness or denial mechanisms, in both children and parents, at least in the more physical domains of HrQoL, is true, then a long‐term health risk for the children would be the consequence.…”

Self‐rated and parent‐rated quality of life (QoL) for community‐based obese and overweight children

“…However, in contrast to other studies (6)(7)(8)(9)(10)(11)(12)(13), overweight-group children did not report a lower QoL score than did normal-weightgroup children in this study. One reason might be that this study used a community-based sample, while most other studies used clinically based samples (8)(9)(10)(11)(12)(13)). An alternative explanation might be that the overweight-group children in our study were well built and heavier than normal because they were muscular and not fat; we did not differentiate between the two (30).…”

Association of nutritional status and health-related quality of life in children with chronic kidney disease

“…Despite previous reports from other cohorts of children [ 50 ], these data do not demonstrate a lower HRQoL in those with markers of obesity (BMI SDS, waist circumference-to-height ratio). The reason for this may be a shift of the perceived normal body shape and “accepted” adiposity in children.…”

Health‐related quality of life in children and adolescents: Current normative data, determinants and reliability on proxy‐report

“…Also a cause for attention is the fact that children, as well as parents, reported no association of HrQoL to BMI. Those findings stands in contrast to many other reports and might be caused by sampling or the fact that only 25 children in our group were obese. However, if this lacking awareness or denial mechanisms, in both children and parents, at least in the more physical domains of HrQoL, is true, then a long‐term health risk for the children would be the consequence.…”

Self‐rated and parent‐rated quality of life (QoL) for community‐based obese and overweight children

“…However, in contrast to other studies (6)(7)(8)(9)(10)(11)(12)(13), overweight-group children did not report a lower QoL score than did normal-weightgroup children in this study. One reason might be that this study used a community-based sample, while most other studies used clinically based samples (8)(9)(10)(11)(12)(13)). An alternative explanation might be that the overweight-group children in our study were well built and heavier than normal because they were muscular and not fat; we did not differentiate between the two (30).…”

Association of nutritional status and health-related quality of life in children with chronic kidney disease

“…Despite previous reports from other cohorts of children [ 50 ], these data do not demonstrate a lower HRQoL in those with markers of obesity (BMI SDS, waist circumference-to-height ratio). The reason for this may be a shift of the perceived normal body shape and “accepted” adiposity in children.…”

Health‐related quality of life in children and adolescents: Current normative data, determinants and reliability on proxy‐report

“…Also a cause for attention is the fact that children, as well as parents, reported no association of HrQoL to BMI. Those findings stands in contrast to many other reports and might be caused by sampling or the fact that only 25 children in our group were obese. However, if this lacking awareness or denial mechanisms, in both children and parents, at least in the more physical domains of HrQoL, is true, then a long‐term health risk for the children would be the consequence.…”

Self‐rated and parent‐rated quality of life (QoL) for community‐based obese and overweight children

“…However, in contrast to other studies (6)(7)(8)(9)(10)(11)(12)(13), overweight-group children did not report a lower QoL score than did normal-weightgroup children in this study. One reason might be that this study used a community-based sample, while most other studies used clinically based samples (8)(9)(10)(11)(12)(13)). An alternative explanation might be that the overweight-group children in our study were well built and heavier than normal because they were muscular and not fat; we did not differentiate between the two (30).…”