Social and Economic Consequences of Overweight in Adolescence and Young Adulthood

Gortmaker, Steven L.; Must, Aviva; Perrin, James M.; Sobol, Arthur M.; Dietz, William H.

doi:10.1056/nejm199309303291406

Cited by 1,359 publications

(867 citation statements)

References 23 publications

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“…5 Negative self-image has been documented in overweight children as young as 5 years of age, 6 and obese adolescents show declining degrees of self-esteem associated with sadness, loneliness, nervousness and high-risk behaviors. 7 In a recent study, conducted in a hospital setting, the HRQOL of obese children was adversely correlated with the degree of obesity and was found to be similar to the HRQOL of children diagnosed with cancer. 8 The objective of our study was to assess the impact of obesity on the QOL of children, and to assess parents' perception of HRQOL of their children.…”

Section: Introductionmentioning

confidence: 92%

Health-related quality of life among children and adolescents: associations with obesity

et al. 2005

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Objective: To assess the impact of obesity on health-related quality of life (HRQOL) of children, and to compare HRQOL scores of obese children in a hospital versus community setting. Design: A cross-sectional study in two clinical samples. Subjects: A total of 182 children and adolescents recruited from the community pediatric clinics and a hospital-based obesity clinic. Measurements: Obesity was defined as body mass index (BMI) 495th percentile for age and gender. Subjects were divided into quartiles of BMI Z-scores each containing 45 or 46 children. The first two quartiles correspond to normal BMI, 3rd and 4th quartiles represent moderate and severe obesity, respectively. HRQOL was assessed by the Pediatric Quality of Life Inventoryt (PedsQLt) questionnaire submitted by both children and their parents. Results: Obese children reported significantly lower HRQOL in physical, social and school domains compared with normal weight children (Po0.01). Analyzing results of HRQOL by BMI quartiles showed that the emotional and school domains scores of the moderately obese children were similar to the normal BMI quartiles. Only in the 4th quartile, that of children with severe obesity, were scores significantly lower. In contrast, in both physical and social domains scores decreased progressively with increased BMI Z-scores. In the obese group, parents' scores were lower than the children's in all domains. HRQOL scores of obese children assessed in the hospital clinic were similar to that of obese children assessed in the community. Conclusions: Moderately obese children had similar emotional and school HRQOL scores as normal weight children, whereas in the physical domain, a significant difference was documented even in moderate obesity. Parents of obese children perceived their child's HRQOL lower than the children themselves. We believe that intervention programs aimed at improving HRQOL should be directed to both parents and children. Understanding the resilience of moderately obese children in school and emotional domains may assist us in the management of childhood obesity.

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Section: Introductionmentioning

confidence: 92%

Health-related quality of life among children and adolescents: associations with obesity

et al. 2005

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“…1,2 Obese children commonly suffer discrimination and teasing from their peers, [3][4][5] which may affect their psychosocial health.…”

Section: Introductionmentioning

confidence: 99%

Quality of life in a clinical sample of obese children

et al. 2006

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Objectives: To measure health-related quality of life (HRQoL) in a clinical sample of obese children by child self-report and parent-proxy report; to compare quality of life assessments provided by obese children and their parents; to assess differences in quality of life between the obese clinical sample and healthy control children. Design: Pairwise comparison of obese children matched for age, gender and socio-economic status with non-obese controls. Subjects: One hundred and twenty-six obese children (body mass index (BMI) X98th centile) and 71 lean control children (BMI o85th centile). Controls were matched with 71 children from the obese clinical group (mean age 8.6, standard deviation (s.d.) 1.9 years; 33 M/38 F). Measurement: The Paediatric Quality of Life Inventory (UK) version 4 was self-administered to parents and to children aged 8-12 years and interview was administered to children aged 5-7 years. This questionnaire assessed physical, social, emotional and school functioning from which total, physical and psychosocial health summary scores were derived. Results: In the obese clinical group (n ¼ 126), parent proxy-reported quality of life was low for all domains. In the obese clinical group, parent-reported scores were significantly lower than child self-reported scores in all domains except physical health and school functioning. Parent-proxy reports were significantly higher for healthy controls than obese children in all domains (median total score 85.2 vs 64.7; 95% confidence interval (CI) 15.6, 24.1). For child self-reports, only physical health was significantly higher for healthy controls than obese children (median score 81.3 vs 75.0; 95% CI 3.1, 12.5). Conclusions: HRQoL is impaired in clinical samples of obese children compared to lean children, but the degree of impairment is likely to be greatest when assessed using the parent perspective rather than the child perspective.

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“…There is very clear evidence that being an obese adolescent and young adult can markedly impair later employment and social prospects independent of scholastic achievement and parental socioeconomic status. 4 In an era where discrimination on the basis of sex, race and religion is an anathema, it is easy to find examples of overt discrimination against the obese by the briefest perusal of the lay media. 5 We hope that a better understanding of the biological factors underlying human obesity will not only eventually lead to improved therapy but might also, in some small way, eventually help to alter the mind set of those who currently prefer condemnation to comprehension.…”

Section: Introductionmentioning

confidence: 99%

Human obesity as a heritable disorder of the central control of energy balance

O’Rahilly

Farooqi

2008

Int J Obes

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In the spirit of celebration associated with the 20th anniversary of the Pennington Biomedical Research Center, we have seized the opportunity of taking a highly personal and not at all comprehensive 'whistle-stop tour' of a large body of evidence that, we feel, supports the following conclusions: (1) that body fat stores are regulated by biological control processes in humans as they are in lower animals; (2) that there are major inherited influences on the efficiency whereby such control processes operate in humans; (3) that the precise nature of those genetic and biological influences and how they interact with environmental factors are beginning to be understood; (4) that most of the genes discovered thus far have their principal impact on hunger, satiety and food intake; (5) that while there is understandable resistance to the notion that genes can influence a human behavior such as the habitual ingestion of food, the implications of these discoveries are essentially benign. Indeed, we hope that they may eventually lead to improved treatment for patients and, in addition, help to inculcate a more enlightened attitude to the obese with a reduction in their experience of social and economic discrimination.

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Social and Economic Consequences of Overweight in Adolescence and Young Adulthood

Cited by 1,359 publications

References 23 publications

Health-related quality of life among children and adolescents: associations with obesity

Health-related quality of life among children and adolescents: associations with obesity

Quality of life in a clinical sample of obese children

Human obesity as a heritable disorder of the central control of energy balance

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