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Decreased Quality of Life Associated With Obesity in School-aged Children
Samuel L. Friedlander, MD;
Emma K. Larkin, MHS;
Carol L. Rosen, MD;
Tonya M. Palermo, PhD;
Susan Redline, MD, MPH
Arch Pediatr Adolesc Med. 2003;157:1206-1211.
Objectives To examine the association between health-related quality of life and body mass index (BMI) in preadolescent school-aged children and to provide the possible risk factors among participant characteristics, BMI status, and health-related quality of life.
Design, Setting, and Participants Cross-sectional analysis of 371 (50% female; 32% minority) children from a community-based sample of 8- to 11-year-olds participating in an ongoing cohort study, excluding those who had sleep apnea or who were born prematurely. Using BMI percentiles for age and sex, 17.5% of the children were considered overweight (BMI  95th percentile), 12.4% were at risk for overweight (BMI 85th-94th percentile), 8.1% were relatively underweight (BMI <20th percentile), and the remaining 62.0% were of normal weight (BMI 20th-84th percentile).
Main Outcome Measures Health-related quality-of-life scores as determined by the Child Health Questionnaire–Parent Form 50, dichotomized into the bottom quartile or decile.
Results After adjustment for covariates (host factors and health status measurements), overweight children compared with normal weight children scored lower on the Psychosocial Health Summary (odds ratio [OR], 2.0; 95% confidence interval [CI], 1.1-3.6) and on subscales measuring self-esteem (OR, 3.5; 95% CI, 1.9-6.3), physical functioning (OR, 2.8; 95% CI, 1.7-6.8), and effect on the parent's emotional well-being (OR, 2.0; 95% CI, 1.1-3.6). Compared with the normal weight group, children who are at risk for overweight scored significantly lower for physical functioning.
Conclusion Overweight children have an increased odds of low scores for several health-related quality-of-life domains, suggesting the importance in considering such dimensions in programs aimed at further understanding obesity in children.
From the Department of Pediatrics, Rainbow Babies & Children's Hospital, Case Western Reserve University School of Medicine, Cleveland, Ohio.
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