Quality of life in obese children - Childhood Obesity - Author Abstract

Nutrition Research Newsletter, May, 2003

Obesity is one of the most chronic disorders in childhood and its prevalence continues to increase rapidly. There is a growing awareness of the long-term health implications of obesity in children and adolescents, yet many pediatricians do not offer treatment to obese children and adolescents in the absence of comorbid conditions. However, the most widespread consequences of childhood obesity may be psychosocial. Health-related quality of life (QOL) is a comprehensive and multidimensional construct, and includes physical, emotional, social, and school functioning. There is little existing information about the health-related QOL of obese children and adolescents. The researchers of the present study hypothesized that obese children and adolescents, when compared with healthy children and adolescents, would have worse health-related QOL findings as seen in other pediatric chronic health conditions.

A pediatric QOL inventory generic score scale was used as the measure of health related QOL. Obese children and adolescents (n=106) between the ages of 5 and 18 years, who were newly referred to pediatric gastroenterology or nutrition clinics for the evaluation of obesity were recruited. Published pediatric QOL inventory reference data were used for comparison. The primary comparison was with healthy children and adolescents aged 5 to 18 years, who were recruited from private practice pediatrician offices and community health clinics. As a secondary comparison, children and adolescents diagnosed as having cancer and who were receiving chemotherapy were recruited at two large children's hospitals. These cancer patients were used because they reported the lowest scores of any chronic illness group assessed with a pediatric QOL inventory.

Compared with healthy children and adolescents, obese children and adolescents reported significantly lower health-related QOL in all domains. Obese children and adolescents were more likely to have impaired health-related QOL than healthy children and adolescents and were similar to children and adolescents diagnosed as having cancer. Children and adolescents with obstructive sleep apnea reported significantly lower health-related QOL total score than obese children and adolescents without obstructive sleep apnea.

Severely obese children and adolescents have lower health-related QOL than children and adolescents who are healthy and have 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.

J Schwimmer, T Burwinkle, J Varni. Health-related quality of life of severely obese children and adolescents. JAMA 289(14):1813-1819 (April 2003) [Correspondence: Jeffrey B. Schwimmer, MD, University of California, 200 W Arbor Dr, San Diego, CA 92103 (e-mail: jschwimmer@ucsd.edu)