Decreased quality of life associated with obesity in school-aged children

Objectives: To examine the association between health-related quality of life and body mass index (BMI) in pre-adolescent 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 greater than or equal to95th 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.