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Health-Related Quality of Life of Overweight and Obese Children
Joanne Williams, PhD;
Melissa Wake, MD;
Kylie Hesketh, BA;
Elise Maher, PhD;
Elizabeth Waters, DPhil
JAMA. 2005;293:70-76.
Context The negative effects of childhood overweight and obesity on quality of life (QOL) have been shown in clinical samples but not yet in population-based community samples.
Objective To determine relationships between weight and health-related QOL reported by parent-proxy and child self-report in a population sample of elementary school children.
Design, Setting, and Participants Cross-sectional data collected in 2000 within the Health of Young Victorians Study, a longitudinal cohort study commenced in 1997. Individuals were recruited via a random 2-stage sampling design from primary schools in Victoria, Australia. Of the 1943 children in the original cohort, 1569 (80.8%) were resurveyed 3 years later at a mean age of 10.4 years.
Main Outcome Measures Health-related QOL using the PedsQL 4.0 survey completed by both parent-proxy and by child self-report. Summary scores for children’s total, physical, and psychosocial health and subscale scores for emotional, social, and school functioning were compared by weight category based on International Obesity Task Force cut points.
Results Of 1456 participants, 1099 (75.5%) children were classified as not overweight; 294 (20.2%) overweight; and 63 (4.3%) obese. Parent-proxy and child self-reported PedsQL scores decreased with increasing child weight. The parent-proxy total PedsQL mean (SD) score for children who were not overweight was 83.1 (12.5); overweight, 80.0 (13.6); and obese, 75.0 (14.5); P<.001. The respective child self-reported total PedsQL mean (SD) scores were 80.5 (12.2), 79.3 (12.8), and 74.0 (14.2); P<.001. At the subscale level, child and parent-proxy reported scores were similar, showing decreases in physical and social functioning for obese children compared with children who were not overweight (all P<.001). Decreases in emotional and school functioning scores by weight category were not significant.
Conclusion The effects of child overweight and obesity on health-related QOL in this community-based sample were significant but smaller than in a clinical sample using the same measure.
Author Affiliations: Centre for Community Child Health, Royal Children’s Hospital and Murdoch Childrens Research Institute, Melbourne, Australia (Drs Williams, Wake, Maher, and Waters and Ms Hesketh); Department of Paediatrics, University of Melbourne, Melbourne, Australia (Drs Wake and Waters); and School of Health and Social Development, Deakin University, Melbourne, Australia (Drs Maher and Waters).
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