Subjective evaluation of psychosocial well-being in children and youths with overweight or obesity: the impact of multidisciplinary obesity treatment

One in 7 US children and adolescents is obese, yet little is known about their health-related quality of life (QOL). To examine the health-related QOL of obese children and adolescents compared with children and adolescents who are healthy or those diagnosed as having cancer. Cross-sectional study of 106 children and adolescents (57 males) between the ages of 5 and 18 years (mean [SD], 12.1 [3] years), who had been referred to an academic children's hospital for evaluation of obesity between January and June 2002. Children and adolescents had a mean (SD) body mass index (BMI) of 34.7 (9.3) and BMI z score of 2.6 (0.5). Child self-report and parent proxy report using a pediatric QOL inventory generic core scale (range, 0-100). The inventory was administered by an interviewer for children aged 5 through 7 years. Scores were compared with previously published scores for healthy children and adolescents and children and adolescents diagnosed as having cancer. Compared with healthy children and adolescents, obese children and adolescents reported significantly (P<.001) lower health-related QOL in all domains (mean [SD] total score, 67 [16.3] for obese children and adolescents; 83 [14.8] for healthy children and adolescents). Obese children and adolescents were more likely to have impaired health-related QOL than healthy children and adolescents (odds ratio [OR], 5.5; 95% confidence interval [CI], 3.4-8.7) and were similar to children and adolescents diagnosed as having cancer (OR, 1.3; 95% CI, 0.8-2.3). Children and adolescents with obstructive sleep apnea reported a significantly lower health-related QOL total score (mean [SD], 53.8 [13.3]) than obese children and adolescents without obstructive sleep apnea (mean [SD], 67.9 [16.2]). For parent proxy report, the child or adolescent's BMI z score was significantly inversely correlated with total score (r = -0.246; P =.01), physical functioning (r = -0.263; P<.01), social functioning (r = -0.347; P<.001), and psychosocial functioning (r = -0.209; P =.03). Severely obese children and adolescents have lower health-related QOL than children and adolescents who are healthy and 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.

To generate body mass index (weight/height(2) (kg/m(2)), BMI) reference values for 0 to 45-y-old Danes and compare these with published European reference values. A national sample used to generate the current Danish height and weight reference (29 106 measurements made 1965-1977; age 0-21 y; sample I), and four samples from Copenhagen (3391 measurements made 1981-1985; age 7-45 y; samples II-III and 2608 measurements made 1991-1994; age 6-45 y; samples IV-V). Using the LMS method, Danish BMI reference values by age and sex were constructed from samples I and II. These were compared with BMI reference values from Sweden (age 6-16 (girls) or 6-19 y (boys)), Germany (6-19 y), UK (0-23 y), and France (0-87 y). Two recently examined but smaller Danish cohorts (samples IV and V) were compared with the reference values to assess the secular trend in BMI. Overall, Danish BMI reference values (samples I and II) fitted best with French reference values and were systematically below UK, Swedish and German reference values. However, the BMI centiles of young adult Danish women were above French reference values and the BMI of Danes was substantially below French and UK reference values during the first months of life. The mean BMI Z-score of the recently examined samples was 0.24 (sample IV, P=0.0001) and 0.15 (sample V, P=0.0001) based on the French reference values and 0.19 (sample IV, P=0.0007) and 0.01 (sample V, P=0.49) based on the Danish reference values. For clinical purposes, we recommend comparing the BMI of Danish children and adolescents with the present Danish reference values and the new IOTF cut-off values and comparing the BMI of Danish adults with the WHO cut-off values. For research purposes, cut-off values and national or internationally used BMI reference values may be used, depending on the research questions.

Research suggests that overweight and obese youths are stigmatized in contemporary society, and are more likely than normal-weight youths to become the victims of bullying. In the current study, meta-analyses were performed to analyze to what extent overweight and obese youths are more likely than normal-weight youths to be the victims of bullying. The databases Psychinfo, ERIC and Medline were searched for relevant articles. Retrieved articles were scanned to find further articles. Language was not used as an exclusion criterion. A total of 14 articles (N=55 231) were included in a meta-analysis on bullying and overweight youths, and a total of 16 articles (N=58 520) were included in a meta-analysis on bullying and obese youths. The results suggested that both overweight and obese youths were more likely to be victims of bullying. The results were not moderated by gender, overweight and obese boys and girls were equally likely to be victimized. Results remained significant after adjustment for publication bias. Both overweight and obesity are risk factors for being a victim of bullying.