Background While childhood obesity is rising rapidly in South Asia, there is limited research on quality of life (QoL) of children with overweight and obesity from the region. This study assessed physical and psychosocial QoL in Sri Lankan children attending a specialized obesity clinic, from both children’s and parents’ perspective, and modifiable social factors affecting QoL. Methods We performed cross-cultural translation of the Pediatric Quality of Life Inventory (PedsQL™) 4.0 (Child-Self Report and Parent-Proxy forms), and assessed self-reported and parental-perception of physical and psychosocial QoL in 8–12 year-olds with overweight and obesity (n=110), referred for obesity management at a tertiary-care children’s hospital in Sri-Lanka. Body mass index (BMI) and pre-selected social factors affecting QoL were also assessed. Data were analyzed by non-parametric tests (Mann-Whitney U test, Wilcoxon test and Spearman correlation). Results The median physical QoL was lower than psychosocial QoL (78.1vs81.7, p=0.032) and physical QoL was inversely correlated with BMI. Parental-perception of children’s physical and psychosocial QoL correlated with child-reported QoL, but was lower. Being bullied (p=0.001) and not getting regular exercise (p=0.031) were associated with lower psychosocial QoL. Both physical and psychosocial QoL were lower in children having difficulties in finding suitable clothes (p< 0.001). Conclusions Children with overweight and obesity from Sri Lanka appeared to have greater impairment of physical QoL than psychosocial QoL. Higher BMI, bullying, lack of regular exercise and lack of suitable clothing, negatively affected QoL. Potential strategies to improve QoL include promoting regular exercise, addressing bullying and promoting availability of children’s clothes in larger sizes to fit children with overweight and obesity.

BackgroundData on quality of life (QoL) of children in South Asia affected by overweight and obesity is limited. This study assessed QoL in Sri Lankan children with overweight and obesity from children’s and parents’ perspective and modifiable social factors potentially affecting QoL of these children.Methods Self-reported QoL and parental-perception of QoL were assessed in 8-12 year-old children with overweight and obesity (n=110), referred for obesity management at a tertiary-care children’s hospital in Sri-Lanka, using linguistically validated Pediatric Quality of Life inventory (PedsQLTM) 4.0 (Child-Self Report and Parent-Proxy forms). Social factors affecting QoL were also collected. Data was analyzed by non-parametric tests.ResultsThe median overall QoL was 80.4 (Inter Quartile Range [IQR] 69.6, 89.5). Physical QoL was lower than psychosocial QoL (78.1vs81.7, p=0.032). Parental-perception of children’s QoL correlated with child-reported QoL, but was lower for overall, physical and psychosocial QoL. Obese children had lower overall QoL, and lower QoL in physical and social functioning, compared to overweight children, and body mass index (BMI) was inversely correlated with physical and social functioning. Social factors associated with lower QOL were: being bullied (p=0.005), not getting regular exercise (p=0.017) and having difficulties in finding suitable clothes (p< 0.001).ConclusionsChildren with overweight and obesity from Sri Lanka appeared to have lower QoL than healthy children, with greater impairment of physical QoL than psychosocial QoL. Lower parental-perception of QoL, higher BMI, bullying, lack of regular exercise and lack of suitable clothing, were associated with lower QoL. Potential strategies to improve QoL include promoting regular exercise and a range of children’s clothes to fit larger children, and prevention of bullying.