Impact of Psychosocial Factors on Quality of Life in Overweight Youth

Abstract

Objective: The psychosocial functioning of overweight youth is a growing concern. Research has shown that overweight children report lower quality of life (QOL) than their non-overweight peers. This study sought to extend the literature by examining the association between peer victimization, child depressive symptoms, parent distress, and health-related QOL in overweight youth. Mediator models are used to assess the effect of child depressive symptoms on the relationship between psychosocial variables and QOL. Research Methods and Procedures:The sample consisted of 96 overweight and at-risk-for-overweight children (mean age ϭ 12.8 years) and their parents who were recruited from a Pediatric Endocrinology Obesity Clinic. Parents completed a demographic questionnaire, the Pediatric Quality of Life Inventory-parent-proxy version, and the Brief Symptom Inventory. Children completed the Children's Depression Inventory-Short Form, the Schwartz Peer Victimization Scale, and the Pediatric Quality of Life Inventory. Results: Increased parent distress, child depressive symptoms, and peer victimization were associated with lower QOL by both parent-proxy and self-report. Child depressive symptoms mediated the relationship between psychosocial variables (parent distress and peer victimization) for selfreported QOL but not for parent-proxy-reported QOL. Discussion: This study documented the important impact of peer victimization and parental distress on the QOL of overweight children. Expanding our understanding of how overweight children experience and interact with their environment is critical. Further research is needed to examine the mechanisms by which parent distress and peer victimization impact the development of depressive symptoms in overweight children, including coping and support strategies that may buffer these children against the development of depressive symptoms and ultimately lower QOL.

Health-related quality of life in obese children and adolescents

“…However, Bland-Altman plots showed a systematic bias Health-related quality of life in obese children and adolescents MD Tsiros et al between parent-and pediatric-reported scores ( Figure 4, r ¼ À0.58, P ¼ 0.015, n ¼ 12), with parents rating HRQOL lower than youths when scores were low (o75-85), and higher when scores were high (485). Similarly, many pediatric obesity studies find parent proxy reports of HRQOL to be lower than pediatric reports, 6,11,12,24,26,[28][29][30]35 with the exception of one population-based study, 6 which found less agreement between parent proxy and child-reported HRQOL in a 12-year-old age group compared with younger children. The pooled analyses conducted in this review showed that pediatric self-ratings became progressively more positive than parent ratings with increasing age (Figure 4, r ¼ À0.54, P ¼ 0.03, n ¼ 12).…”

“…In contrast, three smaller cross-sectional studies from the United States of America did not find a significant inverse relationship between BMI (as a continuous predictor) and overall HRQOL. 13,28,29 Physical functioning. When examining subsets of HRQOL, 12 studies report significantly lower physical functioning in obese compared with lean children 6,11,12,15,17,23,24,27,28,[30][31][32] ( Table 1).…”

“…Numerous studies report that females have lower HRQOL scores in one or more domains 15,[17][18][19]26,28,31,34 which is most often physical functioning. 17,18,26,28,29,34 In contrast, Wake et al 20 report that overweight/obese boys are more likely to score below the 15th percentile for seven of the 12 Child Health Questionnaire subscales, compared with only two scales for girls. In contrast, other studies have found no significant gender-effects on HRQOL.…”

“…Social and emotional support may have a positive link to HRQOL. 26,28,34 Teasing appears to have a negative relationship with HRQOL, 13,29 with some evidence that selfesteem may mediate the effects of teasing. 13 Single-parent families may also have a negative association with pediatric HRQOL, 14,17 as may lower maternal education 6,14 and parental income.…”

“…13 Single-parent families may also have a negative association with pediatric HRQOL, 14,17 as may lower maternal education 6,14 and parental income. 29 …”