Obese Children, Teens Have Poorer Quality Of Life

Monday April 14, 2003

Obese children and adolescents are more than five times more likely to have a poorer health-related quality of life (QOL) than healthy children. In fact, their risk for a lower QOL is about equal to that of children undergoing chemotherapy for cancer, according to the results of a new study.

Jeffrey Schwimmer, MD, and colleagues from the University of California, San Diego, pointed out that while childhood obesity is a well-known cause of health problems, including long-term problems that might eventually lead to an early death, the most widespread consequences might be psychological and social in nature.

The researchers reported their results in the Journal of the American Medical Association (Vol. 289, No. 14:1813-1819).

Childhood Obesity On The Rise

Childhood obesity is defined as having a BMI (body mass index - a ratio of weight to height) greater than that of 95% of others of the same age and sex.

In the US, childhood obesity has reached epidemic proportions over the past two decades. About 15% of children now meet this definition, more than twice the level in 1980, according to the Centers for Disease Control and Prevention (CDC).

Obesity causes a host of childhood health problems, including diabetes, high cholesterol levels, high blood pressure, and fatty liver disease. What's more, childhood obesity is linked to a number of problems as these children become adults. Obesity in adulthood has been linked to heart disease, as well as several types of cancer, including breast, colon, endometrial, esophageal, and kidney cancer.

But many of the obstacles obese children face may be more of an immediate concern, and extend beyond just the physical aspects of health.

Study: Problems In Obese Children Far-Reaching

To get a better idea of the effect of obesity on children's quality of life, Schwimmer and colleagues studied a group of 106 children and adolescents who were referred to their clinic for treatment of obesity.

Each child or teen filled out a questionnaire that asked about their physical, emotional, social, and school functioning. Parents also were asked to separately complete the questionnaire. The results were quantified as a score between 0 and 100, with higher scores indicating a better quality of life.

These results were compared to those from the same questionnaires given to healthy children, and to children undergoing chemotherapy treatment for cancer -- the group shown to have the lowest quality of life scores among chronic illnesses in previous studies.

The average overall score for obese children was 67, compared to 83 for healthy children. The differences were about the same when individual categories (physical, emotional, etc.) were looked at separately. When the grading was done by the parents, the differences were even more striking. The overall scores for obese and healthy children were 63 and 88, respectively.

Obese children were more than five times more likely to have an "impaired" quality of life when compared to healthy children. No single physical factor seemed to account for the differences, and the results were not affected by age, sex, race, or socioeconomic status.

Obese children were about as likely to have a lower quality of life as children undergoing cancer treatment. This was surprising, noted the researchers, because the obese children weren't being exposed to the intensive medical interventions that children with cancer often go through.

Adults Need To Be Aware Of Quality Of Life Issues In Children

The study authors suggested that better awareness among adults is needed to address these issues. More thorough research is also needed in this area, as quality of life in childhood obesity has not been well studied.

"Obesity is one of the most stigmatizing and least socially acceptable conditions in childhood," the authors concluded. "It is critical for physicians, parents, and teachers to be aware of the risk for impaired QOL in these children and adolescents."

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