Original Article
Health-Related Quality of Life in Overweight and Nonoverweight Black and White Adolescents

https://doi.org/10.1016/j.jpeds.2005.05.039Get rights and content

Objectives

To assess the impact of obesity on quality of life (QOL) in black and white adolescents.

Study design

One hundred ten overweight (body mass index [BMI], 41.7 ± 8.9 kg/m2) and 34 nonoverweight adolescents (BMI, 20.6 ± 2.9 kg/m2) and their parents completed measures of QOL.

Results

Overweight was associated with poorer adolescent-reported QOL and parent reports of their children's QOL. Examining groups by weight status and race, overweight whites reported the greatest impairment on Social/Interpersonal, Self-Esteem, and Physical Appearance QOL (all P < .01), whereas parents of overweight blacks reported the poorest General Health Perceptions scores regarding their children. Interactions between BMI z-score and race were detected for Social/Interpersonal, Self-esteem, Daily Living, Self-Efficacy, Self-regard, and Physical Appearance QOL (all P < .05): Higher BMI in whites was associated with greater impairments in QOL than in blacks. Parents reported similar relations for their children.

Conclusions

According to adolescent and parent reports, overweight is associated with poorer QOL in adolescence, regardless of race; however, compared with overweight white adolescents, blacks report less impairment in QOL. Future research is required to determine whether differences in QOL are predictive of treatment success.

Section snippets

Subjects

Extremely overweight (body mass index [BMI], 41.7 ± 8.9 kg/m2; mean ± SD) adolescents (62 black and 48 white) were assessed before entry into an obesity treatment program. Nonoverweight (BMI, 20.1 ± 2.9 kg/m2) adolescents (n = 34) were assessed before they participated in an exercise physiology study for healthy volunteer adolescents. Subjects were recruited through posted flyers and, in the case of overweight volunteers, newspaper advertisements and letters to local physicians. Inclusion and

Subject Characteristics

Overweight subjects were from families with significantly lower Hollingshead socioeconomic class scores (SES) compared with the nonoverweight subjects (Table I). Therefore SES was included as a potential covariate for all analyses.

Among overweight subjects were adolescents with hyperinsulinemia (black: n = 44, 71%; white: n = 37, 77%), hyperlipidemia (black: n = 31, 50%; white: n = 18, 38%), hypertension (black: n = 5, 8.1%; white: n = 7, 15%), type 2 diabetes (black: n = 3, 5%; white: n = 2, 4%), and hepatic

Discussion

We found overweight was a potent indicator of poorer weight and health-related QOL for white and black adolescents. Based on their IWQOL responses, overweight teens appeared to struggle with levels of distress regarding Social/Interpersonal, Self-esteem and Daily Living QOL similar to those reported by obese adults seeking weight loss treatment. However, overweight had a greater impact among heavier whites, compared with blacks, with regard to social and psychologic well-being, aspects of daily

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    • Cited by (0)

    Ms. Fallon and Dr. Tanofsky-Kraff contributed equally to this work.

    Dr Yanovski is a Commissioned Officer in the United States Public Health Service, DHHS.

    This research was supported by the National Institute of Child Health and Human Development (Z01-HD-00641) and the National Center on Minority Health and Health Disparities, NIH, DHHS.

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