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Pediatrics

Weight status and health-related quality of life during childhood and adolescence: effects of age and socioeconomic position

International Journal of Obesity volume 44, pages 637–645 (2020)Cite this article

Subjects

Abstract

Background

Overweight and obesity in children is associated with poor health-related quality of life (HRQoL), but the nuances of this relationship across different age and socio-demographic groups are not well-established. The aim of this study is to examine how the association between weight status and HRQoL changes with age and socioeconomic position (SEP) throughout childhood and adolescence.

Methods

We used data from the Longitudinal Study of Australian Children (LSAC), a cohort study in which children were interviewed biennially from ages 4 to 17 years over seven waves of data. Measurements of HRQoL (using PedsQLTM), body mass index (BMI), and socio-demographic characteristics were collected at each interview. Of the 4983 children recruited into the study, we included data from 4083 children (a total of 24,446 observations). We used generalised estimating equations to assess whether age and SEP modified the association between weight status and HRQoL, after controlling for sex, long-term medical condition, language spoken to child and maternal smoking status.

Results

Age was a significant modifier of the association between weight status and HRQoL, with adjustment for known predictors of HRQoL (P < 0.001). At age 4, children with obesity had, on average, a 0.99 (95% CI 0.02–1.96) point lower PedsQL total score than children at healthy weight. This difference became clinically important by age 9 at 4.50 (95% CI 3.86–5.13) points and increased to 6.69 (95% CI 5.74–7.64) points by age 17. There was no evidence that SEP modified the relationship between weight status and HRQoL (P > 0.05).

Conclusions

Our results demonstrate that the relationship between overweight and obesity status and poor HRQoL is strengthened with increasing age through childhood and adolescence, but is not affected by SEP. Paediatricians, researchers and carers of children with obesity should acknowledge HRQoL outcomes, particularly for older children and adolescents.

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Fig. 1: Association between weight status and HRQoL score.
Fig. 2: HRQoL by socioeconomic position, weight status and age.

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Code availability

The data from LSAC used in this study is available by application to the data custodians: Department of Social Services, Australian Government. The code to analyse these data, based in STATA version 15.0, are available by request to the corresponding author.

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Acknowledgements

We thank the Department of Social Services, Australian Government for providing access to data collected from LSAC. We also thank the funding bodies that support our research.

Funding

AK is supported by the Kassulke Scholarship and the National Health and Medical Research Council (NHMRC) Scholarship (APP1169039) for PhD study. TL is supported by an NHMRC Early Career Fellowship (APP1141392) and a Heart Foundation Postdoctoral Fellowship (award ID 101956). EJT is supported by the NHMRC Centre of Research Excellence in Early prevention of Obesity in Childhood (APP1101675).

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Authors and Affiliations

  1. The University of Sydney, Faculty of Medicine and Health, School of Public Health, Sydney, NSW, 2006, Australia

    Anagha Killedar, Thomas Lung, Armando Teixeira-Pinto, Eng Joo Tan & Alison Hayes

  2. The George Institute for Global Health, University of New South Wales, Sydney, NSW, 2042, Australia

    Thomas Lung

  3. Warwick Medical School, University of Warwick, Coventry, UK

    Stavros Petrou

  4. Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Woodstock Road, Oxford, OX2 6GG, UK

    Stavros Petrou

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  1. Anagha Killedar
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Correspondence to Anagha Killedar.

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Killedar, A., Lung, T., Petrou, S. et al. Weight status and health-related quality of life during childhood and adolescence: effects of age and socioeconomic position. Int J Obes 44, 637–645 (2020). https://doi.org/10.1038/s41366-020-0529-3

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