Abstract
BackgroundHealth-related quality of life (HRQoL) was found to improve in participants of weight management interventions. However, information on moderately overweight youth as well as on maintaining HRQoL improvements following treatment is sparse. We studied the HRQoL of 74 overweight, but not obese participants (32.4% male, mean age = 11.61 ± 1.70 SD) of a comprehensive and effective six-month outpatient training at four time-points up to 12 months after end of treatment.MethodsHRQoL was measured by self-report and proxy-report versions of the generic German KINDL-R, including six sub domains, and an obesity-specific additional module. Changes in original and z-standardized scores were analyzed by (2×4) doubly multivariate analysis of variance. This was done separately for self- and proxy-reported HRQoL, taking into account further socio-demographic background variables and social desirability. Additionally, correlations between changes in HRQoL scores and changes in zBMI were examined.ResultsThere were significant multivariate time effects for self-reported and proxy-reported HRQoL and a significant time-gender interaction in self-reports revealed (p < .05). Improvements in weight-specific HRQoL were evident during treatment (partial η2 = 0.14-0.19). Generic HRQoL further increased after end of treatment. The largest effects were found on the dimension self-esteem (partial η2 = 0.08-0.09 for proxy- and self-reported z-scores, respectively). Correlations with changes in weight were gender-specific, and weight reduction was only associated with HRQoL improvements in girls.ConclusionsPositive effects of outpatient training on generic and weight-specific HRQoL of moderately overweight (not obese) children and adolescents could be demonstrated. Improvements in HRQoL were not consistently bound to weight reduction. While changes in weight-specific HRQoL were more immediate, generic HRQoL further increased after treatment ended. An extended follow-up may therefore be needed to scrutinize HRQoL improvements due to weight management.Trial registrationclinicaltrials.gov NCT00422916
Highlights
Health-related quality of life (HRQoL) was found to improve in participants of weight management interventions
Research shows that in overweight or obese youth weight-specific as well as generic HRQoL is likely to be impaired [7,10,11,12], even when no objective disease markers can be observed [13]. This is to be expected in only modestly overweight children and adolescents, since manifest symptoms are rather unlikely at this age, but decreased self-esteem or psychological impacts may result from a negative body image and stigmatization of overweight youngsters [7,13,14]
Improvements in HRQoL were most notable one year after end of treatment in generic HRQoL and near-term rather in weight-specific HRQoL. These HRQoL improvements were hardly related to weight reduction in the entire sample, but associations were visible in girls
Summary
Health-related quality of life (HRQoL) was found to improve in participants of weight management interventions. Research shows that in overweight or obese youth weight-specific as well as generic HRQoL is likely to be impaired [7,10,11,12], even when no objective disease markers can be observed [13]. This is to be expected in only modestly overweight children and adolescents, since manifest symptoms are rather unlikely at this age, but decreased self-esteem or psychological impacts may result from a negative body image and stigmatization of overweight youngsters [7,13,14]. The proportion of missing values was highest for ‘school’ reported by parents at follow-up 1 and 2 (10.8% each)
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