Abstract
BackgroundWhile childhood obesity is rising rapidly in South Asia, there is limited research on quality of life (QoL) of children with overweight and obesity from the region. This study assessed physical and psychosocial QoL in Sri Lankan children attending a specialized obesity clinic, from both children’s and parents’ perspective, and modifiable social factors affecting QoL.MethodsWe performed cross-cultural translation of the Pediatric Quality of Life Inventory (PedsQL™) 4.0 (Child-Self Report and Parent-Proxy forms), and assessed self-reported and parental-perception of physical and psychosocial QoL in 8–12 year-olds with overweight and obesity (n=110), referred for obesity management at a tertiary-care children’s hospital in Sri-Lanka. Body mass index (BMI) and pre-selected social factors affecting QoL were also assessed. Data were analyzed by non-parametric tests (Mann-Whitney U test, Wilcoxon test and Spearman correlation).ResultsThe median physical QoL was lower than psychosocial QoL (78.1vs81.7, p=0.032) and physical QoL was inversely correlated with BMI. Parental-perception of children’s physical and psychosocial QoL correlated with child-reported QoL, but was lower. Being bullied (p=0.001) and not getting regular exercise (p=0.031) were associated with lower psychosocial QoL. Both physical and psychosocial QoL were lower in children having difficulties in finding suitable clothes (p< 0.001).ConclusionsChildren with overweight and obesity from Sri Lanka appeared to have greater impairment of physical QoL than psychosocial QoL. Higher BMI, bullying, lack of regular exercise and lack of suitable clothing, negatively affected QoL. Potential strategies to improve QoL include promoting regular exercise, addressing bullying and promoting availability of children’s clothes in larger sizes to fit children with overweight and obesity.
Highlights
While childhood obesity is rising rapidly in South Asia, there is limited research on quality of life (QoL) of children with overweight and obesity from the region
The median physical QoL was lower than psychosocial QoL (78.1 vs 81.7, p=0.032)
Further we found a positive association between getting regular exercise and better psychosocial QoL, which corresponds with a previous study reporting lower psychosocial QoL in overweight children who are less physically-active [33]
Summary
While childhood obesity is rising rapidly in South Asia, there is limited research on quality of life (QoL) of children with overweight and obesity from the region. Lifestyle factors and metabolic complications associated with childhood obesity have been studied previously in Sri Lankan children [4,5,6], but there is a paucity of research on impact on their quality of life including physical and psychosocial well-being. QoL is a multidimensional variable including physical, psychological and social aspects Both generic and diseasespecific tools are available to assess health-related QoL [8]. Special generic tools have been developed to measure QoL of children such as the Pediatric Quality of Life Inventory (PedsQL) and Child Health Questionnaire (CHQ), which assess children’s quality of life from their own as well as their parents’ perspective [8, 10]
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