Abstract
Among the various factors that could influence health-related quality of life (HRQoL) in adolescence, body mass index (BMI) seems to play a key role as a main anthropometric parameter. The aim of this cross-sectional study was to determine, in a sample of Italian adolescents, whether HRQoL is associated with the different weight status categories (underweight, normal weight, overweight, obese), according to BMI cut-off points for children, even considering sex differences. Data were collected from 1707 adolescents (n = 828 males) in seven schools. HRQoL was analyzed using the Italian version of KIDSCREEN-52. Males were more overweight and obese than females (13% vs. 10% and 4% vs. 2%, p < 0.05, respectively). In females, BMI categories are associated with physical well-being (p < 0.05), emotion/mood (p < 0.05), self-perception (p < 0.001), financial resources (p < 0.05), and bullying behavior (p < 0.05). In males, weight status is linked to physical well-being dimension (p < 0.001) and perception of self (p < 0.05). Our results may suggest that there is an association between weight status categories and HRQoL, more pronounced in females than in males. Interestingly, the weight status correlated more with the psychological dimension mainly in females, whereas in males, a stronger association between weight and physical status was observed, suggesting that given the complex, multifaceted, and dynamic nature of relationship between health-related quality of life and weight status in adolescents, multiple factors must be considered.
Highlights
Adolescence is a period characterized by important changes in growth and physiological and behavioral development, associated with emotional, social, and cognitive alterations [1]
Among the various factors that could contribute to reduced well-being perception, body weight is considered as a main anthropometric parameter, and both underweight and overweight have an important psychosocial impact [3,4]
The main results of this study can be summarized in the following points: (i) in our female population, physical well-being, mood, and self-perception dimensions correlated with weight status, showing that underweight girls exhibited a higher score in these sub-scales as compared to their overweight and obese counterparts; (ii) in our male cohorts, body mass index (BMI) categories were associated only with physical well-being and self-perception, which were higher in normal weight than obese boys
Summary
Adolescence is a period characterized by important changes in growth and physiological and behavioral development, associated with emotional, social, and cognitive alterations [1]. Many adolescents experience the transition to adulthood by enhancing resilience, while others report a psychosocial vulnerability, which materializes in a compromise in relationships with parents and peers and a decrease in self-esteem, resulting in decreased health-related quality of life (HRQoL) [2]. Among the various factors that could contribute to reduced well-being perception, body weight is considered as a main anthropometric parameter, and both underweight and overweight (up to severe obesity) have an important psychosocial impact [3,4]. This is especially relevant when we consider that obesity and overweight in children and adolescents are recognized as a major public health problem worldwide.
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