Quality of life among obese and non-obese early adolescents

Abstract Background Obesity in adolescents adversely affects both their psychological as well as their physical health. Objective To compare the quality of life between obese and nonobese early adolescents, using the PedsQL inventory. Methods A cross-sectional study was carried out on early adolescents aged 10-12 years among several elementary schools in Denpasar, Bali. Body mass index (BMI) percentiles for age and sex were categorized as obese (BMI ?95th percentile) and non-obese (BMI <95th percentile). Data on quality of life were collected using PedsQL Generic Core Scales version 4.0 inventory, filled by the children and their parents separately. Results Total PedsQL score in obese and non-obese group were significantly difference in both reports [child report: mean difference of 9.59 (95%CI 7.14 to 12.05; P<0.05) and parentproxy report: mean difference at 8.95(95%CI6.64 to 11.26; P<0.05)]. After classifying subjects into impaired and not impaired quality of life based on a total score cut-off <78 as well as other cut-off points for each domain, the individual domains of physical, social, and school function were also significantly associated with obesity (child report: P=0.02, P< 0.001, P=0.018, respectively, and parent-proxy report:P=0.007, P<0.001, P<0.001, respectively). However, emotional function was not significantly associated with obesity (P>0.05). After adjusting for age, gender, and parental education, obesity was significantly associated with PedsQL scores in the child report (OR 7.25; 95%CI 2.94 to 17.89; P<0.05) and the parent-proxy report (OR 10.87; 95%CI 3.83 to 30.84; P<0.05). Conclusion Obese early adolescents report significantly poorer quality of life with regards to the physical, social, school function domains and total quality of life than those who are classified into non-obese. [Paediatr Indones. 2017;57:216-22 ; doi: http:// dx.doi.org/10.14238/pi57.4.2017.216-22 ]. Keywords: obese; early adolescent; health-related quality of life; PedsQL From the Department of Child Health, Udayana UniversityMedical School/Sanglah Hospital, Denpasar, Bali, Indonesia. Reprint requests to: Putu Vivi Paryati, Department of Child Health, Udayana University Medical School/Sanglah Hospital, Jalan P. Nias, Denpasar 80114, Bali, Indonesia. Telp. +62-361-244038; Fax: +62-361- 244038;Email: putuvivi@gmail.com. Obesity is a serious public health problem in children and adolescents, and is an early risk factor for many adult morbidity and mortality issues. Overweight and obesity are reported to be associated with an increased risk of hypertension, coronary arterio sclerosis, elevated cholesterol, type 2 diabetes, joint problems, stroke, and certain types of cancers. Health consequences of overweight and obesity are not just limited to physical health; overweight and obese children experience problems including body dissatisfaction, negative body image, low self-esteem, anxiety, depression, stigmatization, and social marginalization, all of which can influence their psychological and social health.1,2 The prevalence of overweight and obesity in children and adolescents has risen in both developed and developing countries in recent decades. Riset Kesehatan Dasar (Riskesdas) in 2013, reported that Putu Vivi Paryati et al: Quality of life among obese and non-obese early adolescents Paediatr Indones, Vol. 57, No. 4, July 2017 • 217 the prevalences of obesity in children under five in 2007, 2010, and 2013, was 12.2%, 14.0% and 11.9%, respectively. In addition,the obesity prevalences in children aged 5-12, 13-15, and 16-18 years was 8.8%, 2.5%, and 1.6%, respectively.3 In the city of Denpasar, the prevalence of obesity in elementary school children was 15%.4 Quality of life of obese children and adolescents should receive more attention because of the impact of obesity itself. The WHO define quality of life as ‘‘the individual’s perception of their position in life in the context of the culture and value systems in which they live, and in relation to their goals, expectations, standards, and concerns,” in other words, a global view that considers many dimensions of human beings. Measures of quality of life assess important aspects of health, included the effect of a health condition on the child’s daily activities, physical symptoms, social interactions, and emotional wellbeing.5 Studies have shown a consistent relationship between abnormal weight and the perception of low quality of life in children and adolescents.3 Khodaverdi et al. in 2011 found that the quality of life of obese children in physical function, social function, and school function were significantly lower than children with normal weight.6 Furthermore, in early adolescent (10-14 years) some changes can occur, such as anxiety of body appearance, hormonal changes affect the emotion, and navigating friendships and groups of friends. Adjustment to their environment may pose problems for early adolescents, as they leave childhood and enter a new phase that full of challenges. Such adjustments can certainly influence their quality of life.7 Information about obesity and quality of life in early adolescents in Denpasar, Bali, was limited. The aim of this study was to evaluate the association between health-related quality of life and weight status in a community sample of school children aged 10–12 years in Denpasar, Bali.