Impact of Weight on Health-Related Quality of Life in Adolescents With Autoimmune Rheumatic Conditions

BACKGROUND/OBJECTIVE: To evaluate the impact of weight on health-related quality of life (HRQOL) in adolescents with rheumatic conditions using the Impact of Weight on Quality of Life (IWQOL)-Kids scale and explore associations with demographic and anthropometric factors. METHODS: This cross-sectional study recruited adolescents aged 11 to 19 years with rheumatic conditions and their caregivers over a 12-week period during routine pediatric rheumatology visits at a Southeastern US children's hospital. Participants completed the IWQOL-Kids and parent-proxy scales, which assessed 4 subdomains (physical comfort, body esteem, social life, family relations) and a total score. Demographic and clinical data were extracted from electronic medical records. Welch ANOVA tested associations between IWQOL scores and age, sex, and weight classification. RESULTS: Fifty-five caregiver-adolescent dyads participated (enrollment rate: ~92%). Approximately half of adolescents were overweight or obese. Mean adolescent IWQOL total score was 89±13.4, with subdomain scores highest for family relations (96.1±8.5) and lowest for body esteem (81.1±21.2). Adolescents with systemic lupus erythematosus (SLE) reported lower body esteem and physical comfort scores compared with peers. Caregivers had slightly higher total scores (92.8 vs. 89.6), although differences were not statistically significant. Welch ANOVA revealed no significant association between adolescent IWQOL scores and age, sex, or weight classification; however, caregiver scores differed significantly by adolescent weight classification (P=0.002). Over half of participants expressed no desire for weight-based interventions. CONCLUSIONS: Weight negatively impacts body esteem in adolescents with rheumatic conditions, particularly those with SLE. Findings underscore the need for targeted interventions addressing weight-related HRQOL in this population.