Association of Weight Status and Quality of Life Through Childhood and Adolescence: Australian Longitudinal Cohort Analysis

OBJECTIVE: This study examined the relationship between health-related quality of life (HRQoL) and weight status across the pediatric life course. METHODS: We analyzed data from a cohort of 9745 children from the Longitudinal Study of Australian Children, with follow-up over 14 years. HRQoL was measured with the proxy parent-reported Pediatric Quality of Life Inventory (PedsQL). Healthy weight, overweight, obesity, and severe obesity were defined using World Health Organization standards. We investigated the association of child HRQoL and weight status during early childhood (2-5 years), middle childhood (6-11 years), and adolescence (12-17 years), after controlling for continuous age, sex, and socioeconomic position. RESULTS: The negative association between HRQoL and weight status strengthened with increasing age group and higher weight status. Compared to healthy weight, mean (95% CI) differences in total PedsQL score for obesity were -0.9 (-1.7 to -0.2) in early childhood, -3.6 (-4.4 to -2.9) in middle childhood, and -5.5 (-6.4 to -4.6) in adolescence. Weight-associated loss of HRQoL was greatest for adolescents with severe obesity (BMI-z ≥ 3) at -10.5 points (95% CI: -12.9 to -8.1) lower than those in healthy weight. CONCLUSIONS: The study highlights the important contribution of weight status to HRQoL during the child and adolescent life course.