Understanding adolescent health-related quality of life (HRQoL) through the lens of weight pressure and calorie-counting apps: insights in the digital era—a cross sectional study

Abstract Aim To examine the relationship between health-related quality of life (HRQoL, reflecting physical, mental, and social well-being), weight pressure, and calorie-counting apps. Subject and methods This cross-sectional study was performed from November 2021 to February 2022 as part of the GeWIT Project and was conducted among 10th-grade students in Witten, Germany. Self-reported HRQoL from the KIDSCREEN-10 questionnaire, which covered physical, psychological, and social subscales, was used to measure overall HRQoL. Scores were classified as low or high based on the European norm mean and standard deviation, with higher scores indicating better HRQoL. Logistic regression was performed with stratification based on calorie-counting apps between HRQoL and weight pressure adjusted for gender, age, school type, subjective social status, migration background, body mass index (BMI), and physical activity. Results Of 649 participants, 644 were included in the analysis (98.3% response rate). There were nearly equal numbers of girls (47.7%) and boys (47.0%) and a small number of diverse participants (5.3%), and most were 15 years old (59.2%). Nearly half had low HRQoL (46.0%), 62.0% reported moderate to extreme weight pressure, and 36.0% used calorie-counting apps. Moderate to extreme weight pressure was strongly associated with low HRQoL (aOR = 3.03, 95% CI 2.05–4.50), with an even stronger association among calorie-counting app users (aOR = 4.76, 95% CI 2.06–10.97). Conclusion Associations were found between low HRQoL and weight pressure, and the correlation was exacerbated by the use of calorie-counting apps. Thus the use of calorie-counting apps, particularly among teenagers experiencing weight pressure, should be further evaluated. Public health measures to address body image disturbance could be helpful among youth.