Quality of life and BMI changes in youth participating in an integrated pediatric obesity treatment program
Changes in Quality of Life (QOL) measures over time with treatment of obesity have not previously been described for youth. We describe the changes from baseline through two follow up visits in youth QOL (assessed by the Pediatric Quality Life Inventory, PedsQL4.0), teen depression (assessed by the Patient Health Questionnaire, PHQ9A), Body Mass Index (BMI) and BMI z-score. We also report caregiver proxy ratings of youth QOL.
A sample of 267 pairs of youth and caregiver participants were recruited at their first visit to an outpatient weight-treatment clinic that provides care integrated between a physician, dietician, and mental health provider; of the 267, 113 attended a visit two (V2) follow-up appointment, and 48 attended visit three (V3). We investigated multiple factors longitudinally experienced by youth who are overweight and their caregivers across up to three different integrated care visits. We determined relationships at baseline in QOL, PHQ9A, and BMI z-score, as well as changes in variables over time using linear mixed models with time as a covariate.
Overall across three visits the results indicate that youth had slight declines in relative BMI, significant increases in their QOL and improvements in depression.
We encourage clinicians and researchers to track youth longitudinally throughout treatment to investigate not only youth’s BMI changes, but also psychosocial changes including QOL.
- Federal Interagency Forum on Child and Family Statistics: America’s children: Key national indicators of well-being. Washington, DC: U.S. Government Printing Office; 2007.
- Hedley A, Ogden C, Johnson C, Carroll M, Curtin L, Flegal K: Prevalence of overweight and obesity among US children, adolescents and adults, 1999–2002. J Am Med Assoc 2004, 291:2847–2850. CrossRef
- Ogden CL, Carroll MD, Kit BK, Flegal KM: Prevalence of obesity and trends in body mass index among US children and adolescents, 1999–2010. J Am Med Assoc 2012, 307:483–490. CrossRef
- Barlow S, the Expert Committee: Expert committee recommendations regarding the prevention, assessment, and treatment of child and adolescent overweight and obesity: summary Report. Pediatrics 2007, 120:164–192. CrossRef
- Engle G: The need for a new medical model: a challenge for biomedicine. Science 1977, 196:129–136. CrossRef
- Janicke D: Impact of psychosocial factors on quality of life in overweight youth. Obesity 2007, 15:1799–1807. CrossRef
- Ravens-Sieberer U, Redegeld M, Bullinger M: Quality of life after in-patient rehabilitation in children with obesity. Int J Obes Relat Metab Disord 2001, 25:63–65. CrossRef
- Schwimmer J, Burwinkle T, Varni J: Health-related quality of life of severely obese children and adolescents. J Am Med Assoc 1813, 2003:289.
- Swallen K, Reither E, Haas S, Meier A: Overweight, obesity and health-related quality of life among adolescents: the national longitudinal study of adolescent health. Pediatrics 2005, 115:340–347. CrossRef
- Williams J, Wake M, Hesketh K, Maher E, Waters E: Health-related quality of life of overweight and obese children. J Am Med Assoc 2005, 283:70–76. CrossRef
- Zeller M, Roehrig H, Modi A, Daniels S, Inge T: Health-related quality of life and depressive symptoms in adolescents with extreme obesity presenting for bariatric surgery. Pediatrics 2006, 117:1155–1161. CrossRef
- Epstein L, Paluch R, Gordy C, Saelens B, Ernst M: Problem solving in the treatment of childhood obesity. Journal of Counseling and Clinical Psychology 2000, 68:717–721. CrossRef
- Britz B, Siegfried W, Ziegler A, et al.: Rates of psychiatric disorders in a clinical study group of adolescents with extreme obesity and in obese adolescents ascertained via a population based study. Int J Obes 2000, 24:1707–1714. CrossRef
- Patterson JE, Peek CJ, Heinrich RL, Bischoff RJ, Scherger J: Mental health professionals in medical settings: A primer. New York, NY: Norton; 2000.
- Patient Healthcare Questionnaire. PRIME-MD. Pfizer Inc, PHQ-9 Copyright; 2000.
- Chan K, Mangione-Smith R, Burwinkle T, Rosen M, Varni J: The PedsQL reliability and validity of the short-form generic core scales and asthma module. Medical Care 2000, 43:256–265. CrossRef
- Varni J: Measurement model for the pediatric quality of life inventory. Medical Care 1999, 37:126–139. CrossRef
- Varni J: Reliability and validity of the pediatric quality of life inventory version 4.0 generic core scales in healthy and patient populations. Medical Care 2001, 39:800–812. CrossRef
- Varni J: The PedsQL4.0 Generic Core Scales: sensitivity, responsiveness, and impact on clinical decision-making. J Behav Med 2002, 25:175–193. CrossRef
- Varni J: The PedsQL4.0 as a pediatric population health measure: feasibility, reliability, and validity. Ambul Pediatr 2003, 3:329–341. CrossRef
- Richardson L, McCauley E, Grossman D, McCarty C, Richards J, Russo J, Rockhill C: Evaluation of the patient health questionnaire-9 item for detecting major depression among adolescents. Pediatrics 2010, 126:1117–1123. CrossRef
- Spitzer RL, Kroenke K, Williams JB: The patient health questionnaire study group. Validity and utility of a self report version of PRIME-MD: the PHQ primary care study. J Am Med Assoc 1999, 282:1737–1744. CrossRef
- Spritzer RL, Williams JB, Kroenke K, Hornyak R, McMurray J: Validity and utility of the PRIME-MD in assessment of 3,000 obstetric-gynecologic patients: The PRIMEMD patient health questionnaire obstetrics-gynecology study. Am J Obstet Gynecol 2000, 183:759–769. CrossRef
- Cole T, Bellizzi M, Flegal K, Dietz W: Establishing a standard definition for child overweight and obesity worldwide: international survey. Br Med J 2000, 320:1240–1243. CrossRef
- Paluch R, Epstein L, Roemmich J: Comparison of methods to evaluate changes in relative body mass index in pediatric weight control. Am J Hum Biol 2007, 19:487–494. CrossRef
- Centers for Disease Control and Prevention: Clinical growth charts. http://www.cdc.gov/growthcharts/
- Gulati AK, Kaplan DW, Daniels SR: Clinical tracking of severely obese children: a new growth chart. Pediatrics 2012, 130:1136–1140. CrossRef
- Verbeke G, Molenberghs G: Linear Mixed Models for Longitudinal Data. New York, NY: Springer; 2000.
- Pratt KJ, Lamson AL, Swanson MS, Lazorick S, Collier C: The importance of assessing for depression with HRQOL in treatment seeking youth and their caregivers. Qual Life Res 2012, 21:1367–1377. CrossRef
- Yao F, Muller HG, Wang JL: Functional data analysis for sparse longitudinal data. J Am Stat Assoc 2005, 100:577–590. CrossRef
- Skelton JA, Goff DC, Ip E, Beech BM: Attrition in a multidisciplinary pediatric weight management clinic. Childhood Obesity 2011, 7:185–193.
- Skelton JA, Beech BM: Attrition in paediatric weight management: a review of the literature and new directions. Obesity Rev 2011, 12:e273-e281. CrossRef
- Quality of life and BMI changes in youth participating in an integrated pediatric obesity treatment program
- Open Access
- Available under Open Access This content is freely available online to anyone, anywhere at any time.
Health and Quality of Life Outcomes
- Online Date
- July 2013
- Online ISSN
- BioMed Central
- Additional Links
- Pediatric obesity
- Quality of life
- Obesity treatment
- Author Affiliations
- 12. Department of Human Development and Family Science, The Ohio State University, 109C Campbell Hall, 1787 Neil Ave, Columbus, OH, 43210, USA
- 13. Departments of Pediatrics and Public Health, Brody School of Medicine, East Carolina University, Greenville, NC, 27858, USA
- 14. Department of Child Development and Family Relations, College of Human Ecology, East Carolina University, Greenville, NC, 27858, USA
- 15. Department of Biostatistics, College of Allied Health Sciences, East Carolina University, Greenville, NC, 27858, USA