The current study investigated the association between body mass index (BMI) and health-related quality of life (HRQoL) among a large and non-clinical sample of adolescents, and tested the possible moderating effect of perceived teacher and classmate support on this association.
French-speaking Belgian adolescents (n = 11,342) self-reported height and weight, HRQoL (KIDSCREEN-10), as well as their perception of teacher and classmate relationships. Adjusting for sociodemographics, linear regression analyses with HRQoL as the outcome variable were performed for boys and girls separately. Interactions between BMI and teacher support, and between BMI and classmate support were included to examine the effect of this support on the association between BMI and HRQoL.
Obesity was associated with lower HRQoL for boys (β = − 2.14, p = 0.002) and for girls (β = − 2.96, p = 0.001), while only overweight girls showed a significant impaired HRQoL compared with normal-weight ones (β = − 0.94, p = 0.01). In both sexes, lower perceived teacher and classmate support was associated with lower HRQoL. Interactions between BMI and perceived teacher relationships, and between BMI and perceived classmate relationships, were not significant for boys as for girls.
Perceived school-related social support constitutes an important dimension of adolescent well-being, suggesting the relevance of considering it for promoting greater HRQoL in overweight and obese youth. Future studies are needed to confirm the absence of moderating effect of this support and explore its effect on other weight-related factors, like body image, weight misperception and bullying, associated with decreased HRQoL in adolescents.
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Body mass index
Family Affluence Scale
Health Behaviour in School-aged Children
Health-related quality of life
International Obesity Task Force
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The authors would like to thank the schools and students for their participation in the French-speaking Belgian HBSC survey. They also thank the HBSC international coordination centre (University of St Andrews, United Kingdom) and the HBSC data management centre (University of Bergen, Norway) for their scientific support, Patrick De Smet (SIPES, Université libre de Bruxelles, Belgium) for his collaboration in data cleaning and management, Michèle Dramaix (Université libre de Bruxelles, Belgium) for her help in statistical analyses, as well as two anonymous reviewers for their relevant comments.
This work was funded by the Wallonia-Brussels Federation, the Birth and Children Office (ONE), the Walloon Region and the French Community Commission. Researchers performed the study (study design, data collection, analyses, interpretation and writing) independently of the funding bodies.
Conflict of interest
The authors declare that they do not have conflict of interest.
The study was approved by the regional education boards of the four different school networks in the Wallonia-Brussels Federation (i.e. Conseil de l’Enseignement des Communes et des Provinces, Direction Générale de l’Enseignement obligatoire de la Fédération Wallonie-Bruxelles, Conseil des Pouvoirs organisateurs de l’Enseignement officiel neutre subventionné, Secrétariat Général de l’Enseignement Catholique).
Given the nature of the survey, informed consent was not considered as necessary by the education authority of school networks in the Wallonia-Brussels Federation.
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Lebacq, T., Dujeu, M., Méroc, E. et al. Perceived social support from teachers and classmates does not moderate the inverse association between body mass index and health-related quality of life in adolescents. Qual Life Res 28, 895–905 (2019). https://doi.org/10.1007/s11136-018-2079-x