title: Is obesity associated with reduced health-related quality of life in Latino, Black and White children in the community?
abstract: OBJECTIVE
  Few studies have examined the impact of obesity on health-related quality of life (HRQOL) in non-clinical community samples of children, and methodological limitations have hindered drawing firm conclusions, especially whether the impact is similar across racial/ethnic groups. The present aims were to examine at what levels of non-normal weight, school-aged children experience lower HRQOL and whether this differs among racial/ethnic groups, when controlling for socioeconomic status (SES) differences.
  
  
  METHODS
  Cross-sectional community cohort survey.
  
  
  METHODS
  Data are from the Healthy Passages, reporting on 4824 Latino, black and white 5th graders in a population-based survey conducted in three United States metropolitan areas. Children's weight status was classified from measured weight and height into underweight (1%), normal weight (52%), overweight (19%), obese (13%) and extremely obese (14%). Children reported their own HRQOL using the Pediatric Quality of Life Inventory and additional scales addressing global self-worth, physical appearance and body satisfaction. Parents reported children's overall health status.
  
  
  RESULTS
  Each increment in higher non-healthy weight class-overweight to obese to extremely obese-was associated with significantly lower scores in more domains of psychosocial HRQOL compared with that in normal weight. However, only extremely obese children reported significantly lower physical HRQOL. Differences among weight classes remained when adjusting for SES and were independent of race/ethnicity. Underweight children generally reported HRQOL that was not significantly different from normal weight children.
  
  
  CONCLUSIONS
  Overweight, obese and extremely obese 5th graders on average experience worse HRQOL than normal weight children, especially in psychosocial domains including self-worth and peer relationships, regardless of race/ethnicity. If messages can be conveyed in a sensitive and supportive manner, the desire to improve HRQOL could provide additional motivation for children and their parents in addressing unhealthy weight.
authors.affiliation: Department of Psychological Sciences, Center of Excellence on Health Disparities, Health Sciences Research Institute, University of California, Merced, Merced, CA 95343, USA. jwallander@ucmerced.edu
authors.forename: J L
authors.initials: JL
authors.lastname: Wallander
authors.forename: S
authors.initials: S
authors.lastname: Kerbawy
authors.forename: S
authors.initials: S
authors.lastname: Toomey
authors.forename: R
authors.initials: R
authors.lastname: Lowry
authors.forename: M N
authors.initials: MN
authors.lastname: Elliott
authors.forename: S L
authors.initials: SL
authors.lastname: Escobar-Chaves
authors.forename: L
authors.initials: L
authors.lastname: Franzini
authors.forename: M A
authors.initials: MA
authors.lastname: Schuster
mesh_terms: D001741:Black or African American / Q000706:statistics & numerical data*; D001828:Body Image / Q000523:psychology*; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D010290:Parents / Q000523:psychology*; D063766:Pediatric Obesity / Q000453:epidemiology / Q000208:ethnology / Q000523:psychology*; D010379:Peer Group; D015995:Prevalence; D011788:Quality of Life; D012572:School Health Services; D012574:Schools; D012649:Self Concept; D012923:Social Class; D012931:Social Environment; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data*