Relationship between overweight and health-related quality of life in secondary school children in Fiji: results from a cross-sectional population-based study.
OBJECTIVE
To investigate the relationship between excess weight (overweight and obesity) and health-related quality of life (HRQoL) in a sample of secondary school children in Fiji, by gender, age and ethnicity.


METHODS
The study comprised 8947 children from forms 3-6 (age 12-18 years) in 18 secondary schools on Viti Levu, the main island of Fiji. Body mass index (BMI) was calculated from measured height and weight, and weight status was classified according to the International Obesity Task Force recommendations. HRQoL was measured by the self-report version of the Pediatric Quality of Life Inventory 4.0.


RESULTS
HRQoL was similar in children with obesity and normal weight. Generally, this was replicated when analyzed separately by gender and ethnicity, but age stratification revealed disparities. In 12-14-year-old children, obesity was associated with better HRQoL, owing to better social and school functioning and well-being, and in 15-18-year olds with poorer HRQoL, owing to worse physical, emotional and social functioning and well-being (Cohen's d 0.2-0.3). Children with a BMI in the overweight range also reported a slightly lower HRQoL than children with a BMI in the normal weight range, but although statistically significant, the size of this difference was trivial (Cohen's d <0.2).


CONCLUSIONS
The results suggest that, overall there is no meaningful negative association between excess weight and HRQoL in secondary school children in Fiji. This is in contradiction to the negative relationship between excess weight and HRQoL shown in studies from other countries and cultures. The assumption that a large body size is associated with a lower quality of life cannot be held universally. Although a generally low HRQoL among children in Fiji may be masking or overriding the potential effect of excess weight on HRQoL, socio-economic and/or socio-cultural factors, may help to explain these relationships.
1] Deakin Health Economics, Faculty of Health, Deakin University, Melbourne, Victoria, Australia [2] WHO Collaborating Centre for Obesity Prevention, Faculty of Health, Deakin University, Melbourne, Victoria, Australia [3] Child and Adolescent Psychiatry, Clinical Sciences, Umeå University, Umeå, Sweden.
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Petersen
1] Deakin Health Economics, Faculty of Health, Deakin University, Melbourne, Victoria, Australia [2] WHO Collaborating Centre for Obesity Prevention, Faculty of Health, Deakin University, Melbourne, Victoria, Australia.
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Moodie
WHO Collaborating Centre for Obesity Prevention, Faculty of Health, Deakin University, Melbourne, Victoria, Australia.
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Mavoa
Pacific Research Centre for the Prevention of Obesity and Non-Communicable Diseases (C-POND), Fiji School of Medicine, College of Medicine, Nursing and Health Sciences, Fiji National University, Suva, Fiji.
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Waqa
Pacific Research Centre for the Prevention of Obesity and Non-Communicable Diseases (C-POND), Fiji School of Medicine, College of Medicine, Nursing and Health Sciences, Fiji National University, Suva, Fiji.
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Goundar
1] WHO Collaborating Centre for Obesity Prevention, Faculty of Health, Deakin University, Melbourne, Victoria, Australia [2] School of Population Health, University of Auckland, Auckland, New Zealand.
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Swinburn
D000293:Adolescent; D000294:Adolescent Behavior / Q000208:ethnology / Q000523:psychology*; D001823:Body Composition; D015992:Body Mass Index; D002648:Child; D003430:Cross-Sectional Studies; D003466:Cultural Characteristics; D005260:Female; D005367:Fiji / Q000453:epidemiology; D006304:Health Status; D006801:Humans; D008297:Male; D050177:Overweight / Q000453:epidemiology / Q000208:ethnology / Q000523:psychology*; D010809:Physical Fitness; D011788:Quality of Life; D012574:Schools; D012649:Self Concept; D057566:Self Report; D012959:Socioeconomic Factors