title: Influence of specific individual and environmental variables on the relationship between body mass index and health-related quality of life in overweight and obese adolescents.
abstract: OBJECTIVE
  Overweight and obese adolescents are at risk for low health-related quality of life (HRQOL). We examined the role of individual- and environmental-level variables on the relationship between body mass index (BMI kg/m(2)) and HRQOL in adolescents.
  
  
  METHODS
  Linear regressions were performed to conduct mediation and moderation analyses on the relationship between BMI and HRQOL in overweight and obese adolescents (N = 205). HRQOL was measured by the Pediatric Quality of Life Inventory. Hypothesized mediators included depression, measured by the Center for Epidemiologic Studies Depression Scale; body image, measured by the gender-specific body dissatisfaction subscale of the Eating Disorder Inventory; and self-esteem, measured by the Rosenberg Self-Esteem Scale. Mediation was assessed using Baron and Kenny's approach and Sobel's test of indirect effects. Anglo-acculturation, measured by the Short Acculturation Scale for Hispanics-Youth, and environmental perception, measured by parent-proxy report of the Neighborhood Environment Walkability Scale, were hypothesized moderators.
  
  
  RESULTS
  Body image mediated the relationship between BMI and HRQOL (b = -0.34, SE = 0.17, adj R (2) = 0.19, p = .051), and self-esteem was a partial mediator (b = -0.37, SE = 0.17, adj R (2) = 0.24, p = .027). Sobel's test confirmed these results (p < .05). No significant moderation effects were found.
  
  
  CONCLUSIONS
  The finding that individual-level factors, such as body image and self-esteem, influence the relationship between BMI and HRQOL while environmental factors, such as neighborhood environment and acculturation, do not extends previous research. The finding that body image and self-esteem partially mediate this relationship presents new areas to investigate in interventions that address BMI in youth.
authors: Department of Family and Preventive Medicine, University of California, San Diego, 9500 Gilman Drive, Dept 0811, La Jolla, CA, 92093-0811, USA, jkolodzi@ucsd.edu.
authors: Julia K
authors: JK
authors: Kolodziejczyk
authors: Kyle
authors: K
authors: Gutzmer
authors: Shana M
authors: SM
authors: Wright
authors: Elva M
authors: EM
authors: Arredondo
authors: Linda
authors: L
authors: Hill
authors: Kevin
authors: K
authors: Patrick
authors: Jeannie S
authors: JS
authors: Huang
authors: Michael
authors: M
authors: Gottschalk
authors: Gregory J
authors: GJ
authors: Norman
mesh_terms: D000069:Acculturation; D000293:Adolescent; D001828:Body Image; D015992:Body Mass Index; D002648:Child; D003863:Depression; D005260:Female; D006801:Humans; D008297:Male; D009765:Obesity / Q000503:physiopathology; D050177:Overweight / Q000503:physiopathology*; D010290:Parents; D010465:Perception; D011788:Quality of Life; D012649:Self Concept; D057566:Self Report