title: Health-related quality of life and physical activity in children and adolescents 2 years after an inpatient weight-loss program.
abstract: OBJECTIVE
  To investigate changes in health-related quality of life (HRQOL), body mass index (BMI), physical activity, and sedentary behavior at 24 months after an inpatient weight-loss program and to examine correlations between changes in HRQOL and BMI or physical activity.
  
  
  METHODS
  This prospective study included 707 overweight and obese individuals (mean age, 14 ± 2 years; 57% girls) participating in a 4- to 6-week inpatient weight-loss program, 381 of whom completed a 24-month follow-up. HRQOL, physical activity, sedentary behavior, and BMI were assessed at baseline, at discharge, and at 6, 12, and 24 months after starting therapy. Longitudinal analyses were conducted using repeated-measures mixed models, adjusted for age, sex, and baseline outcome and accounting for attrition over time.
  
  
  RESULTS
  All variables improved over treatment and 6-month follow-up (P < .05). At 24 months, overall HRQOL indicated improvements relative to baseline (3 points on a scale of 0-100; 95% CI, 1.68-4.47; P < .001). Of the 6 HRQOL domains, the greatest improvement was observed for self-esteem (11 points; 95% CI, 8.40-13.14; P < .001). BMI was 0.5 kg/m(2) lower than at baseline (95% CI, -0.92 to -0.02; P = .04). Long-term changes in physical activity explained 30% of the variation in overall HRQOL (P = .01), and change in BMI was not associated with a change in HRQOL.
  
  
  CONCLUSIONS
  This inpatient weight-loss program was associated with positive changes in HRQOL over the long term, with particular improvements in self-esteem. The results indicate the potential role of physical activity in improving HRQOL without a substantial change in body composition.
authors.affiliation: Department of Prevention, Rehabilitation and Sports Medicine, Klinikum rechts der Isar, Technische Universität München, Germany. Electronic address: heitkamp@sport.med.tum.de.
authors.forename: Melanie
authors.initials: M
authors.lastname: Rank
authors.affiliation: Department of Prevention, Rehabilitation and Sports Medicine, Klinikum rechts der Isar, Technische Universität München, Germany; Sports Center, University of Passau, Germany.
authors.forename: Desiree C
authors.initials: DC
authors.lastname: Wilks
authors.affiliation: National Institute for Health Innovation, University of Auckland, New Zealand.
authors.forename: Louise
authors.initials: L
authors.lastname: Foley
authors.affiliation: National Institute for Health Innovation, University of Auckland, New Zealand.
authors.forename: Yannan
authors.initials: Y
authors.lastname: Jiang
authors.affiliation: Rehabilitation Clinic Schoensicht, Berchtesgaden, Germany.
authors.forename: Helmut
authors.initials: H
authors.lastname: Langhof
authors.affiliation: Department of Prevention, Rehabilitation and Sports Medicine, Klinikum rechts der Isar, Technische Universität München, Germany.
authors.forename: Monika
authors.initials: M
authors.lastname: Siegrist
authors.affiliation: Department of Prevention, Rehabilitation and Sports Medicine, Klinikum rechts der Isar, Technische Universität München, Germany; DZHK (German Center for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany; Else-Kröner-Fresenius-Zentrum, Klinikum rechts der Isar, Munich, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Halle
mesh_terms: D000293:Adolescent; D000886:Anthropometry; D001823:Body Composition; D015992:Body Mass Index; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007297:Inpatients; D016014:Linear Models; D008297:Male; D009043:Motor Activity; D009765:Obesity / Q000523:psychology / Q000628:therapy*; D050177:Overweight / Q000523:psychology / Q000628:therapy; D011446:Prospective Studies; D011788:Quality of Life; D012649:Self Concept; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D061217:Weight Reduction Programs / Q000379:methods*