title: Severe obesity and comorbid condition impact on the weight-related quality of life of the adolescent patient.
abstract: OBJECTIVE
  To assess links between comorbid health status, severe excess weight, and weight-related quality of life (WRQOL) in adolescents with severe obesity and undergoing weight-loss surgery (WLS) to inform clinical care.
  
  
  METHODS
  Baseline (preoperative) data from Teen Longitudinal Assessment of Bariatric Surgery, a prospective multicenter observational study of 242 adolescents with severe obesity (MedianBMI = 50.5 kg/m(2); Meanage = 17.1; 75.6% female; 71.9% white) undergoing WLS, were used to examine the impact of demographics, body mass index (BMI), presence/absence of 16 comorbid conditions, and a cumulative comorbidity load (CLoad) index on WRQOL scores (Impact of Weight on Quality of Life-Kids).
  
  
  RESULTS
  WRQOL was significantly lower than reference samples of healthy weight, overweight, and obese samples. Of 16 comorbid conditions, the most prevalent were dyslipidemia (74.4%), chronic pain (58.3%), and obstructive sleep apnea (56.6%). Male subjects had a greater CLoad (P = .01) and BMI (P = .01), yet less impairment in total WRQOL (P < .01) than females. CLoad was a significant predictor of male WRQOL. For females, psychosocial (vs physical) comorbidities, BMI, and white race were significant predictors of WRQOL impairment. Less prevalent conditions (eg, stress urinary incontinence) also emerged as contributors to lower WRQOL.
  
  
  CONCLUSIONS
  WRQOL impairment is substantial for adolescents with severe obesity undergoing WLS, with predictors varying by sex. These patient-data highlight targets for education, support, and adjunctive care referrals before WLS. Furthermore, they provide a comprehensive empirical base for understanding heterogeneity in adolescent WRQOL outcomes after WLS, as weight and comorbidity profiles change over time.
authors.affiliation: Cincinnati Children's Hospital Medical Center, Cincinnati, OH. Electronic address: meg.zeller@cchmc.org.
authors.forename: Meg H
authors.initials: MH
authors.lastname: Zeller
authors.affiliation: Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
authors.forename: Thomas H
authors.initials: TH
authors.lastname: Inge
authors.affiliation: Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
authors.forename: Avani C
authors.initials: AC
authors.lastname: Modi
authors.affiliation: Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
authors.forename: Todd M
authors.initials: TM
authors.lastname: Jenkins
authors.affiliation: Nationwide Children's Hospital, Columbus, OH.
authors.forename: Marc P
authors.initials: MP
authors.lastname: Michalsky
authors.affiliation: Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
authors.forename: Michael
authors.initials: M
authors.lastname: Helmrath
authors.affiliation: University of Pittsburgh Medical Center, Pittsburgh, PA.
authors.forename: Anita
authors.initials: A
authors.lastname: Courcoulas
authors.affiliation: University of Alabama at Birmingham, Birmingham, AL; University at Buffalo, Buffalo, NY.
authors.forename: Carroll M
authors.initials: CM
authors.lastname: Harmon
authors.affiliation: University of Pittsburgh Medical Center, Pittsburgh, PA.
authors.forename: Dana
authors.initials: D
authors.lastname: Rofey
authors.affiliation: Nationwide Children's Hospital, Columbus, OH.
authors.forename: Amy
authors.initials: A
authors.lastname: Baughcum
authors.affiliation: University of Alabama at Birmingham, Birmingham, AL.
authors.forename: Heather
authors.initials: H
authors.lastname: Austin
authors.affiliation: Texas Children's Hospital, Houston, TX.
authors.forename: Karin
authors.initials: K
authors.lastname: Price
authors.affiliation: Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
authors.forename: Stavra A
authors.initials: SA
authors.lastname: Xanthakos
authors.affiliation: Texas Children's Hospital, Houston, TX.
authors.forename: Mary L
authors.initials: ML
authors.lastname: Brandt
authors.affiliation: National Institute of Diabetes and Digestive and Kidney Diseases, NIH, Bethesda, MD.
authors.forename: Mary
authors.initials: M
authors.lastname: Horlick
authors.affiliation: University of Cincinnati, Cincinnati, OH.
authors.forename: Ralph
authors.initials: R
authors.lastname: Buncher
mesh_terms: D000293:Adolescent; D005260:Female; D006801:Humans; D008297:Male; D055815:Young Adult; D050110:Bariatric Surgery; D001835:Body Weight; D015897:Comorbidity; D005500:Follow-Up Studies; D009767:Obesity, Morbid / Q000453:epidemiology / Q000523:psychology / Q000601:surgery; D015995:Prevalence; D011379:Prognosis; D011446:Prospective Studies; D011788:Quality of Life; D014481:United States / Q000453:epidemiology