title: Unhealthy weight control behaviors mediate the association between weight status and weight-specific health-related quality of life in treatment-seeking youth who are obese.
abstract: OBJECTIVE
  Examine whether unhealthy and extreme weight control behaviors (WCBs) mediate the relationship between youth weight status and disease-specific health-related quality of life (HRQOL) in treatment-seeking youth who are overweight and obese (OV/OB).
  
  
  METHODS
  82 youth 10-17 years of age who were OV/OB and attending an outpatient obesity-related medical appointment completed measures assessing unhealthy and extreme WCBs and disease-specific HRQOL. Parents completed a demographic questionnaire and medical staff measured youth height and weight.
  
  
  RESULTS
  Regression analyses revealed that unhealthy WCBs mediated the associations between youth weight status and emotional and social avoidance disease-specific HRQOL, such that higher body mass index (BMI) predicted unhealthy WCBs, which were ultimately associated with poorer emotional and social HRQOL. Mediation analyses were not significant for total, physical, teasing/marginalization, and positive attributes disease-specific HRQOL. In addition, extreme WCBs did not mediate the association between youth weight status and any subscales of the disease-specific HRQOL measure.
  
  
  CONCLUSIONS
  Weight status is an important predictor of disease-specific HRQOL in OV/OB youth; however, the association with emotional and social HRQOL is partially accounted for by youth engagement in unhealthy WCBs. Clinicians and researchers should assess WCBs and further research should explore and evaluate appropriate intervention strategies to address unhealthy WCBs in pediatric weight management prevention and treatment efforts.
authors.affiliation: Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, 2500 North State St., Jackson, MS, 39216-4505, USA. cstacklim@umc.edu.
authors.forename: Crystal S
authors.identifier: http://orcid.org/0000-0002-7445-7463
authors.initials: CS
authors.lastname: Lim
authors.affiliation: Nutrition Obesity Research Center, University of Alabama at Birmingham, 1717 11th Avenue South, Medical Towers 102F, Birmingham, AL, 35205, USA.
authors.forename: Marissa A
authors.initials: MA
authors.lastname: Gowey
authors.affiliation: Division of Behavioral Health, Nemours/A.I. DuPont Hospital for Children, 1600 Rockland Road, Wilmington, DE, 19803, USA.|Division of Weight Management, Nemours/A.I. DuPont Hospital for Children, 1600 Rockland Road, Wilmington, DE, 19803, USA.
authors.forename: Megan J
authors.initials: MJ
authors.lastname: Cohen
authors.affiliation: Department of Pediatrics, University of Florida, 1701 SW 16th Ave, Building A, Room 2160, Gainesville, FL, 32608, USA.
authors.forename: Janet
authors.initials: J
authors.lastname: Silverstein
authors.affiliation: Department of Clinical and Health Psychology, University of Florida, P.O. Box 100165, Gainesville, FL, 32610-0165, USA.
authors.forename: David M
authors.initials: DM
authors.lastname: Janicke
mesh_terms: D000293:Adolescent; D001828:Body Image / Q000523:psychology*; D001835:Body Weight; D002648:Child; D005260:Female; D015438:Health Behavior; D006304:Health Status; D006801:Humans; D008297:Male; D009765:Obesity / Q000523:psychology*; D011788:Quality of Life / Q000523:psychology*; D011795:Surveys and Questionnaires
keywords: Childhood obesity; Health-related quality of life; Weight control behaviors