Psychosocial measures and weight change in a clinical paediatric population with obesity

Poor quality of life has been shown to occur in youth with obesity. This study aimed to assess associations between health-related quality of life, general mental health and general psychological distress measures, collectively termed psychosocial health questionnaires (PSH), with weight outcomes in a busy paediatric weight management service.

A cross-sectional longitudinal clinical cohort, 'Childhood Overweight BioRepository of Australia (COBRA)', was used (n = 250, median age 11, range 2-18 year, mean BMI z-score 2.5 ± 0.2). Clinical data were collected and HRQOL questionnaires; Pediatric Quality of Life 4.0 (PedsQL), 'Sizing Me/Them Up' (SMU/STU), and psychological well-being questionnaires; strengths and difficulties questionnaire (SDQ) and Kessler 10 (K10) were completed by the child and primary caregiver. PSH results were compared to age- and sex-adjusted BMI z-score at baseline and follow-up. Direct logistic regression modelling was performed to assess the impact of PSH factors on the likelihood of successful weight reduction over a period of ≥ 12 months.

Mean self-report PSH scores were: 68.0 ± 15.28 (PedsQL, range 0-100), 64.8 ± 15.8, (SMU, range 0-100), 17.3 ± 4.4 (SDQ, range 0-40) and 20.0 ± 7.7 (K10, range 0-50). A significant negative correlation was observed between PSH scores and childhood obesity (baseline BMI z-scores (p < 0.01)). No correlations were observed between psychological well-being measures and BMI z-scores. Higher subscale scores of the PedsQL and SDQ, which measure impaired psychosocial health and more difficulties with hyperactivity and inattention, significantly predict weight loss in children with obesity after 12 months.

PSH questionnaires may be useful in identifying individuals who require additional support to achieve weight loss goals in a tertiary weight management service.