Effect of a Family-Based Weight Management Intervention on the Association Between Weight Loss and Children’s Quality of Life

Abstract

Background and Significance: Childhood obesity is associated with numerous morbidities, and effective interventions are needed to provide children and their parents the tools and skills they need to make healthier lifestyle choices. Children with obesity are more likely to have poorer health-related quality of life (HRQOL) and poorer weight-specific quality of life (WSQOL) compared to their peers. The impact of weight management interventions on children’s HRQOL and WSQOL is not fully understood. Whether and how weight loss changes parents’ and children’s perceptions of the children’s quality of life can provide insight into interventions’ effectiveness and highlight opportunities for adapting interventions.Objective: To determine the association between pediatric participants’ weight loss and change in their quality of life, specifically HRQOL and WSQOL, among participants enrolled in family-based behavioral weight management interventions. Methods: This study used a one-arm quasi-experimental design and combined data from two previous pediatric weight management intervention studies. Parents with overweight/obesity and their children ages 7 to 11 with overweight/obesity participated in a 20-week, family-based weight management intervention focused on increasing healthier lifestyle eating and activity behaviors. Child height, child weight, and child self-reported and parent proxy-reported HRQOL and WSQOL were collected. Child self-reported and parent proxy-reported HRQOL and WSQOL scores were compared. Multiple regression was used to assess the association between change in child BMI z-score and change in child HRQOL and WSQOL. Results: Parent proxy-reported WSQOL was significantly lower than child self-reported WSQOL at all timepoints, but quality of life significantly increased with treatment. Change in child BMI z-score was significantly negatively associated with change in child self-reported total WSQOL (improvements in child weight status associated with improvements in weight-related quality of life) but not child self-reported total HRQOL. Change in child BMI z-score was also significantly negatively associated with parent proxy-reported HRQOL and WSQOL. Conclusions: The change in children’s self-reported quality of life does not track with changes in their weight status as much as changes in parents’ perceptions of child quality of life improvements. Parent perceptions of child HRQOL and WSQOL indicate significant improvement with intervention that is more linked to child weight status changes. Pediatric weight management interventions may need modification to show children how their weight loss is related to their improving quality of life.