Health-related quality of life and physical activity in children and adolescents 2 years after an inpatient weight-loss program

J Pediatr. 2014 Oct;165(4):732-7.e2. doi: 10.1016/j.jpeds.2014.05.045. Epub 2014 Jul 16.


Objectives: 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.

Study design: 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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Anthropometry
  • Body Composition
  • Body Mass Index
  • Child
  • Female
  • Follow-Up Studies
  • Humans
  • Inpatients
  • Linear Models
  • Male
  • Motor Activity
  • Obesity / psychology
  • Obesity / therapy*
  • Overweight / psychology
  • Overweight / therapy
  • Prospective Studies
  • Quality of Life*
  • Self Concept
  • Surveys and Questionnaires
  • Time Factors
  • Treatment Outcome
  • Weight Reduction Programs / methods*