Abstract
Background
Obesity and obesity-related morbidities are associated with poor psychosocial adjustment and health-related quality of life (HRQoL). This study aims to examine HRQoL and psychosocial outcomes in children with metabolically healthy obesity (MHO) and metabolically unhealthy obesity (MUO), and the effects of familial health on these outcomes.
Methods
Four hundred and six children with BMI for age ≥ 97th percentile were classified as having MHO and MUO based on the absence or presence of metabolic abnormalities. HRQoL and psychosocial outcomes were assessed using validated questionnaires such as PedsQL and DASS-21.
Results
There were no significant differences in HRQoL and psychosocial outcomes between children with MHO and children with MUO. Children with MUO and prior knowledge of existing metabolic conditions reported significantly lower total HRQoL (71.18 ± 17.42 vs. 75.34 ± 15.33), and higher depression (12.16 ± 11.80 vs. 8.95 ± 8.52) and stress (12.11 ± 8.21 vs. 10.04 ± 7.92) compared to children with MHO. Children with MUO who had fathers with metabolically unhealthy phenotype reported significantly lower total HRQoL (72.41 ± 15.67 vs. 76.82 ± 14.91) compared to children with MUO who had fathers with metabolically healthy phenotype.
Conclusion
Prior knowledge of existing metabolic abnormalities was associated with poorer HRQoL and mental health in children with obesity. Paternal metabolic health status influenced HRQoL in children with MUO.
Impact
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First study that compared health-related quality of life (HRQoL) and psychosocial outcomes between children with metabolically healthy obesity (MHO) and children with metabolically unhealthy obesity (MUO).
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No significant differences in HRQoL and psychosocial outcomes between children with metabolically healthy obesity (MHO) and children with metabolically unhealthy obesity (MUO).
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Children with MUO who had prior knowledge of existing metabolic conditions reported lower HRQoL, higher depression and stress compared to children with MHO.
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Paternal metabolic health status was found to influence HRQoL in children with MUO.
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Mental health support intervention with paternal involvement should be provided for children with MUO.
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Data availability
The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.
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Funding
This study is supported by the Clinical Scientist-Individual Research Grant administered by Ministry of Health’s National Medical Research Council (NMRC), Singapore- NMRC/CIRG/1407/2014.
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D.S.Q.O. was responsible for conceptualisation of study design, data acquisition, reviewing of analysis, results interpretation and writing of the manuscript. S.G.O. was responsible for data analysis, results interpretation and writing of the manuscript. J.M.X.C. contributed to data extraction and analysis. Y.Y.L., C.W.L.H., V.T., V.K., K.Y.L. and A.A.S. contributed to data acquisition and reviewing of the manuscript. K.G. and Y.S.L. provided feedback on the study design, and they were responsible for results interpretation and reviewing of the manuscript. All authors were involved in the final approval of the version to be published.
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The study was performed in accordance with the Declaration of Helsinki and ethics approval was obtained from Domain Specific Review Board of National Healthcare Group, Singapore (Reference number: 2015/00314). Written informed consent was obtained from all study participants.
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Ooi, D.S.Q., Ong, S.G., Chia, J.M.X. et al. Quality of life and psychosocial outcomes among children with metabolically healthy and unhealthy obesity. Pediatr Res 94, 1089–1097 (2023). https://doi.org/10.1038/s41390-023-02572-8
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DOI: https://doi.org/10.1038/s41390-023-02572-8
