Association between Health-Related Quality of Life and Emotional Problems in Rural Adolescents with Overweight and Obesity

Ariuna S. Kosovtseva, Lyubov V. Rychkova, Anna V. Pogodina, Vladimir M. Polyakov, Zhanna G. Ajurova

International Journal of Biomedicine. 2020;10(4):442-447.
DOI: 10.21103/Article10(4)_OA22
Originally published December 10, 2020


Background: Health-related quality of life (HRQL) and emotional functioning are important parameters of weight-loss motivation. The aim of this study was to identify the association between emotional/personal characteristics and HRQL in adolescents with overweight and obesity.
Methods and Results: Our cross-sectional case-control study included 172 adolescents: 19 of them overweight, 67 obese, and 86 healthy. We measured anthropometry and performed a psychological examination (PedsQL 4.0, The State-Trait Anxiety Inventory, Buss-Durkee Hostility Inventory, and Personality inventory Mini-SMIL). Negative correlations prevailed between PedsQL scales and psychological traits of healthy adolescents: increases in anxiety, covert anger, and depression were associated with a decrease of HRQL (Total Scale Scores, Psychosocial Health Score, Physical Health Score, and Emotional, Social and School functioning). The psychological impairment (Irritability, Resentment, Guilt, Covert anger) positively correlated with a change in HRQL (Total Scale Scores, Psychosocial Health Score, and Physical Health Score) in obese adolescents.
Conclusion: Obese adolescents had an inadequate association between HRQL and emotional state: the accumulation of anxiety and aggression was accompanied by an increase in HRQL. These difficulties can be a barrier to having treatment and weight-loss motivation.

anxiety • anger • emotion • weight-loss motivation

1. Atay Z, Bereket A. Current status on obesity in childhood and adolescence: Prevalence, etiology, co-morbidities and management. Obesity Medicine. 2016;3:1–9. doi: 10.1016/j.obmed.2016.05.00.5
2. Topçu S, Orhon FŞ, Tayfun M, Uçaktürk SA, Demirel F. Anxiety, depression and self-esteem levels in obese children: a case-control study. J Pediatr Endocrinol Metab. 2016 Mar;29(3):357-61. doi: 10.1515/jpem-2015-0254. 
3. Fox CK, Gross AC, Rudser KD, Foy AM, Kelly AS. Depression, Anxiety, and Severity of Obesity in Adolescents: Is Emotional Eating the Link? Clin Pediatr (Phila). 2016 Oct;55(12):1120-5. doi: 10.1177/0009922815615825. 
4. Sheinbein DH, Stein RI, Hayes JF, Brown ML, Balantekin KN, Conlon RPK, Saelens BE, Perri MG, Welch RR, Schechtman KB, Epstein LH, Wilfley DE. Factors associated with depression and anxiety symptoms among children seeking treatment for obesity: A social-ecological approach. Pediatr Obes. 2019 Aug;14(8):e12518. doi: 10.1111/ijpo.12518.
5. Tso M, Rowland B, Toumbourou JW, Guadagno BL. Overweight or obesity associations with physical aggression in children and adolescents: a meta-analysis. Int J Behav Dev. 2017;42(1):116-131. doi: 10.1177/0165025417690265.
6. Derks IPM, Bolhuis K, Yalcin Z, Gaillard R, Hillegers MHJ, Larsson H, Lundström S, Lichtenstein P, van Beijsterveldt CEM, Bartels M, Boomsma DI, Tiemeier H, Jansen PW. Testing Bidirectional Associations Between Childhood Aggression and BMI: Results from Three Cohorts. Obesity (Silver Spring). 2019 May;27(5):822-829. doi: 10.1002/oby.22419.
7. Liu W, Lin R, Guo C, Xiong L, Chen S, Liu W. Prevalence of body dissatisfaction and its effects on health-related quality of life among primary school students in Guangzhou, China. BMC Public Health. 2019 Feb 20;19(1):213. doi: 10.1186/s12889-019-6519-5. 
8. Lee KS, Vaillancourt T. Body mass index, peer victimization, and body dissatisfaction across 7 years of childhood and adolescence: Evidence of moderated and mediated pathways. Dev Sci. 2019 Mar;22(2):e12734. doi: 10.1111/desc.12734. 
9. Griffiths LJ, Parsons TJ, Hill AJ. Self-esteem and quality of life in obese children and adolescents: a systematic review. Int J Pediatr Obes. 2010 Aug;5(4):282-304. doi: 10.3109/17477160903473697. 
10. Thomaseo Burton E, Jones TL, Smith WA, Han JC. Psychosocial Functioning After One Year of Interdisciplinary Pediatric Weight Management. Behav Med. 2020 Apr-Jun;46(2):92-99. doi: 10.1080/08964289.2019.1570073.
11. Pogodina A, Rychkova L, Kravtzova O, Klimkina J, Kosovtzeva A. Cardiometabolic Risk Factors and Health-Related Quality of Life in Adolescents with Obesity. Child Obes. 2017 Dec;13(6):499-506. doi: 10.1089/chi.2016.0330.
12. Schwimmer JB, Burwinkle TM, Varni JW. Health-related quality of life of severely obese children and adolescents. JAMA. 2003 Apr 9;289(14):1813-9. doi: 10.1001/jama.289.14.1813. 
13. Jalali-Farahani S, Shojaei FA, Parvin P, Amiri P. Comparison of health-related quality of life (HRQoL) among healthy, obese and chronically ill Iranian children. BMC Public Health. 2018 Dec 4;18(1):1337. doi: 10.1186/s12889-018-6239-2.
14. Vallis M. Quality of life and psychological well-being in obesity management: improving the odds of success by managing distress. Int J Clin Pract. 2016 Mar;70(3):196-205. doi: 10.1111/ijcp.12765.
15. Lazarevich I, Irigoyen Camacho ME, Velázquez-Alva MDC, Zepeda Zepeda M. Relationship among obesity, depression, and emotional eating in young adults. Appetite. 2016 Dec 1;107:639-644. doi: 10.1016/j.appet.2016.09.011. 
16. Puder JJ, Munsch S. Psychological correlates of childhood obesity. Int J Obes (Lond). 2010 Dec;34 Suppl 2:S37-43. doi: 10.1038/ijo.2010.238. 
17. KhaninYL. A brief guide to the use of reactive and personal anxiety scale by Ch.D. Spielberger. Leningrad: LNIITEK; 1976. [In Russian].
18. Khvan AA, Zaitsev YA, Kuznetsova YA. [Standardization of the A. Bass and A. Darki questionnaire]. Psychological diagnosis. 2008;1:35-58.[In Russian].
19. Sobchik LN. Psychodiagnostics in medicine. Practical guide. Moscow: Borgis. 2007. [In Russian].
20. Varni JW, Burwinkle TM, Seid M, Skarr D. The PedsQL 4.0 as a pediatric population health measure: feasibility, reliability, and validity. Ambul Pediatr. 2003 Nov-Dec;3(6):329-41. doi: 10.1367/1539-4409(2003)003<0329:tpaapp>;2. 
21. van Ittersum K, Wansink B. Extraverted children are more biased by bowl sizes than introverts. PLoS One. 2013 Oct 30;8(10):e78224. doi: 10.1371/journal.pone.0078224.
22. Eysenck HJ. Biological dimensions of personality. Handbook of personality: Theory and research. New York: Guilford Press; 1990.
23. Herman CP, Koenig-Nobert S, Peterson JB, Polivy J. Matching effects on eating: do individual differences make a difference? Appetite. 2005 Oct;45(2):108-9. doi: 10.1016/j.appet.2005.03.013. 
24. Muraven M, Baumeister RF. Self-regulation and depletion of limited resources: does self-control resemble a muscle? Psychol Bull. 2000 Mar;126(2):247-59. doi: 10.1037/0033-2909.126.2.247. 
25. Stice E, Spoor S, Ng J, Zald DH. Relation of obesity to consummatory and anticipatory food reward. Physiol Behav. 2009 Jul 14;97(5):551-60. doi: 10.1016/j.physbeh.2009.03.020. Epub 2009 Mar 27.
26. Hasler G, Pine DS, Kleinbaum DG, Gamma A, Luckenbaugh D, Ajdacic V, Eich D, Rössler W, Angst J. Depressive symptoms during childhood and adult obesity: the Zurich Cohort Study. Mol Psychiatry. 2005 Sep;10(9):842-50. doi: 10.1038/
27. Boodai SA, Reilly JJ. Health related quality of life of obese adolescents in Kuwait. BMC Pediatr. 2013 Jul 11;13:105. doi: 10.1186/1471-2431-13-105. 
28. Keating CL, Moodie ML, Swinburn BA. The health-related quality of life of overweight and obese adolescents--a study measuring body mass index and adolescent-reported perceptions. Int J Pediatr Obes. 2011 Oct;6(5-6):434-41. doi: 10.3109/17477166.2011.590197. 
29. Riazi A, Shakoor S, Dundas I, Eiser C, McKenzie SA. Health-related quality of life in a clinical sample of obese children and adolescents. Health Qual Life Outcomes. 2010 Nov 15;8:134. doi: 10.1186/1477-7525-8-134. 
30. Zeller M, Kirk S, Claytor R, Khoury P, Grieme J, Santangelo M, Daniels S. Predictors of attrition from a pediatric weight management program. J Pediatr. 2004 Apr;144(4):466-70. doi: 10.1016/j.jpeds.2003.12.031.

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Received September 18, 2020.
Accepted October 17, 2020.
©2020 International Medical Research and Development Corporation.