Fat Kids Rank Quality of Life Low

By LINDSEY TANNER, Associated Press Medical Writer ; April 2003

CHICAGO - Obese children rate their quality of life with scores as low as those of young cancer patients on chemotherapy, a study found, highlighting the physical and emotional toll of being too fat.

Teasing at school, difficulties playing sports, fatigue, sleep apnea and other obesity-linked problems all severely affect obese youngsters' well-being, the study found.

While the researchers didn't expect to find youngsters mirroring the cliche of the fat, happy child, the dismal scores were far lower than anticipated, said lead author Dr. Jeffrey Schwimmer, a pediatric gastroenterologist at the University of California in San Diego.

"The magnitude... is striking," Schwimmer said. "The likelihood of significant quality-of-life impairment was profound for obese children."

The study appears in Wednesday's Journal of the American Medical Association, an edition devoted to obesity studies.

It comes amid doctors' growing concern about the nation's obesity epidemic and recent data suggesting 15 percent of U.S. youngsters are severely overweight or obese.

A JAMA editorial notes that Schwimmer's study found that severely obese youngsters and adolescents seeking obesity treatment have more than a fivefold increased risk of reporting low quality of life than healthy youngsters.

"It seems clear that one of the most compelling medical challenges of the 21st century is to develop effective strategies to prevent and treat pediatric obesity," Drs. Jack and Susan Yanovski of the National Institutes of Health said in the editorial.

Schwimmer's study involved 106 children aged 5 to 18 who filled out a questionnaire last year used by pediatricians to evaluate quality of life issues. Parents answered the same questionnaires, and their ratings of their children's well-being were even lower than the youngsters' self-ratings.

On the 100-point questionnaire, obese youngsters scored an average of 67 points — 16 points lower than in a group of 400 mostly normal weight healthy youngsters. The obese children's scores were similar to quality of life self-ratings from a previously published study of about 100 pediatric cancer patients.

Youngsters were asked to rate things like their ability to walk more than one block, play sports, sleep well, get along with others and keep up in school.

Girls and boys appeared to be equally adversely affected by obesity.

Youngsters were aged 12 on average, with an average height of 5 feet 1 inch and average weight of 174 pounds. All had a body-mass index that would be considered obese.

Obesity-related ailments were common and included fatty liver disease, obstructive sleep apnea, diabetes and orthopedic problems caused by excess weight.

"Even in the absence of these physical conditions, children and parents reported a low quality of life," Schwimmer said.

Dr. Nancy Krebs, head of the American Academy of Pediatrics' nutrition committee, said the results aren't surprising given what is known about self-esteem and health problems in obese youngsters.

On the other hand, Krebs said, "It is almost becoming the norm," which may be de-stigamatizing obesity and making it easier for affected children to cope.

Still, the prevalence only underscores the need to treat it, she said.