Weight associated factors in relation to health-related quality of life (HRQoL) in Iranian adolescents

OBJECTIVE: This study aimed to explore body weight factors associated with HRQoL of Iranian adolescents. METHODS: A total of 584 adolescents (12–18 years) were included in this cross-sectional study. Participants were selected using a multi-stage sampling method from schools located in Isfahan city in Iran. Body weight, height and waist circumference of adolescents were measured according to standard protocol and body mass index-for-age was determined using Anthroplus software. Adolescents completed a set of self-administered questionnaires which included questions about perceptions of adolescents regarding their body weight status and adolescents’ satisfaction regarding their body weight. To assess HRQoL, adolescents completed the Iranian version of the Pediatric Quality of Life Inventory™ version 4.0 (PedsQL™ 4.0). RESULTS: The mean age of participants was 15.1 ± 1.3 years. The overall prevalence of overweight and obesity were higher in boys compared to girls (34.5 vs. 26.7% respectively). More boys (49.5%) had incorrect perceptions regarding their body weight status compared to girls (37.0%), and more girls (39.0%) were dissatisfied with their body weight compared to boys (28.8%). HRQoL scores were not significantly different among body weight status groups except for significantly lower physical functioning scores in underweight adolescents compared to their counterparts (p = 0.049; power = 64%). Based on perception of body weight status, only boys who perceived themselves as underweight or overweight reported lower scores in different subscales of HRQoL compared to those who perceived themselves as normal weight (p < 0.05; power > 85%). In girls, body weight dissatisfaction was significantly associated with poorer HRQoL in psychosocial dimensions, while in boys, body weight dissatisfaction was significantly associated with poorer HRQoL in physical and social functioning subscales (p < 0.05; power > 85%). CONCLUSION: In conclusion, impairment in HRQoL mainly depends on adolescents’ perception and dissatisfaction regarding their body weight and less on their actual body weight status. These findings implying that more attention should be paid to body image as an important target for interventions aiming at promoting HRQoL during early years of life.