Weight perception moderates the relationship between BMI-z and Health-Related Quality of Life in Victorian Adolescents. — ASN Events

Weight perception moderates the relationship between BMI-z and Health-Related Quality of Life in Victorian Adolescents. (#100)

Joshua Hayward 1 , Lynne Millar 1 , Solveig Petersen 2 , Boyd Swinburn 1 3 , Andrew Lewis 4
  1. World Health Organization Collaborating Centre for Obesity Prevention, Deakin University, Geelong, VIC, Australia
  2. Child and Adolescent Psychiatry, Umea University, Umea, Sweden
  3. School of Population Health, University of Auckland, Auckland, New Zealand
  4. School of Psychology, Deakin University, Burwood, Vic, Australia

Background: There is a well-established negative association between body weight and Health Related Quality of Life (HRQoL) in adolescents; however, some adolescents with obesity display more resilience to decreases in HRQoL. A hypothesised moderator is weight perception. 

Objective: To investigate whether weight perception moderated the association between objective body weight and HRQoL in adolescence.

Design: Cross sectional analysis of baseline survey data. Linear regression interaction analyses were conducted to examine the moderation effect of weight perception. Analyses were adjusted for sex, age and clustering by school.

Subjects: Secondary school students involved in the It’s Your Move obesity prevention project in the Barwon South West region of Victoria, Australia (N= 3,040). Measures included; standardized Body Mass Index (BMI-z; WHO growth standards), weight perception, and HRQoL, measured by the Pediatric Quality of Life Inventory.  

Results: The interaction between BMI-z and weight perception was significantly associated with HRQoL outcomes in adolescents; adolescents who perceived themselves as overweight and had a BMI in the overweight/ obesity range reported lower HRQoL than those who perceived themselves as “about right” weight. Conversely, adolescents who perceived themselves as underweight and had a BMI-z in the lower end of the normal range reported lower HRQoL than those with “about right” weight perceptions. 

Conclusion: This was the first study to report on third-variable impacts of a body-perception variable on the relationship between adolescent overweight/obesity and HRQoL and as hypothesised, adolescents’ weight perceptions significantly moderated the relationship between weight status and HRQoL. Most importantly, misperceiving measured overweight/obesity as about right was associated with enhanced HRQoL. This has serious implications for practise and future interventions as, while it is important that people have a realistic view of their weight, this reality check should be handled sensitively so that the information impacts minimally on their HRQoL.