Health-Related Quality of Life in Children and Adolescents 2 Years after an Inpatient Weight-Loss Program

Objectives To investigate changes in health-related quality of life (HRQOL) at 24 months after an inpatient weight-loss program, and to examine concurrent changes in body mass index (BMI) and physical activity. Study design This prospective study included 707 overweight and obese children and adolescents (mean age, 14 ± 2 years; 57% girls) participating in a 4- to 6-week inpatient weight-loss program, 381 of whom completed a 24-month follow-up. HRQOL, physical activity, and BMI were assessed at baseline, at discharge, and at 6, 12, and 24 months after starting therapy. Longitudinal analyses were conducted using repeated-measures mixed models, adjusted for age, sex, and baseline outcome and accounting for attrition over time. Results At 24 months, overall HRQOL indicated significant improvements relative to baseline (3 points on a scale of 0-100; 95% CI, 1.68-4.47; P < .001). Of the 6 HRQOL domains, the greatest improvement was observed for self-esteem (11 points; 95% CI, 8.40-13.14; P < .001). BMI was 0.5 kg/m2 lower than at baseline (95% CI, −0.92 to −0.02; P = .04). Long-term changes in physical activity explained 30% of the variation in overall HRQOL ( P = .01), and change in BMI was not associated with a change in HRQOL. Conclusion This inpatient weight-loss program was associated with positive changes in HRQOL over the long term, with particular improvement in self-esteem. The results indicate the potential role of physical activity in improving HRQOL without a substantial change in body composition.