Study finds self-esteem of obese children below that of peers

CHICAGO -- A study has found a startling level of despair among obese children, with many rating their quality of life as low as that of young cancer patients on chemotherapy.

The research published in today's Journal of the American Medical Association offers a sobering glimpse of what life is like for many obese youngsters nationwide. They are teased about their size, have trouble playing sports and suffer physical ailments linked to their weight.

The study was published in an edition of the journal devoted to obesity research. It also comes amid growing concern about the nation's obesity epidemic and recent data suggesting 15 percent of U.S. youngsters are severely overweight or obese.

Increasing prevalence

Obesity researcher Kelly Brownell, who runs a Yale University weight disorders center, said the increasing prevalence of obesity hasn't made it any less stigmatizing.

"It just breaks your heart," Brownell said, relating a story from a Yale patient who recalled being absent from school as a child and learning the teacher had told the class, "She's probably home eating."

In the study, 106 children ages 5 to 18 were asked to rate their well-being on physical, emotional and social measures.

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."

Weight-related ailments

Obese youngsters were more likely to miss school than healthy, mostly normal weight kids. Schwimmer said that's probably because they suffered more weight-related physical ailments and endured more teasing at school.

A JAMA editorial noted that study participants had a more than a fivefold increased risk of reporting low quality of life than healthy youngsters.

The study participants filled out questionnaires last year used by pediatricians. The youngsters rated such things as their ability to walk more than one block, play sports, sleep well, get along with others and keep up in school.

Obese youths scored an average of 67 points out of 100 -- 16 points lower than a group of 400 mostly normal weight children.

The obese children's scores were similar to quality of life self-ratings from a previously published study of about 100 pediatric cancer patients.

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

On average, the youngsters were 12 years old, 5-foot-1 and 174 pounds. Their average body-mass index -- a ratio of height to weight -- was nearly 35. In adults, a BMI of 30 or higher is considered obese but in youngsters the index depends on gender and age.

Obesity-related ailments were common among the participants 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.

Parents answered the same questionnaires, and their ratings of their children's well-being were even lower than the youngsters' self-ratings, he said.

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On the Net:

JAMA: http://jama.ama-assn.org

CDC on BMI: http://www.cdc.gov/nccdphp/dnpa/bmi/index.htm