Systematic review of literature on health-related quality of life in overweight and obese children and adolescents: On what domains are obese and overweight children and adolescents most affected?

Background Rising prevalence rates of obesity and overweight have been observed worldwide not only in adults, but also in children and adolescents. Obesity and overweight are associated with a number of adverse health effects and can cause impairments on an individual’s physical, social and psychological well-being. In this study, a systematic review of the literature on obesity or overweight and its impact on the health-related quality of life (HRQoL) in children and adolescents was conducted. Methods Systematic literature search was performed in various databases including Medline, PsycINFO, PSYNDEX, DARE, the Cochrane Library, and Web of Science. In addition, the internet was searched and reference lists of articles were analyzed. Selection criteria included the use of a standardized quality of life instrument, publication between 1990 and 2008 in the English or German language, and inclusion of participants up to the age of 18 years. Results 392 studies were identified as potentially relevant. Of these, 306 were excluded as they did not fully meet the selection criteria. Full texts were obtained for 87 publications, 51 of which were not suitable for the review. The remaining 36 publications were subdivided into: randomized controlled trials (RCT) (3), population-based studies (15), and clinically-based non-RCT studies (18). Most of the studies were cross-sectional and were based on national (or regional) samples. HRQoL in overweight/obese subjects was impaired primarily on the physical and/or psychosocial domain. Conclusions The results of this review indicate two primary areas of impairment of overweight/obese children and adolescents which is an important finding useful for conceptualization of intervention measures. Differences by age and gender were identified as well. Public Health measures should not only aim at improving the physical health of these children, but should also take the subjective health into account.