Published online April 3, 2006
PEDIATRICS Vol. 117 No. 4 April 2006, pp. 1155-1161 (doi:10.1542/peds.2005-1141)
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Health-Related Quality of Life and Depressive Symptoms in Adolescents With Extreme Obesity Presenting for Bariatric Surgery

Meg H. Zeller, PhDa, Helmut R. Roehrig, PhDa, Avani C. Modi, PhDa, Stephen R. Daniels, MD, PhDb and Thomas H. Inge, MD, PhDc

a Division of Behavioral Medicine and Clinical Psychology
b Division of Cardiology
c Department of Pediatric Surgery, College of Medicine, Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio

OBJECTIVE. We sought to document health-related quality of life (HRQoL) impairment and depressive symptomatology in adolescents with extreme obesity considering surgical weight loss.

STUDY DESIGN. A retrospective review of clinical data was conducted for 33 consecutive extremely obese adolescents presenting for evaluation at a bariatric surgery program for adolescents. Adolescents completed the PedsQL and the Beck Depression Inventory. Mothers completed the parent-proxy PedsQL and the Child Behavior Checklist.

RESULTS. HRQoL scores from both informants were markedly impaired relative to published norms on healthy youth. Moderate agreement was found for self-reported and parent-proxy HRQoL. Approximately 30% of youth met criteria for clinically significant depressive symptoms when based on self-report and 45% of youth when based on mother report. Only 21% of youth were currently engaged in some form of psychological treatment (eg, medication or therapy).

CONCLUSIONS. The day-to-day life of adolescents with extreme obesity seeking bariatric surgery is globally and severely impaired. However, only some of these adolescents demonstrate clinically significant levels of depressive symptomatology. These data will be critical to the development of more informed patient selection criteria and more efficacious treatment paradigms for this vulnerable pediatric subgroup.

Key Words: obesity • pediatric • psychosocial • bariatric • weight loss surgery

Abbreviations: HRQoL—health-related quality of life • BDI—Beck Depression Inventory • DSM—Diagnostic and Statistical Manual of Mental Disorders

Accepted Aug 17, 2005.


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A. C. Modi, S. M. Guilfoyle, and M. H. Zeller
Impaired Health-related Quality of Life in Caregivers of Youth Seeking Obesity Treatment
J. Pediatr. Psychol., March 1, 2009; 34(2): 147 - 155.
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