Supplementary Material for: Weight-related impairment in children and adolescents with overweight and obesity: A cross-sectional study on associations with sociodemographic characteristics and health-related quality of life

Introduction: This study investigated associations between weight-related impairment (WrI), degree of overweight/obesity, and health-related quality of life (HrQoL) in children and adolescents with overweight or obesity. Methods: Data were collected within the LIFE Child cohort study conducted in Leipzig, Germany. We used a repeated cross-sectional dataset containing 539 data points of 270 10- to 17-year-old children with overweight (n = 83 data points), obesity (n = 276 data points), or severe obesity (n = 180 data points) who had completed questionnaires on WrI (Kindl-R, total score) and HrQoL (Kidscreen-27, scores physical wellbeing, psychological wellbeing, peer relations, family relations, school). Associations between weight status, WrI, and HrQoL were assessed using regression analyses, adjusting for age, sex, and socio-economic status. Results: Children with obesity or severe obesity showed significantly more WrI than children with overweight. Regarding HrQoL, however, only physical and psychological wellbeing were significantly associated with weight group. Higher WrI was strongly associated with lower HrQoL in all domains (b ranging between -6.07 and -3.16, all p < .001). The association between WrI and psychological wellbeing was stronger in children with obesity or severe obesity than in children with overweight. In multivariate models, only WrI, but not the degree of overweight/obesity was associated with the different domains of HrQoL. Conclusion: The findings suggest that WrI and not weight per se impacts HrQoL of children and adolescents with overweight and obesity.