RESUMEN
OBJECTIVES: To examine the relationship between health-related quality of life (HRQoL) and body mass index (BMI) of obese children. METHODS: This cross-sectional study included 387 children. HRQoL was measured with the PedsQLTM 4.0 Generic Core Scale. BMI was classified according to the World Health Organization Asia-Pacific obesity guidelines. Psychosocial factors (body image, self-esteem, and depression/anxiety) were also measured. Data were analyzed using one-way analysis of variance, Pearson's correlation and Path analysis. RESULTS: Obese participants reported lower score for physical evaluation, self-esteem, appearance evaluation component of body image, total HRQoL score, and physical/emotional/social function components of HRQoL ; they reported higher score for depression/anxiety. In addition, results indicated that as BMI increased, appearance evaluation, total HRQoL score, and social function component of HRQoL dropped. Path analysis revealed that BMI did not directly affect HRQoL ; however, BMI directly affects body image and self-esteem, indirectly mediates depression/anxiety, and thereby impacts on an individual's HRQoL. CONCLUSIONS: Body image and self-esteem, rather than BMI itself, have more influence on HRQoL. This reinforces the importance of therapeutic intervention to enhance body image and self-esteem among obese children.