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Summary: Background: Body mass index (BMI) is often used to diagnose obesity in childhood and adolescence but has limitations as an index of obesity‐related morbidity. The Edmonton Obesity Staging System for Pediatrics (EOSS‐P) is a clinical staging system that uses weight‐related comorbidities to determine health risk in paediatric populations. The purpose of this study was to investigate the associations of EOSS‐P and BMI percentile with quality of life (QOL), cardiorespiratory fitness (CRF) and muscular strength in adolescents with obesity. Methods: Participants were enrolled at baseline in the Healthy Eating, Aerobic and Resistance Training in Youth trial (BMI = 34.6 ± 4.5 kg m−2, age = 15.6 ± 1.4 years, N = 299). QOL, CRF (peak oxygen uptake, VO2peak) and muscular strength were assessed by the Pediatric QOL Inventory (PedsQL), indirect calorimetry during a maximal treadmill test and eight‐repetition maximum bench and leg press tests, respectively. Participants were staged from 0 to 3 (absent to severe health risk) according to EOSS‐P. Associations were assessed using age‐adjusted and sex‐adjusted general linear models. Results: Quality of life decreased with increasing EOSS‐P stages (p < 0.001). QOL was 75.7 ± 11.4 in stage 0/1, 69.1 ± 13.1 in stage 2 and 55.4 ± 13.0 in stage 3. BMI percentile was associated with VO2peak (β = –0.044 mlO2 kg−1 min−1 per unit increase in BMI percentile, p < 0.001), bench press (β = 0.832 kg per unit increase in BMI percentile, p = 0.029) and leg press (β = 3.992 kg, p = 0.003). There were no significant differences in treadmill time or VO2peak between EOSS‐P stages (p > 0.05). Conclusion: As EOSS‐P stages increase, QOL decreases. BMI percentile was negatively associated with CRF and positively associated with muscular strength. [ABSTRACT FROM AUTHOR]

Summary: Introduction: Despite efforts to improve adherence to physical activity interventions in youth with obesity, low adherence and attrition remain areas of great concern. Objective: The study was designed to determine which physiological and/or psychological factors predicted low adherence in adolescents with obesity enrolled in a 6‐month exercise intervention study aimed to improve body composition. Methods: Three hundred four adolescents with obesity aged 14–18 years who volunteered for the HEARTY (Healthy Eating Aerobic and Resistance Training in Youth) randomized controlled trial completed physiological (body mass index, waist circumference, per cent body fat, resting metabolic rate and aerobic fitness) and psychological (body image, mood, self‐esteem and self‐efficacy) measures. Results: One hundred forty‐one out of 228 (62%) randomized to exercise groups had low adherence (completed <70% of the prescribed four exercise sessions per week) to the intervention protocol. Logistic regression revealed that there were no baseline demographic or physiological variables that predicted low adherence in the participants. Appearance concern (a subscale of body image) (odds ratio [OR] 1.46, 95% confidence interval [CI]: 1.01, 2.1, P = 0.04), depressive mood (OR 1.12, 95% CI: 1.01, 1.23, P = 0.03) and confused mood (OR 1.16, 95% CI: 1.05, 1.27, P = 0.003) (two subscales of mood) were significant predictors of low adherence. Conclusions: Adolescents with obesity who had higher appearance concerns and depressive and confused moods were less likely to adhere to exercise. Body image and mood should be screened to identify adolescents who may be at high risk of poor adherence and who may need concurrent or treatment support to address these psychological issues to derive maximal health benefits from an exercise programme. [ABSTRACT FROM AUTHOR]

This paper discusses the critical period of adolescence and its potential role in the development and persistence of obesity. The adolescent years are characteristic of changes in body composition (location and quantity of body fat), physical fitness and decreased insulin sensitivity during puberty. This period of growth and maturation is also marked with behavioural changes in diet, physical activity, sedentary behaviour and psychological health. Physical activity and sport participation decline during adolescence especially in teenage girls, while sedentary behaviour, risk for depression and body esteem issues increase during the teenage years. These physiological and behavioural changes during adolescence warrant the attention of health practitioners to prevent the onset and continuation of obesity throughout the lifespan. [ABSTRACT FROM AUTHOR]