The Effect of Body Mass Index, Negative Affect, and Disordered Eating on Health-Related Quality of Life in Preadolescent Youth: A Moderated Mediation Analysis

Abstract

Objective: To examine the indirect effect of BMI z-score on health-related quality of life (HRQOL) through disordered eating attitudes and behaviors in a community sample of preadolescent children, as well as the degree to which negative affect moderated the association between BMI z-score and disordered eating attitudes and behaviors. Methods: Participants included 165 predominately Caucasian children (50% female) between 8 and 12 years of age (M= 9.41, SD= 1.01). HRQOL, disordered eating attitudes and behaviors, and negative affect were assessed using self-report measures, and height and weight were collected by research staff in order to calculate BMI z-score. The conditional indirect effects of BMI on HRQOL through disordered eating attitudes and behaviors at different values of negative affect were analyzed while controlling for child age and gender. Results: Consistent with previous research in treatment-seeking and adolescent samples, the indirect effect of BMI z-score on HRQOL through disordered eating attitudes and behaviors was significant in the community sample of preadolescents. Findings failed to provide support for the hypothesis that negative affect moderated the relationship between BMI z-score and disordered eating attitudes and behaviors. Conclusion: Intervening on disordered eating attitudes and behaviors in preadolescents with higher weight status is critical to prevent the risk trajectory for future clinical eating disorders and poor HRQOL.