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Objectives: To assess links between comorbid health status, severe excess weight, and weight-related quality of life (WRQOL) in adolescents with severe obesity and undergoing weight-loss surgery (WLS) to inform clinical care., Study Design: Baseline (preoperative) data from Teen Longitudinal Assessment of Bariatric Surgery, a prospective multicenter observational study of 242 adolescents with severe obesity (MedianBMI = 50.5 kg/m(2); Meanage = 17.1; 75.6% female; 71.9% white) undergoing WLS, were used to examine the impact of demographics, body mass index (BMI), presence/absence of 16 comorbid conditions, and a cumulative comorbidity load (CLoad) index on WRQOL scores (Impact of Weight on Quality of Life-Kids)., Results: WRQOL was significantly lower than reference samples of healthy weight, overweight, and obese samples. Of 16 comorbid conditions, the most prevalent were dyslipidemia (74.4%), chronic pain (58.3%), and obstructive sleep apnea (56.6%). Male subjects had a greater CLoad (P = .01) and BMI (P = .01), yet less impairment in total WRQOL (P < .01) than females. CLoad was a significant predictor of male WRQOL. For females, psychosocial (vs physical) comorbidities, BMI, and white race were significant predictors of WRQOL impairment. Less prevalent conditions (eg, stress urinary incontinence) also emerged as contributors to lower WRQOL., Conclusions: WRQOL impairment is substantial for adolescents with severe obesity undergoing WLS, with predictors varying by sex. These patient-data highlight targets for education, support, and adjunctive care referrals before WLS. Furthermore, they provide a comprehensive empirical base for understanding heterogeneity in adolescent WRQOL outcomes after WLS, as weight and comorbidity profiles change over time., (Copyright © 2015 Elsevier Inc. All rights reserved.)

Objectives: To define inpatient care of obese children with or without an obesity diagnosis., Study Design: A total of 29,352 inpatient discharges (18,459 unique inpatients) from a tertiary children's hospital were analyzed. Body mass index (BMI) was calculated from measured height and weight. "Obesity" was defined as BMI >or=95th percentile by using Centers for Disease Control and Prevention 2000 growth charts. "Diagnosed obesity" was defined by primary, secondary or tertiary International Classification of Diseases, Ninth Revision codes for "obesity" or "overweight." Analyses controlled for multiple inpatient records per individual., Results: A total of 5989 discharges from the hospital (20.4%) were associated with obesity, but only 512 discharges (1.7%) indicated obesity as a diagnosis. An obesity diagnosis identified only 5.5% of inpatient days for obese inpatients. Obese patients with an obesity diagnosis (Ob/Dx) had fewer hospital discharges per person and shorter lengths of stay than obese patients without an obesity diagnosis (Ob/No Dx). Patients with Ob/Dx had higher odds of mental health, endocrine, and musculoskeletal disorders than non-obese inpatients, but Ob/No Dx patients generally did not., Conclusions: Inpatient obesity diagnoses underestimate inpatient utilization and misidentify patterns of care for obese children. Extreme caution is warranted when using obesity diagnoses to study healthcare utilization by obese children.