An observational study in Childhood Obesity, Overweight (BMI > 25) and Underweight, sponsored by Maastricht University Medical Center. Completed at 16 sites in India. Open to participants aged 14 Years to 16 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2026-04-29.
Sponsored by Maastricht University Medical Center · Observational
A school-based cross-sectional study that aims to generate context-specific evidence on how weight status is related to resilience, health behaviour, and quality of life among Indian adolescents.
Primary Objective
To assess differences in overall resilience (total score of Adolescent Resilience score from ARQ49) between normal-weight and overweight/obese Indian adolescents aged 14-16 years.
Secondary Objectives
To examine the associations among resilience, dietary and physical activity behaviors, and PedsQL within the overall sample and within different weight groups, and to evaluate parental nutrition knowledge as a moderator of the relationship between weight status and resilience or health outcomes.
Exploratory Objective
Study hypotheses
The investigators hypothesized that adolescents with overweight/obesity, compared with their normal-weight peers, would demonstrate lower scores on total resilience (primary outcome), as well as on internal and external resilience indices; report lower diet self-efficacy, physical activity self-efficacy, self-esteem, and optimism; report less frequent health-promoting behaviors (including lower fruit and vegetable intake and fewer days achieving ≥ 60 min/day of moderate-to-vigorous physical activity); and report lower PedsQL scores.
Parental nutrition knowledge will not be treated as a between-group outcome; instead, it will be tested as a moderator in association analyses, examining whether parental nutrition knowledge influences the relationship between weight status and resilience or health outcomes.
Furthermore, the investigators hypothesized that higher resilience scores would be positively associated with healthier dietary behaviors, greater physical activity participation, and higher PedsQL scores across the overall sample, with these associations expected to hold true within both normal-weight and overweight/obese groups. In addition, analyses involving underweight adolescents will be exploratory and descriptive in nature. We will explore whether underweight adolescents show different levels of resilience, health behaviors, and HRQoL compared with adolescents with normal weight.
Childhood and adolescent obesity is associated with adverse physical, psychological, and social outcomes, including reduced health-related quality of life (HRQoL). In India, the coexistence of underweight and overweight highlights the need to examine behavioural and psychosocial factors alongside anthropometric measures.
Resilience, defined as the capacity to adapt to stress and challenges, is a multidimensional construct encompassing individual, family, peer, school, and community domains. Internal resilience-related traits such as diet and physical activity self-efficacy, self-esteem, and optimism may influence adolescents' health behaviours and well-being. However, evidence examining these factors together, particularly in relation to weight status among Indian adolescents, remains limited.
This study is a school-based cross-sectional investigation conducted among adolescents aged 14-16 years in Kolkata, India. The primary objective is to assess differences in overall resilience (ARQ49 total score) between normal-weight and overweight/obese adolescents. Secondary objectives include comparing internal resilience-related traits, dietary behaviours, physical activity patterns, and HRQoL (PedsQL), and examining associations among these variables within the overall sample. An exploratory objective assesses similar outcomes among underweight adolescents.
Participants are recruited from public and private secondary schools using non-probability and snowball sampling through existing professional networks. One parent or guardian per adolescent participates to provide data on parental nutrition knowledge and related contextual factors.
Data collection includes validated self-administered questionnaires and anthropometric measurements (height and weight) to calculate BMI-for-age z-scores using international standards. Statistical analyses include group comparisons across weight categories and multivariable models examining associations among resilience, health behaviours, parental factors, and HRQoL, accounting for clustering at the school level.
This study aims to generate context-specific evidence on how psychosocial resilience and behavioural factors relate to weight status and well-being among Indian adolescents.
1,129 studies on the registry are indexed under Pediatric Obesity; 187 are open to participants now.
This study's enrollment of 720 is above the median of 180 across 235 observational studies indexed under Pediatric Obesity.
Browse Pediatric Obesity studies →Maastricht University Medical Center is the lead sponsor of 853 studies on the registry; 114 are open to participants now.
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School-going Indian adolescents aged 14 to 16 years, studying in grades 8 to 10 in secondary schools in Kolkata, India. Participants were recruited from public and private schools. One parent or guardian of each participating adolescent was also invited to participate. Weight status categories (underweight, normal weight, and overweight/obese) were defined analytically using BMI-for-age z-scores based on IOTF cut-offs.
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Eligibility Criteria
Inclusion Criteria:
Exclusion Criteria:
Adolescent participants (14-16 years): Participants will be categorized into weight status groups (underweight, normal-weight, overweight/obese) based on BMI-for-age z-scores for analysis. Group 1: Overweight BMI Cut-Off Points (kg/m²) by International Obesity Task Force; IOTF Overweight (including obesity) ≥25.00 Group 2: Obese BMI Cut-Off Points (kg/m²) by International Obesity Task Force; IOTF Obese ≥30.00 Group 3: Normal-weight BMI Cut-Off Points (kg/m²) by International Obesity Task Force; IOTF Normal Weight - 18.5-24.99
Overall resilience (ARQ49 total score)
Overall resilience will be assessed using the Adolescent Resilience Questionnaire (ARQ49). The total score will be calculated by summing responses across all items, with higher scores indicating higher levels of psychosocial resilience.
Time frame: At baseline (single time-point assessment)
Health-related quality of life (HRQoL)
HRQoL will be assessed using the Pediatric Quality of Life Inventory (PedsQL). Scores will be transformed to a 0-100 scale, with higher scores indicating better quality of life.
Time frame: At baseline (single time-point assessment)
Diet and Physical activity self-efficacy
Self-efficacy will be assessed using a validated Diet and Physical Activity Self-Efficacy Scale. The scale includes multiple domains related to confidence in engaging in physical activity and making healthy dietary choices. Subscale scores will be calculated for each domain, with higher scores indicating greater self-efficacy.
Time frame: At baseline (single time-point assessment)
Optimism
Optimism will be assessed using the Youth Life Orientation Test (Y-LOT). A total score will be calculated, with higher scores indicating a more optimistic outlook.
Time frame: At baseline (single time-point assessment)
Dietary and PA behaviour
Dietary and physical activity behaviour will be assessed using selected items from the Global School-based Student Health Survey (GSHS), including frequency of consumption of key food groups and hours/days of physical activity (weekly/monthy). Responses will be analysed as categorical or frequency-based variables.
Time frame: At baseline (single time-point assessment)
Self-esteem
Self-esteem will be measured using the Rosenberg Self-Esteem Scale (RSES). Total scores will be calculated, with higher scores indicating higher self-esteem.
Time frame: At baseline (single time-point assessment)
Plan to share: No — Individual participant data will not be shared publicly because the study involves adolescent participants and linked parent data, and open sharing would raise ethical and privacy concerns. De-identified data may be considered upon reasonable request, subject to review by the research team, applicable ethical approvals, and a data-sharing agreement, in accordance with Maastricht University data governance requirements.
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Ran from Feb 2023 to primary completion in Feb 2024, 12 months.
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This study is completed, as verified in Apr 2026. You cannot join it, but the record below documents what was studied.
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