This study aimed to determine the association between overweight and health-related quality of life (HRQoL) in Tehranian school children. A total of 631 school children aged 8-14 year old were selected from elementary and secondary schools, and body weight status was determined according to WHO growth references for 5-19 year old children. Children were categorized into the overweight and non-overweight groups. The HRQoL was assessed using Iranian versions of Pediatric Quality of Life Inventory version™ 4.0 (PedsQL). Overweight elementary school boys had significantly higher scores for physical functioning, school functioning and total HRQoL, compared to non-overweight ones (p < 0.05). On the other hand, except for emotional functioning subscale, overweight secondary school boys had significantly lower HRQoL scores, compared to their non-overweight counterparts (p < 0.05). In girls, only social functioning subscale scores were significantly lower in elementary school girls compared to non-overweight ones (p < 0.05). Based on parents' perspective, overweight elementary school boys had poorer HRQoL compared to their non-overweight counterparts, significant only for emotional functioning (p < 0.05). For secondary school boys, overweight boys had lower HRQoL scores compared to non-overweight ones, significant for all subscales except for emotional functioning. Based on parents' reports, in both elementary and secondary school girls, there were no significant differences in HRQoL scores between overweight and non-overweight groups. To conclude, in boys while overweight significantly increased HRQoL in children, it significantly decreased HRQoL among adolescents. However, except for social functioning in elementary school girls, there was no significant association between HRQoL scores and overweight. Parents' reports showed an association between overweight and HRQoL, only in boys.
