Background The prior research suggests that obesity significantly affects the health-related quality of life (HRQoL) of adolescents both in community-based and observational studies. However, the relationship between race and HRQoL has remained relatively unexplored in overweight adolescents.

Objectives To assess the impact of obesity on HRQoL in Mongolian and Caucasian adolescents living in rural areas of Russia.

Methods The study included in total 77 adolescents with overweight and obesity aged 12–17 years from rural areas of Buryatia, Russia. Forty-six of them were Mongolians (13 were Soyots (minor ethnic group), 33 were Buryats) and 31 were Caucasians. To compare, we recruited from the same community-based sample seventy-three adolescents with normal weight, comparable in gender, age and race/ethnos with the overweight group.

Height, weight and waist circumference were objectively measured using standardised methods. BMI and waist circumference Z-scores derived using the age and sex specific reference. HRQOL was measured by the self-report version of the Paediatric Quality of Life Inventory 4.0.

Results Overweight was associated with poorer adolescent-reported HRQoL total and in all domains in comparison to the control group in Caucasians adolescents (all p<0.01), but not in the Mongolians.

Subgroup analysis for overweight adolescents indicated that after controlling for gender, age, Tanner stage of adolescents, education and social status of their mothers, HRQOL scores were significantly lower in the Mongolians compared with the Caucasians regardless of BMI z-score in all domains. Moreover, abdominal obesity was independently associated with poorer scores in the domains of emotional (β=−0.27; p=0.02), social (β=−0.24; p=0.02) and psychosocial (β=−0.28; p=0.01) functioning and total HRQOL scores (β=−0.25, p=0.02).

Conclusion In the rural community-based sample, overweight Caucasian adolescents have significantly poorer HRQOL than their non-overweight peers of the same race, and they have worse HRQoL than obese Mongolian adolescents with comparable anthropometric characteristics.

When developing health improvement programs for adolescents from rural Buryatia, it should be considered that the improvement of quality of life may become a good motivation to lose weight for Caucasian adolescents but not for Mongolian adolescents.