A bi-directional relationship between obesity and health-related quality of life: evidence from the longitudinal AusDiab study

Abstract

Objective: To assess the prospective relationship between obesity and health-related quality of life, including a novel assessment of the impact of health-related quality of life on weight gain. Design and setting: Longitudinal, national, population-based Australian Diabetes, Obesity and Lifestyle (AusDiab) study, with surveys conducted in 1999/2000 and 2004/2005. Participants: A total of 5985 men and women aged X25 years at study entry. Main outcome measure(s): At both time points, height, weight and waist circumference were measured and self-report data on health-related quality of life from the SF-36 questionnaire were obtained. Cross-sectional and bi-directional, prospective associations between obesity categories and health-related quality of life were assessed. Results: Higher body mass index (BMI) at baseline was associated with deterioration in health-related quality of life over 5 years for seven of the eight health-related quality of life domains in women (all Pp0.01, with the exception of mental health, P40.05), and six out of eight in men (all Po0.05, with the exception of role-emotional, P ¼ 0.055, and mental health, P40.05).Each of the quality-of-life domains related to mental health as well as the mental component summary were inversely associated with BMI change (all Po0.0001 for women and Pp0.01 for men), with the exception of vitality, which was significant in women only (P ¼ 0.008). For the physical domains, change in BMI was inversely associated with baseline general health in women only (P ¼ 0.023). Conclusions: Obesity was associated with a deterioration in health-related quality of life (including both physical and mental health domains) in this cohort of Australian adults followed over 5 years. Health-related quality of life was also a predictor of weight gain over 5 years, indicating a bi-directional association between obesity and health-related quality of life. The identification of those with poor health-related quality of life may be important in assessing the risk of future weight gain, and a focus on health-related quality of life may be beneficial in weight management strategies.

Longitudinal Association Between Body Mass Index and Health-Related Quality of Life.

“…Numerous cross-sectional studies have affirmed that compared to normal-weight individuals, obese individuals are more likely to have a poorer level of physical HRQoL [8][9][10][11][12][13][14][15][16][17]22,25,30,31,34,37]. Our study results confirmed that BMI is inversely associated with physical SF-12 summary score.…”

“…In populations with diabetes or hypertension, a higher BMI was a predictor for later decreased physical HRQoL but not for mental HRQoL [32,33]. Three cohort studies indicated that weight gain over time was linked to an impairment of physical HRQoL [34][35][36]. With the exception of these results, there is a lack of evidence that a change in body weight has an impact on later HRQoL.…”

Prevalence of musculoskeletal symptoms in obese patients candidates for bariatric surgery and its impact on health related quality of life

“…Cameron and cols. showed that obesity was related with impairment in both physical and mental components of health-related quality of life in Australian adults followed over 5 years (28). One factor that could explain the higher values for mental health components found in the current study is the fact that all patients in this study had been receiving psychological care during the months preceding the surgery because this service is part of the bariatric surgery program at our institution.…”

“…demonstrated that a bidirectional relationship was observed between the decline of quality of life and increase in weight. Accordingly, reduced quality of life increases the likelihood of increasing weight, and increased weight leads to reduced quality of life (28).…”

Lower Extremity Pain Is Associated With Reduced Function and Psychosocial Health in Obese Children

“…Obesity-related musculoskeletal comorbidities, including joint pain and lower extremity malalignment, are well characterized among adults [16,17,47]. In adults, increasing body mass index (BMI) and obesity result in knee pain [19], progressive physical disability [5,18], diminished health-related quality of life [18], and a clear risk of development of knee osteoarthritis [7,24,47]. Recent evidence shows that obesity in young adulthood is associated with a threefold increase in knee osteoarthritis by age 60 years [4,14,26].…”