Association between Body Mass Index and Health-Related Quality of Life: The "Obesity Paradox" in 21,218 Adults of the Chinese General Population

Abstract

BackgroundThere was no consistent recognition of the association between high or low body mass index (BMI) and health related quality of life (HRQL). The aim of this research was to study the association between BMI and HRQL in Chinese adults, and to further explore the stability of that association in the subgroup analysis stratified by status of chronic conditions.MethodsA total of 21,218 adults aged 18 and older were classified as underweight, normal weight, overweight, class I obese, and class II obese based on their BMI. HRQL was measured by the SF-36 Health Survey. The independent impact of each BMI category on HRQL was examined through standard least squares regression by comparing the difference of SF-36 scores and the minimum clinically important differences (MCID), which was defined as 3 points.ResultsCompared to the normal weight, the class I obese was significantly associated with better HRQL scores in the mental component summary (MCS) (75.1 vs. 73.4, P<0.001). The underweight had the lowest score in both the physical components summary (PCS) (75.4 vs. 77.5, P<0.001) and mental components summary (MCS) (71.8 vs. 73.4, P<0.001). For the MCID, the HRQL score was reduced by more than 3 points in the physical functioning for the class II obese (D=-3.43) and the general health for the underweight (D=-3.71). Stratified analyses showed a similar result in the health subjects and chronic conditions, and it was significant in the chronic conditions.ConclusionsThe class I obese showed the best HRQL, especially in the mental domain. The worst HRQL was found in the underweight. The class II obese reduced HRQL in the physical functioning only. “Obesity paradox” was more obvious in the participants with chronic conditions.

The prevalence and correlates of burnout among Chinese preschool teachers

“…However, several studies showed that excess body weight could decrease the morality of patients [40][41][42], which is called the "obesity paradox." Some studies have indicated that the "obesity paradox" phenomenon also existed between BMI and health-related quality of life (HRQL) [43,44]. The type I obese was significantly correlated with higher mental component summary scores of HRQL in comparison to the healthy weight [43].…”

“…Some studies have indicated that the "obesity paradox" phenomenon also existed between BMI and health-related quality of life (HRQL) [43,44]. The type I obese was significantly correlated with higher mental component summary scores of HRQL in comparison to the healthy weight [43]. A recent study showed that better HRQL predicted a lower likelihood of having burnout [45].…”

Qualidade de vida e excesso de peso em trabalhadores em turnos alternantes

“…Estes resultados são respaldados por outros estudos quanto ao domínio saúde mental. Huang et al 16 e Yanbo et al 3 , mostraram que o domínio saúde mental não se associa ao excesso de peso. Outro fator relevante a ser considerado é a idade: a população Figura 1 Escore dos trabalhadores de turnos alternantes para o indicador de Adiposidade (A) e de Qualidade de Vida (QV) (B).…”

“…Assim, o trabalho desempenhado, junto com as condições físicas, mentais, emocionais, econômicas, ambientais e sociais, pode interferir na QV do indivíduo. Entre as condições físicas, o excesso de peso e a distribuição da gordura corporal são fatores associados a uma ampla gama de complicações e agravos à saúde, os quais podem reduzir a QV 3,4 .…”

Gender-Related Differential Effects of Obesity on Health-Related Quality of Life via Obesity-Related Comorbidities

“…7,8,11,21,22 Previous studies have yielded heterogeneous findings regarding the relationship between excess weight and psychosocial functioning: some report no or limited effect, 7,13,[18][19][20][21] some negative effects, [9][10][11] and others positive effects in men 8,22 or in patients with class I obesity. 38 Complex links between weight, psychosociological factors, and psychiatric illness have been described. 39,40 Our analyses show that the results for the mental health subscale differ strongly between men and women.…”