The association between obesity and quality of life: a retrospective analysis of a large-scale population-based cohort study.
Long-term conditions
Obesity
Quality of life
Journal
BMC public health
ISSN: 1471-2458
Titre abrégé: BMC Public Health
Pays: England
ID NLM: 100968562
Informations de publication
Date de publication:
03 11 2021
03 11 2021
Historique:
received:
08
03
2021
accepted:
21
09
2021
entrez:
4
11
2021
pubmed:
5
11
2021
medline:
15
12
2021
Statut:
epublish
Résumé
The relationship between obesity and health-related quality of life (HRQoL) may be confounded by factors such as multimorbidity. The aim of the study was to explore this relationship, controlling for long-term conditions and other health, lifestyle and demographic factors in a general adult population. There was specific interest in the impact of high weight status, measured by body mass index (BMI) levels (obesity, morbid obesity) compared with individuals of normal weight. Health, lifestyle and demographic data were collected from 64,631 individuals aged 16 years and over registered in the Yorkshire Health Study; a long-term cohort study. Data were collected in 2 waves: from patients attending GP surgeries in the South Yorkshire region; and using online recruitment across the entire Yorkshire and Humber area. Univariable and multivariable regression methods were utilised to identify factors associated with HRQoL as measured by the EQ-5D summary score. Long-term conditions were tested as both covariates and mediating factors on the causal pathway between obesity and HRQoL. Increasing levels of obesity are associated with reduced HRQoL, although this difference is negligible between those of normal weight and those who are overweight. Individuals with obesity and morbid obesity score 4.9 and 11.3 percentage points less on the EQ-5D summary scale respectively than those of normal weight. Concurrent physical, and particularly mental health-related long-term conditions are substantively related to HRQoL: those with 3 or more reported mental or physical health conditions score 29.8 and 14.6 percentage points less on the EQ-5D summary scale respectively than those with fewer conditions. Long-term conditions can be conceptualised as lying on the causal path between obesity and HRQoL, but there is weak evidence for a partial mediating relationship only. To conclude, in agreement with the established literature we have found a clear inverse relationship between increasing weight status and decreasing HRQoL and confirmed the mediating role of long-term conditions in the reduction of HRQoL in people with obesity. Nevertheless, a high BMI remains independently related to HRQoL, suggesting that 'healthy people with obesity' may be in transition to an unhealthy future.
Sections du résumé
BACKGROUND
The relationship between obesity and health-related quality of life (HRQoL) may be confounded by factors such as multimorbidity. The aim of the study was to explore this relationship, controlling for long-term conditions and other health, lifestyle and demographic factors in a general adult population. There was specific interest in the impact of high weight status, measured by body mass index (BMI) levels (obesity, morbid obesity) compared with individuals of normal weight.
METHODS
Health, lifestyle and demographic data were collected from 64,631 individuals aged 16 years and over registered in the Yorkshire Health Study; a long-term cohort study. Data were collected in 2 waves: from patients attending GP surgeries in the South Yorkshire region; and using online recruitment across the entire Yorkshire and Humber area. Univariable and multivariable regression methods were utilised to identify factors associated with HRQoL as measured by the EQ-5D summary score. Long-term conditions were tested as both covariates and mediating factors on the causal pathway between obesity and HRQoL.
RESULTS
Increasing levels of obesity are associated with reduced HRQoL, although this difference is negligible between those of normal weight and those who are overweight. Individuals with obesity and morbid obesity score 4.9 and 11.3 percentage points less on the EQ-5D summary scale respectively than those of normal weight. Concurrent physical, and particularly mental health-related long-term conditions are substantively related to HRQoL: those with 3 or more reported mental or physical health conditions score 29.8 and 14.6 percentage points less on the EQ-5D summary scale respectively than those with fewer conditions. Long-term conditions can be conceptualised as lying on the causal path between obesity and HRQoL, but there is weak evidence for a partial mediating relationship only.
CONCLUSIONS
To conclude, in agreement with the established literature we have found a clear inverse relationship between increasing weight status and decreasing HRQoL and confirmed the mediating role of long-term conditions in the reduction of HRQoL in people with obesity. Nevertheless, a high BMI remains independently related to HRQoL, suggesting that 'healthy people with obesity' may be in transition to an unhealthy future.
Identifiants
pubmed: 34732156
doi: 10.1186/s12889-021-12009-8
pii: 10.1186/s12889-021-12009-8
pmc: PMC8567540
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1990Informations de copyright
© 2021. The Author(s).
Références
Int J Obes (Lond). 2008 Jan;32(1):192-200
pubmed: 17712309
BMJ Open. 2016 Sep 28;6(9):e012038
pubmed: 27683515
Best Pract Res Clin Endocrinol Metab. 2013 Apr;27(2):139-46
pubmed: 23731876
Mol Cell Endocrinol. 2010 Mar 25;316(2):104-8
pubmed: 19628019
Eur J Health Econ. 2015 Mar;16(2):141-51
pubmed: 24408476
Diabetes Obes Metab. 2009 Jul;11(7):665-79
pubmed: 19476478
Diabetes Metab Syndr. 2019 Jan - Feb;13(1):155-160
pubmed: 30641689
Obes Res. 2001 Nov;9(11):713-21
pubmed: 11707538
J Public Health (Oxf). 2005 Jun;27(2):156-64
pubmed: 15820993
BMC Public Health. 2011 Aug 11;11:640
pubmed: 21834964
J Pain Res. 2015 Jul 14;8:399-408
pubmed: 26203274
Int J Epidemiol. 2021 Aug 30;50(4):1070-1070d
pubmed: 33570146
Obes Surg. 2016 Feb;26(2):395-409
pubmed: 26494369
BMC Health Serv Res. 2017 Jan 24;17(1):78
pubmed: 28118838
BMC Public Health. 2013 Oct 25;13:1009
pubmed: 24156626
BMC Public Health. 2012 Feb 24;12:143
pubmed: 22364437
Rev Bras Epidemiol. 2014 Dec;17(4):818-29
pubmed: 25388483
Exp Clin Endocrinol Diabetes. 1998;106 Suppl 2:7-9
pubmed: 9792474
Int J Obes (Lond). 2007 Jan;31(1):189-96
pubmed: 16682976
Obes Res. 2000 Mar;8(2):160-70
pubmed: 10757202
Clin Obes. 2017 Oct;7(5):273-289
pubmed: 28695722
J Clin Invest. 2019 Oct 1;129(10):3978-3989
pubmed: 31524630
Arch Gen Psychiatry. 2006 Jul;63(7):824-30
pubmed: 16818872
Diabetes Metab Syndr. 2018 Nov;12(6):1095-1100
pubmed: 29799416
J Nutr Educ Behav. 2014 Mar-Apr;46(2):90-101
pubmed: 24183706