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Obesity and health-related quality of life: a cross-sectional analysis of the US population


OBJECTIVE: To examine the relationship between body mass index (BMI) and health-related quality-of-life (HRQL), in the presence of dietary controls and/or exercise in a national sample in the United States.

METHODS: BMI and its association with HRQL domains (physical, mental and activity limitations) were examined using the Centers' for Disease Control and Prevention's 2000 Behavioral Risk Factor Surveillence System (BRFSS) data, after adjusting for various sociodemographic factors, self-reported health-status, and diet/exercise behavior.

RESULTS: Based on World Health Organization's (WHO) classification of obesity, the study sample (N=182 372) included approximately 43.7% nonoverweight, 36% overweight, 14% obese, and 7% severely obese respondents. Exercise and dietary modifications were used by 17.5% of overweight, 15.2% of obese, and 12.5% of severely obese individuals. Logistic regression results using nonoverweight BMI as the reference category showed that severely obese (OR=1.87, 95% CI 1.64–2.12) and obese (OR=1.21, 95% CI 1.09–1.33) were more likely to experience greater than 14 unhealthy days affecting the physical health domain. Severely obese (OR=1.41, 95% CI 1.26–1.59) and obese (OR=1.17, 95% CI 1.07–1.28) were also more likely to experience greater than 14 unhealthy days affecting the mental health domain. Similarly, severely obese (OR=1.73, 95% CI 1.50–1.99) and obese (OR=1.22, 95% CI 1.08–1.37) were more likely to experience greater than 14 days with activity limitations. Exercise and dietary controls were associated with better HRQL across all three domains.

CONCLUSION: The study highlights the relationship between BMI and HRQL in the United States. The study also underlines the positive correlation of exercise and dietary modifications with HRQL.

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The authors express their gratitude to the Centers for Disease Control and Prevention in Atlanta, Georgia for furnishing the BRFSS data.

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Correspondence to M K Hassan.

Appendix A: BRFSS HRQL core module

Appendix A: BRFSS HRQL core module

(A) General health

Would you say that in general your health is:

1. Excellent

2. Very good

3. Good

4. Fair

5. Poor

(B) Number of days physical health not good

Now thinking about your physical health, which includes physical illness and injury, for how many days during the past 30 days was your physical health not good?

(C) Number of days mental health not good

Now thinking about your mental health, which includes stress, depression, and problems with emotions, for how many days during the past 30 days was your mental health not good?

(D) Activity limitations

During the past 30 days, for about how many days did poor physical or mental health keep you from doing your usual activities, such as self-care, work, or recreation?

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Hassan, M., Joshi, A., Madhavan, S. et al. Obesity and health-related quality of life: a cross-sectional analysis of the US population. Int J Obes 27, 1227–1232 (2003).

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