Being overweight has broader repercussions than its oft-discussed association with diabetes, stroke, heart disease, cancer and arthritis. It can affect quality of life, according to a study.
"The health burden of obesity goes beyond its association with specific disease states," said lead author David A. Katz, MD, MSc, of the University of Wisconsin, Madison. "Bodily functions that non-obese people take for granted are disturbed in people who are obese."
Katz and colleagues analyzed health data on nearly 3,000 patients who were seeing their doctors for a variety of typical medical concerns. Patients completed a quality-of-life survey that measured items such as physical functioning, bodily pain, health perceptions and vitality. Patients’ body mass index (BMI) was also measured.
BMI -- the measurement of choice for those who study obesity -- uses a mathematical formula that takes into account both height and weight. BMI equals a person’s weight in kilograms divided by height in meters squared (BMI=kg/m²). Overweight is defined as having a BMI of 25 to 29.9 kg/m², and obesity is defined as a BMI of 30 kg/m², according to the study.
Overweight and obese patients had significantly lower physical functioning levels than non-overweight patients. Also, obese patients perceived their health as worse and had lower levels of vitality than non-overweight patients, Katz and colleagues found.
"Because of their increased weight, patients with high BMI are more likely to be limited in basic activities of daily living, including walking several blocks, bending, kneeling and stooping," said Katz.
The researchers noted significant racial as well as gender differences among the overweight study participants. Relative to non-overweight participants, overweight blacks rated their quality of life as lower than overweight whites, and overweight women rated their quality of life as lower than overweight men.
"The effects of obesity on general health perceptions may be mediated in part by poor self-image, which is exacerbated by negative attitudes of peers, family members, health professionals and potential employers toward obese persons, and powerful societal messages to be thin," noted Katz.
The results of this study appear in the current issue of the Journal of General Internal Medicine.
More than 50 percent of the U.S. adult population is overweight, according to data from the 1988-1994 Third National Health and Nutrition Examination Survey (NHANES III). Also, over the past two decades, obesity has increased more than 50 percent -- from 14.5 percent to 22.5 percent of adults, according to the National Institutes of Health.
"Our findings demonstrate that even modest levels of overweight are associated with significant reductions in health-related quality of life," said Katz, who noted that national BMI standards "provide a useful target for clinicians in working with patients to set realistic goals for weight loss."
Dr. Katz was supported in part by the Robert Wood Johnson Generalist Physician Faculty Scholars Program and the University of Wisconsin Department of Medicine at the time of this work. The Medical Outcomes Study data collection and analysis were sponsored by grants from the Henry J. Kaiser Family Foundation, the Robert Wood Johnson Foundation, the Pew Charitable Trusts, the National Institute on Aging, the National Institute of Mental Health, the RAND Corporation and The New England Medical Center.
The Journal of General Internal Medicine, a monthly peer-reviewed journal of the Society of General Internal Medicine, publishes original articles on research and education in primary care. For information about the journal, contact Renee F. Wilson at (410) 955-9868.
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Journal of General Internal Medicine