Factors that Moderate the Relationship between Obesity and Physical Quality of Life
January 30, 2009 by rainier
In addition to overall evidence linking obesity and impaired physical quality of life, numerous factors that moderate the relationship have been identified including demographic variables, obesity-related factors, and treatment seeking. First, women appear to be more vulnerable to the negative effects of obesity on quality of life. Obese women tend to report poorer health-related quality of life than obese men do . Among women, higher body weight also is associated with higher rates of health care utilization .
Severity of obesity clearly is related to physical quality of life; that is, more severely obese individuals report poorer health than do those with milder obesity. For example, Doll et al found a strong linear relationship between BMI and poorer quality of life. Similarly, data from the Swedish Obese Subjects study , a longitudinal study of severely obese men (BMI > 34 kg/m2) and women (BMI > 38 kg/m2) have documented that health-related quality of life in severely obese individuals is significantly more impaired than in less obese individuals.
Central adiposity, or an excess of visceral fat, also has been associated with increased morbidity, independent of BMI . Measurements of waist-to-hip ratio (WHR) and waist circumference have gained acceptance as useful proxies for amount of visceral adipose tissue, and are associated with cardiovascular risk factors and poorer health outcomes. Specifically, in adults, waist circumferences > 35 inches in women and > 40 inches in men or a WHR >1 are associated with higher risk for the development of obesity related risk factors including hypertension, hyperlipidemia, and type 2 diabetes . There is substantial evidence that men and women with large waist circumferences have an excess burden of poor health. For example, in a large cross-sectional, population-based study of Dutch men and women , the risk of major cardiovascular risk factors, type 2 diabetes, back problems, and problems with activities of daily living increased significantly for men and women with greater waist circumferences.
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