Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Paper
  • Published:

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

Abstract

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.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

Similar content being viewed by others

References

  1. Berke EM, Morden NE . Medical management of obesity. Am Fam Physician 2000; 62: 419–426.

    CAS  PubMed  Google Scholar 

  2. Fontaine K, Cheskin L, Borofsky E . Health-related quality of life in obese persons seeking treatment. J Fam Prac 1996; 43: 265–270.

    CAS  Google Scholar 

  3. Katz DA, McHorney CA, Atkinson RL . Impact of obesity on health-related quality of life in patients with chronic illness. J Gen Intern Med 2000; 15: 789–796.

    Article  CAS  Google Scholar 

  4. Myers A, Rosen J . Obesity stigmatization and coping: relation to mental health symptoms, body image and self-esteem. Int J Obes Relat Metab Disord 1999; 23: 221–230.

    Article  CAS  Google Scholar 

  5. Doll HA, Peterson SE, Stewart-Brown SL . Obesity and physical and emotional well-being: associations between body mass index, chronic illness, and the physical and mental components of the SF-36 questionnaire. Obes Res 2000; 8: 160–170.

    Article  CAS  Google Scholar 

  6. Fontaine KR, Bartlett SJ, Barofsky I . Health-related quality of life among obese persons seeking and not currently seeking treatment. Int J Eat Disord 2000; 27: 101–105.

    Article  CAS  Google Scholar 

  7. National Institutes of Health/National Heart, Lung and Blood Institute. Clinical guidelines on the identification, evaluation and treatment of overweight and obesity in adults—the evidence report. Obes Res 1998; 6(Suppl): 51S–209S.

  8. Centers for Disease Control and Prevention. Measuring healthy days. CDC: Atlanta, Georgia; November 2000.

  9. Centers of Disease Control and Prevention. Health-related quality of life among persons with epilepsy—Texas, 1998. MMWR 2001; 50: 24–26, 35.

  10. Newschaffer CJ . Validation of Behavioral Risk Factor Surveillance System (BRFSS) HRQOL measures in a statewide sample. CDC: Atlanta; 1998.

    Google Scholar 

  11. Idler E, Benyamini Y . Self-rated health and mortality: a review of twenty-seven community studies. J Health Soc Behav 1997; 38: 21–37.

    Article  CAS  Google Scholar 

  12. Ford E, Moriarty D, Zack M . Self-reported body mass index and health-related quality of life: findings from the BRFSS. Obes Res 2001; 9: 21–31.

    Article  CAS  Google Scholar 

  13. Flegal KM, Carrol MD, Kuczmarski RJ, Johnson CL . Overweight and obesity in the United States: prevalence and trends, 1960–1994. Int J Obes Relat Metab Disord 1998; 22: 39–47.

    Article  CAS  Google Scholar 

  14. Mokdad A, Serdula K, Dietz W . The spread of obesity epidemic in the United States, 1991–1998. JAMA 1999; 282: 1519–1522.

    Article  CAS  Google Scholar 

  15. Levy AS et al. Weight control practices of US adults trying to lose weight. Ann Intern Med 1993; 119: 661–666.

    Article  CAS  Google Scholar 

  16. French SA, Jeffery RW, Murray D . Is dieting good for you? Prevalence, duration and associated weight and behavior changes for specific weight loss strategies over four years in US adults. Int J Obes Relat Metab Disord 1999; 23: 320–327.

    Article  CAS  Google Scholar 

  17. Stewart A, Brooks R . Effects of being overweight. Am J Public Health 1986; 76: 1410–1415.

    Article  Google Scholar 

  18. Mathias SD, Williamson CL, Colwell HH . Assessing health-related quality of life and health state preference in persons with obesity: a validation study. Qual Life Res 1997; 6:311–322.

    Article  CAS  Google Scholar 

  19. Rothblum ED . The relationship between obesity, employment discrimination and employment related victimization. J Voc Behav 1990; 37: 251–266.

    Article  Google Scholar 

  20. Brownell KD . Execise and obesity treatment: psychological aspects. Int J Obes Relat Metab Disord 1995; 19(Suppl): S122–S125.

    PubMed  Google Scholar 

  21. Wing RR, Epstein LH, Marcus MD, Kupfer DJ . Mood changes in behavioral weight loss programs. J Psychosom Res 1984; 28: 189–196.

    Article  CAS  Google Scholar 

  22. Stein AD, Lederman RI, Shea S . The Behavioral Risk Factor Surveillance System Questionnaire: its reliability in a statewide sample. Am J Public Health 1993; 83: 1768–1772.

    Article  CAS  Google Scholar 

  23. Jackson C, Jatulis DE, Fortmann SP . The Behavioral Risk Factor Survey and the Stanford Five-City Project Survey: a comparison of cardiovascular risk behavior estimates. Am J Public Health 1992; 82: 412–416.

    Article  CAS  Google Scholar 

  24. Healthy People 2010. Leading health Indicators. Available at: http://www.health.gov/healthypeople/Document/html/uih/uih_bw/uih_4.htm#overandobese. Accessed 07/11/02.

Download references

Acknowledgements

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

Author information

Authors and Affiliations

Authors

Corresponding author

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?

Rights and permissions

Reprints and permissions

About this article

Cite this article

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). https://doi.org/10.1038/sj.ijo.0802396

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.ijo.0802396

Keywords

This article is cited by

Search

Quick links