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Keramat SA, Perales F, Alam K, Rashid R, Haque R, Monasi N, Hashmi R, Siddika F, Siddiqui ZH, Ali MA, Gebremariam ND, Kondalsamy-Chennakesavan S. Multimorbidity and health-related quality of life amongst Indigenous Australians: A longitudinal analysis. Qual Life Res 2024; 33:195-206. [PMID: 37587324 PMCID: PMC10784343 DOI: 10.1007/s11136-023-03500-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/27/2023] [Indexed: 08/18/2023]
Abstract
BACKGROUND The burden of multimorbidity has been observed worldwide and it has significant consequences on health outcomes. In Australia, health-related quality of life (HRQoL) is comparatively low amongst Aboriginal and/or Torres Strait Islanders, yet no studies have examined the effect of multimorbidity on HRQoL within this at-risk population. This study seeks to fill that gap by employing a longitudinal research design. METHODS Longitudinal data were derived from three waves (9, 13, and 17) of the household, income and labour dynamics in Australia (HILDA) Survey. A total of 1007 person-year observations from 592 Aboriginal and/or Torres Strait Islander individuals aged 15 years and above were included. HRQoL was captured using the 36-item Short-Form Health Survey (SF-36), and multimorbidity was defined using self-reports of having been diagnosed with two or more chronic health conditions. Symmetric fixed-effects linear regression models were used to assess how intraindividual changes in multimorbidity were associated with intraindividual changes in HRQoL. RESULTS Approximately 21% of Indigenous Australians were classified as experiencing multimorbidity. Respondents had statistically significantly lower HRQoL on the SF-36 sub-scales, summary measures, and health-utility index in those observations in which they experienced multimorbidity. Among others, multimorbidity was associated with lower scores on the SF-36 physical-component scale (β = - 6.527; Standard Error [SE] = 1.579), mental-component scale (β = - 3.765; SE = 1.590) and short-form six-dimension utility index (β = - 0.075; SE = 0.017). CONCLUSION This study demonstrates that having multiple chronic conditions is statistically significantly associated with lower HRQoL amongst Indigenous Australians. These findings suggest that comprehensive and culturally sensitive health strategies addressing the complex needs of individuals with multimorbidity should be implemented to improve the HRQoL of Indigenous Australians.
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Affiliation(s)
- Syed Afroz Keramat
- Faculty of Medicine, Centre for Health Services Research, The University of Queensland, Brisbane, QLD, Australia.
- Economics Discipline, Khulna University, Khulna, 9208, Bangladesh.
| | - Francisco Perales
- School of Social Science, The University of Queensland, Michie Building (#9), St Lucia, Brisbane, QLD, 4067, Australia
| | - Khorshed Alam
- School of Business and Centre for Health Research, University of Southern Queensland, Toowoomba, QLD, 4350, Australia
| | - Rumana Rashid
- Economics Discipline, Khulna University, Khulna, 9208, Bangladesh
| | - Rezwanul Haque
- School of Business and Centre for Health Research, University of Southern Queensland, Toowoomba, QLD, 4350, Australia
| | - Nahid Monasi
- School of Business and Centre for Health Research, University of Southern Queensland, Toowoomba, QLD, 4350, Australia
| | - Rubayyat Hashmi
- School of Business and Centre for Health Research, University of Southern Queensland, Toowoomba, QLD, 4350, Australia
| | - Farzana Siddika
- Department of Mathematics and Natural Sciences, BRAC University, Dhaka, Bangladesh
| | - Zubayer Hassan Siddiqui
- Department of Business Administration, Bangladesh University of Professionals, Dhaka, Bangladesh
| | - Mohammad Afshar Ali
- School of Business and Centre for Health Research, University of Southern Queensland, Toowoomba, QLD, 4350, Australia
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Lifestyle Risk Factors for Overweight/Obesity in Spanish Children. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9121947. [PMID: 36553390 PMCID: PMC9777298 DOI: 10.3390/children9121947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 11/29/2022] [Accepted: 12/03/2022] [Indexed: 12/14/2022]
Abstract
Childhood obesity is one of the main public health concerns in Europe. The aim was to identify possible risk factors associated with overweight/obesity in Spanish preschool and school-age children. The sample (1075 (50.7% girls) children aged 3 to 12) is part of the project 'Alimentando el Cambio' whose objective is to promote healthy lifestyles in schools. Child height and weight were measured, and parents filled out questionnaires related to the children's lifestyle. There was a positive and significant association between sweetened beverage consumption and body mass index (BMI) z-score in both sexes and age groups. There was a negative and significant association between BMI z-score and dairy products in girls of both age groups. There was also a protective effect of regular nut consumption on overweight/obesity in girls 6-12 y. Night-time sleep during weekdays showed a negative association with BMI z-score for older boys and girls. A positive and significant association was found between total screen time and BMI z-score during weekdays. Regarding emotional well-being and self-esteem, having girls 6-12 y laughing and feeling happy and good about themselves in the last week was a protective factor against overweight/obesity. Childhood obesity prevention efforts may benefit from targeting these key risk factors.
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Chen M, Yin W, Sung-Chan P, Wang Z, Shi J. The Interactive Role of Family Functioning among BMI Status, Physical Activity, and High-Fat Food in Adolescents: Evidence from Shanghai, China. Nutrients 2022; 14:nu14194053. [PMID: 36235707 PMCID: PMC9572029 DOI: 10.3390/nu14194053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 09/24/2022] [Accepted: 09/26/2022] [Indexed: 11/16/2022] Open
Abstract
Objectives: Family functioning (FF), physical activity (PA), and high-fat food consumption (HF) are associated with adolescents being overweight and obese; however, little is known about their interactions. Therefore, this study aimed to examine how they work jointly on adolescent obesity with BMI as the outcome variable. Methods: A cross-sectional survey utilizing a cluster sampling design was conducted. Multinomial logistic regressions, multiplication interaction (MI), and marginal effects (MEs) were tested. Results: Active PA (non-overweight vs. obesity: OR = 2.260, 95% CI [1.318, 3.874]; overweight vs. obesity: OR = 2.096, 95% CI [1.167, 3.766]), healthy HF (non-overweight vs. obesity: OR = 2.048, 95% CI [1.105, 3.796]) and healthy FF (overweight vs. obesity: OR = 2.084, 95% CI [1.099, 3.952]) reduced obesity risk. Overweight students with healthy FF were less likely to become obese regardless of PA (inactive: OR = 2.181, 95% CI [1.114, 4.272]; active: OR = 3.870, 95% CI [1.719, 8.713]) or HF (unhealthy: OR = 4.615, 95% CI [1.049, 20.306]; healthy: OR = 5.116, 95% CI [1.352, 19.362]). The MEs of inactive PA and unhealthy FF were −0.071, 0.035, and 0.036 for non-overweight, overweight, and obese individuals, respectively (p < 0.05); the MEs of HF and healthy FF individuals were −0.267 and 0.198 for non-overweight and obese individuals, respectively (p < 0.05). Conclusions: Unhealthy FF regulated the influence of inactive PA or unhealthy HF on adolescent obesity, altogether leading to a higher risk of obesity.
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Affiliation(s)
- Mingyue Chen
- School of Public Health, Shanghai Jiaotong University School of Medicine, Shanghai 200025, China
| | - Wei Yin
- Department of Social and Behavioural Sciences, College of Liberal Arts and Social Sciences, City University of Hong Kong, Hong Kong, China
| | - Pauline Sung-Chan
- Hong Kong Institute of Economics & Business Strategy, HKU School of Business, The University of Hong Kong, Hong Kong, China
- Correspondence: (P.S.-C.); (Z.W.); (J.S.)
| | - Zhaoxin Wang
- The First Affiliated Hospital of Hainan Medical University, Haikou 571199, China
- School of Management, Hainan Medical University, Haikou 571199, China
- Correspondence: (P.S.-C.); (Z.W.); (J.S.)
| | - Jianwei Shi
- Department of General Practice, Yangpu Hospital, Tongji University School of Medicine, Shanghai 200090, China
- Department of Social Medicine and Health Management, School of Public Health, Shanghai Jiaotong University School of Medicine, Shanghai 200025, China
- Correspondence: (P.S.-C.); (Z.W.); (J.S.)
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Kapoor N, Arora S, Kalra S. Gender Disparities in People Living with Obesity - An Unchartered Territory. J Midlife Health 2021; 12:103-107. [PMID: 34526743 PMCID: PMC8409720 DOI: 10.4103/jmh.jmh_48_21] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 05/27/2021] [Accepted: 05/30/2021] [Indexed: 01/21/2023] Open
Abstract
Gender is an important risk factor for the development of obesity. Female gender is associated with twice the risk of being overweight or having obesity. Women are also at higher risk for developing obesity-related physical and psychological comorbidities and have a twofold higher mortality risk than overweight men. Several risk factors have been described to explain the gender bias associated with an obese phenotype and these disparities have far-reaching implications on the medical, psychosocial, and the economical impact of an individual. Despite extensive awareness about gender differences related to obesity, this is still considered as an unchartered territory in obesity medicine. This is probably because of the complex multiple dimensions involved with the understanding of subject coupled with the lack of composite outcomes measures that could assist in the study of these factors. In this scoping review, we share the existing literature regarding the magnitude of gender disparities and gender discrimination in people living with obesity. We describe key factors leading to this gender bias and the impact of this discrimination on the psychological, social, and metabolic health of a given individual with obesity. We also discuss the possible implications of gender disparities on treatment of obesity which may help reduce the current mortality gap between overweight women and men.
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Affiliation(s)
- Nitin Kapoor
- Department of Endocrinology, Diabetes and Metabolism, Christian Medical College, Vellore, Tamil Nadu, India.,Noncommunicable Disease Unit, The Nossal Institute for Global Health, Melbourne School of Population and Global Health, University of Melbourne, Victoria, Australia
| | - Saurabh Arora
- Department of Endocrinology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - Sanjay Kalra
- Department of Endocrinology, Bharti Hospital, Karnal, Haryana, India
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5
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Bhargava A, Arnold AP, Bangasser DA, Denton KM, Gupta A, Hilliard Krause LM, Mayer EA, McCarthy M, Miller WL, Raznahan A, Verma R. Considering Sex as a Biological Variable in Basic and Clinical Studies: An Endocrine Society Scientific Statement. Endocr Rev 2021; 42:219-258. [PMID: 33704446 PMCID: PMC8348944 DOI: 10.1210/endrev/bnaa034] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Indexed: 02/08/2023]
Abstract
In May 2014, the National Institutes of Health (NIH) stated its intent to "require applicants to consider sex as a biological variable (SABV) in the design and analysis of NIH-funded research involving animals and cells." Since then, proposed research plans that include animals routinely state that both sexes/genders will be used; however, in many instances, researchers and reviewers are at a loss about the issue of sex differences. Moreover, the terms sex and gender are used interchangeably by many researchers, further complicating the issue. In addition, the sex or gender of the researcher might influence study outcomes, especially those concerning behavioral studies, in both animals and humans. The act of observation may change the outcome (the "observer effect") and any experimental manipulation, no matter how well-controlled, is subject to it. This is nowhere more applicable than in physiology and behavior. The sex of established cultured cell lines is another issue, in addition to aneuploidy; chromosomal numbers can change as cells are passaged. Additionally, culture medium contains steroids, growth hormone, and insulin that might influence expression of various genes. These issues often are not taken into account, determined, or even considered. Issues pertaining to the "sex" of cultured cells are beyond the scope of this Statement. However, we will discuss the factors that influence sex and gender in both basic research (that using animal models) and clinical research (that involving human subjects), as well as in some areas of science where sex differences are routinely studied. Sex differences in baseline physiology and associated mechanisms form the foundation for understanding sex differences in diseases pathology, treatments, and outcomes. The purpose of this Statement is to highlight lessons learned, caveats, and what to consider when evaluating data pertaining to sex differences, using 3 areas of research as examples; it is not intended to serve as a guideline for research design.
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Affiliation(s)
- Aditi Bhargava
- Center for Reproductive Sciences, San Francisco, CA, USA
- Department of Obstetrics and Gynecology, University of California, San Francisco, CA, USA
| | - Arthur P Arnold
- Department of Integrative Biology & Physiology, University of California, Los Angeles, Los Angeles, CA, USA
| | - Debra A Bangasser
- Department of Psychology and Neuroscience Program, Temple University, Philadelphia, PA, USA
| | - Kate M Denton
- Cardiovascular Disease Program, Monash Biomedicine Discovery Institute and Department of Physiology, Monash University, Clayton, Victoria, Australia
| | - Arpana Gupta
- G. Oppenheimer Center for Neurobiology of Stress and Resilience, Division of Digestive Diseases, University of California, Los Angeles, Los Angeles, CA, USA
| | - Lucinda M Hilliard Krause
- Cardiovascular Disease Program, Monash Biomedicine Discovery Institute and Department of Physiology, Monash University, Clayton, Victoria, Australia
| | - Emeran A Mayer
- G. Oppenheimer Center for Neurobiology of Stress and Resilience, Division of Digestive Diseases, University of California, Los Angeles, Los Angeles, CA, USA
| | - Margaret McCarthy
- Department of Pharmacology and Program in Neuroscience, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Walter L Miller
- Center for Reproductive Sciences, San Francisco, CA, USA
- Department of Pediatrics, University of California, San Francisco, CA, USA
| | - Armin Raznahan
- Section on Developmental Neurogenomics, Human Genetics Branch, National Institutes of Mental Health, Intramural Research Program, Bethesda, MD, USA
| | - Ragini Verma
- Diffusion and Connectomics In Precision Healthcare Research (DiCIPHR) lab, Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
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Yadav R, Yadav RK, Pandey RM, Upadhyay AD. Predictors of Health-Related Quality of Life in Indians with Metabolic Syndrome Undergoing Randomized Controlled Trial of Yoga-Based Lifestyle Intervention vs Dietary Intervention. Behav Med 2021; 47:151-160. [PMID: 31743071 DOI: 10.1080/08964289.2019.1683711] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The present study explores the efficacy of 12-week yoga + diet-based lifestyle intervention (YBLI) vs dietary intervention (DI) on health-related quality of life (HRQoL) and identifies the predictors of change in HRQoL in Indians with metabolic syndrome (Met S). Data from the historical randomized controlled trial was used including adults (n = 260, 20-45 years) with Met S. Four domains of HRQoL were measured at baseline, 2 and 12 weeks using WHOQOL-BREF questionnaire. Generalized estimating equation and chi-square test was used to compare 12-week changes in HRQoL domains and proportion of subjects, respectively. Changes in HRQoL were predicted using regression models concerning changes in body mass index (BMI), physical activity, total calorie intake, adiponectin, and superoxide dismutase (SOD) levels. Exploratory mediation analysis was carried out using Baron & Kenny approach. YBLI resulted in a significantly greater increase in the physical domain score of HRQoL than DI. A significantly greater proportion of subjects in YBLI group (71%) showed an increase in physical domain scores compared to DI (51%). A unit change in BMI negatively predicted a unit change in physical, psychological and environmental health. Whereas, a unit change in adiponectin and SOD levels positively predicted a unit change in physical and environmental health. Partial mediation between YBLI intervention and physical HRQoL domain was observed via adiponectin. In conclusion, a 12-week YBLI has a positive and greater effect on HRQoL physical domain score than following DI alone. Changes in BMI, adiponectin, and SOD levels may predict changes in HRQoL domains after lifestyle intervention.
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Affiliation(s)
- Rashmi Yadav
- Department of Physiology, All India Institute of Medical Sciences
| | - Raj Kumar Yadav
- Department of Physiology, All India Institute of Medical Sciences
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7
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Smith MP. Self-estimated BMI, but not self-perceived body size, accurately identifies unhealthy weight in US adults. BMC Public Health 2021; 21:253. [PMID: 33516202 PMCID: PMC7847588 DOI: 10.1186/s12889-021-10316-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 01/24/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Self-perceptions of health and disease can be a major driver of health behaviors. Improving accuracy of self-ascertainment of obesity may prompt uptake of weight-control behaviors in those with obesity. METHODS We assess performance of self-perceived body size ('too small', 'about right' or 'too large'), self-estimated BMI in kg/m2, and sociodemographics in detecting measured BMI category (under-, normal-, overweight and obese; BMI cutpoints 18.5, 25 and 30) in first bivariate and then multivariable models. RESULTS Of 37,281 adults in the US from NHANES, 2, 34, 33 and 32% were under-, normal-, overweight and obese. Respectively 56, 73, 60 and 91% self-perceived as 'too small', 'about right', 'too large' and 'too large.' Of those who self-perceived as 'too small', 22% were underweight and 10% were overweight or obese. 99.7% of obese participants self-estimated a BMI in the overweight/obese range, including many who did not self-perceive as 'too large'. Among obese participants, self-perception as either 'about right' or 'too small' was more likely for those who were younger (OR for perception as 'too large' 1.01 per year, 95% confidence interval 1.00-1.01) male (OR 0.33, (0.28-0.39)) nonwhite (ORs 0.36-0.79 for different ethnicities), low-income (ORs 0.61 and 1.8 for the lowest and highest of six categories, vs. the third) or measured recently (OR 0.98 (0.96-1.0) per year since 1999). Misperception was less common, but still existed, for participants with moderate or severe obesity (ORs 2.9 (2.3-3.5) and 7.9 (5.4-12), vs. 'mild.') (all p < 0.01.) CONCLUSIONS: A tenth of adults in the US with obesity, especially those from overweight peer groups, self-perceive as normal or underweight and thus may not be motivated to control their weight. However, virtually all self-estimate an overweight or obese BMI. If measured BMI is not available, self-estimates are sufficiently accurate that interventions may rely on it to identify obesity.
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Affiliation(s)
- Maia Phillips Smith
- St. George's University School of Medicine, PO Box 7, True Blue, West Indies, Grenada.
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Nadjidai SE, Kusljic S, Dowling NL, Magennis J, Stokes L, Ng CH, Daniel C. Physical comorbidities in private psychiatric inpatients: Prevalence and its association with quality of life and functional impairment. Int J Ment Health Nurs 2020; 29:1253-1261. [PMID: 32677324 DOI: 10.1111/inm.12764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 06/10/2020] [Accepted: 06/11/2020] [Indexed: 11/26/2022]
Abstract
The aim of this study was to examine the association between physical health conditions and quality of life and functioning in private psychiatric inpatients. We sought to determine whether quality of life and functioning was poorer in individuals with physical comorbidity compared to those without. A quantitative correlational descriptive design was utilized. Seventy patients were included in sequential order within a week of admission to hospital. Participants completed the SF-36 survey, and the corresponding hospital records were audited. The STROBE guidelines were followed in the reporting of this research. The study found that 64.3% (45/70) of participants had one or more comorbid physical health conditions, primarily cardiovascular, respiratory, musculoskeletal, endocrine and medically unexplained conditions or syndromes. Chronic pain was experienced by 40% (28/70) of participants, and 47.6% (33/70) were found to be overweight or obese. Tobacco smoking and obesity were risk factors associated with physical comorbidity (P = 0.02 and P < 0.001, respectively). Quality of life and functioning were poorer in those with physical health conditions, particularly in the SF-36 domains of bodily pain, physical functioning and general health (P < 0.001, P = 0.003 and P = 0.005, respectively). Physical health conditions were largely prevalent, and quality of life and functioning were poorer in those with physical comorbidities. The implementation of clinical guidelines for the monitoring of physical health has been proposed as well as a dedicated physical health nursing role. Continuation of integrative programmes focusing on both physical and mental health may also benefit patients in this setting.
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Affiliation(s)
- Sarah E Nadjidai
- Professorial Unit, Department of Psychiatry, The Melbourne Clinic, The University of Melbourne, Melbourne, Victoria, Australia
| | - Snezana Kusljic
- Department of Nursing, The University of Melbourne, Melbourne, Victoria, Australia.,The Florey Institute of Neuroscience and Mental Health, Melbourne, Victoria, Australia
| | - Nathan L Dowling
- Professorial Unit, Department of Psychiatry, The Melbourne Clinic, The University of Melbourne, Melbourne, Victoria, Australia
| | | | - Lisa Stokes
- Department of Nursing, The University of Melbourne, Melbourne, Victoria, Australia.,The Melbourne Clinic, Melbourne, Victoria, Australia
| | - Chee H Ng
- Professorial Unit, Department of Psychiatry, The Melbourne Clinic, The University of Melbourne, Melbourne, Victoria, Australia
| | - Catherine Daniel
- Department of Nursing, The University of Melbourne, Melbourne, Victoria, Australia
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Bullivant B, Mitchison D, Skromanis S, Mond J. Elucidating individuals' beliefs about the severity of eating disorders and obesity: implications for public health programs. Eat Weight Disord 2020; 25:929-938. [PMID: 31098985 DOI: 10.1007/s40519-019-00708-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Accepted: 05/02/2019] [Indexed: 11/25/2022] Open
Abstract
PURPOSE To examine perceptions of the severity of eating disorders and obesity and the effects on these of an information manipulation while also considering the influence of potential covariates such as age, gender, physical and mental health and beliefs about the prevalence and causes of the respective conditions. METHODS Australian women and men (n = 488) aged 18-73 years were randomly assigned to one of four conditions: no information, neutral information, eating disorders emphasis and obesity emphasis. Mixed-model analysis of variance (ANOVA) was used to compare the perceived severity of eating disorders and obesity (within-subjects factor), while also testing the effect of manipulating information, i.e., selectively emphasising the occurrence and adverse effects of one condition or the other (between-subjects factor), on perceptions of severity. Correlational analysis was used to examine associations between perceptions of severity and potential covariates, those covariates for which significant associations were observed being included as covariates in the ANOVA. RESULTS Eating disorders were perceived to be a more severe condition than obesity and the information manipulation was largely ineffective. Perceptions of the severity of both eating disorders and obesity were found to be associated with several covariates, including gender, body dissatisfaction, familiarity with and beliefs about the prevalence of eating disorders and beliefs about the causes of both eating disorders and obesity. CONCLUSIONS The findings support the need for-and provide a platform for-greater collaboration between obesity and eating disorder researchers in the development of integrated prevention and health promotion programs. LEVEL OF EVIDENCE Level III.
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Affiliation(s)
- Bianca Bullivant
- Boden Institute of Obesity, Nutrition, Exercise and Eating Disorders, University of Sydney, Sydney, Australia
- Department of Psychology, Macquarie University, Sydney, Australia
| | - Deborah Mitchison
- Centre for Emotional Health, Macquarie University, Sydney, Australia
- School of Medicine, Western Sydney University, Sydney, Australia
| | - Sarah Skromanis
- Centre for Rural Health, College of Health and Medicine, University of Tasmania, E, Rm 003, Locked Bag 1322, Launceston, TAS, 7250, Australia
| | - Jonathan Mond
- School of Medicine, Western Sydney University, Sydney, Australia.
- Centre for Rural Health, College of Health and Medicine, University of Tasmania, E, Rm 003, Locked Bag 1322, Launceston, TAS, 7250, Australia.
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Bullivant B, Denham AR, Stephens C, Olson RE, Mitchison D, Gill T, Maguire S, Latner JD, Hay P, Rodgers B, Stevenson RJ, Touyz S, Mond JM. Elucidating knowledge and beliefs about obesity and eating disorders among key stakeholders: paving the way for an integrated approach to health promotion. BMC Public Health 2019; 19:1681. [PMID: 31842820 PMCID: PMC6916014 DOI: 10.1186/s12889-019-7971-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2019] [Accepted: 11/19/2019] [Indexed: 12/22/2022] Open
Abstract
Background Understanding the knowledge and beliefs of key stakeholders is crucial in developing effective public health interventions. Knowledge and beliefs about obesity and eating disorders (EDs) have rarely been considered, despite increasing awareness of the need for integrated health promotion programs. We investigated key aspects of knowledge and beliefs about obesity and EDs among key stakeholders in Australia. Methods Using a semi-structured question guide, eight focus groups and seven individual interviews were conducted with 62 participants including health professionals, personal trainers, teachers and consumer group representatives. An inductive thematic approach was used for data analysis. Results The findings suggest that, relative to obesity, EDs are poorly understood among teachers, personal trainers, and certain health professionals. Areas of commonality and distinction between the two conditions were identified. Integrated health promotion efforts that focus on shared risk (e.g., low self-esteem, body dissatisfaction) and protective (e.g., healthy eating, regular exercise) factors were supported. Suggested target groups for such efforts included young children, adolescents and parents. Conclusions The findings indicate areas where the EDs and obesity fields have common ground and can work together in developing integrated health promotion programs.
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Affiliation(s)
- Bianca Bullivant
- Boden Institute of Obesity, Nutrition, Exercise and Eating Disorders, Faculty of Medicine, The University of Sydney, Sydney, NSW, 2006, Australia. .,Macquarie University, Sydney, New South Wales, Australia.
| | - Aaron R Denham
- Macquarie University, Sydney, New South Wales, Australia
| | - Clare Stephens
- Macquarie University, Sydney, New South Wales, Australia
| | - Rebecca E Olson
- The University of Queensland, St. Lucia, Queensland, Australia
| | - Deborah Mitchison
- Macquarie University, Sydney, New South Wales, Australia.,Western Sydney University, Penrith, New South Wales, Australia
| | - Timothy Gill
- Boden Institute of Obesity, Nutrition, Exercise and Eating Disorders, Faculty of Medicine, The University of Sydney, Sydney, NSW, 2006, Australia
| | - Sarah Maguire
- Boden Institute of Obesity, Nutrition, Exercise and Eating Disorders, Faculty of Medicine, The University of Sydney, Sydney, NSW, 2006, Australia
| | | | - Phillipa Hay
- Western Sydney University, Penrith, New South Wales, Australia
| | - Bryan Rodgers
- Australian National University, Canberra, Australian Capital Territory, Australia
| | | | - Stephen Touyz
- Boden Institute of Obesity, Nutrition, Exercise and Eating Disorders, Faculty of Medicine, The University of Sydney, Sydney, NSW, 2006, Australia
| | - Jonathan M Mond
- Western Sydney University, Penrith, New South Wales, Australia.,University of Tasmania, Launceston, Tasmania, Australia
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Kilpela LS, Verzijl CL, Becker CB. Body image in older women: a mediator of BMI and wellness behaviors. J Women Aging 2019; 33:298-311. [PMID: 31751189 DOI: 10.1080/08952841.2019.1692629] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Negative body image is prevalent among mid- and late-life women. In younger women, negative body image is associated with reduced quality of life (QOL) when controlling for body mass index (BMI), and mediates the relationship between obesity and emotional wellbeing. Yet, much remains unknown about body image in older populations. In our sample of women aged 50-86 (N = 181), negative body image mediated the relationship between BMI and sleep, all four domains of QOL, negative affect, nutritious food consumption, and psychosocial impairment, but not enjoyment of physical activity. Findings suggest negative body image impacts the wellbeing of older women.
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Affiliation(s)
- Lisa Smith Kilpela
- Department of Psychiatry, Barshop Institute for Longevity and Aging Studies, University of Texas Health Science Center San Antonio, San Antonio, TX, USA
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Purton T, Mond J, Cicero D, Wagner A, Stefano E, Rand-Giovannetti D, Latner J. Body dissatisfaction, internalized weight bias and quality of life in young men and women. Qual Life Res 2019; 28:1825-1833. [DOI: 10.1007/s11136-019-02140-w] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/14/2019] [Indexed: 12/20/2022]
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de Montigny F, Cloutier L, Meunier S, Cyr C, Coulombe S, Tremblay G, Auger N, Roy B, Gaboury I, Lavoie B, Dion H, Houle J. Association between weight status and men's positive mental health: The influence of marital status. Obes Res Clin Pract 2016; 11:389-397. [PMID: 28007535 DOI: 10.1016/j.orcp.2016.12.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Revised: 10/25/2016] [Accepted: 12/02/2016] [Indexed: 10/20/2022]
Abstract
The purpose of this study was to (1) examine the association between weight status and men's positive mental health, defined as the presence of symptoms of emotional, psychological, and social well-being, and (2) evaluate the moderating effect of marital status. A total of 645 men aged between 19 and 71 years self-reported their height and weight and answered a questionnaire measuring their emotional, psychological, and social well-being. Analysis of variance revealed that mean levels of emotional, psychological, and social well-being did not significantly differ according to men's weight status. Moderation analyses indicated that, for men in a relationship (married or living common-law), there were no significant associations between overweight, obesity, and the three components of positive mental health. However, for single men, overweight was marginally associated with higher emotional well-being, while obesity was associated with lower psychological well-being and marginally associated with lower social well-being. Results of the present study suggest that health professionals and researchers should take the characteristics (such as marital status) of men with obesity and overweight into account when working with them. Mental health researchers may need to examine men in each weight category separately (e.g. obesity vs. overweight), since the association with positive mental health can differ from one category to another.
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Affiliation(s)
| | - Lyne Cloutier
- Department of Nursing, Université du Québec à Trois-Rivières, Trois-Rivières, Canada.
| | - Sophie Meunier
- Department of Psychology, Université du Québec à Montréal, Montréal, Canada.
| | - Caroline Cyr
- Department of Psychology and Psychoeducation, Université du Québec en Outaouais, Gatineau, Canada.
| | - Simon Coulombe
- Department of Psychology, Université du Québec à Montréal, Montréal, Canada.
| | - Gilles Tremblay
- School of Social Work, Université Laval, Québec City, Canada.
| | - Nathalie Auger
- Institut national de santé publique du Québec, Montréal, Canada.
| | - Bernard Roy
- Faculty of Nursing, Université Laval, Québec City, Canada.
| | - Isabelle Gaboury
- Department of Family Medicine and Emergency Medicine, Université de Sherbrooke, Canada.
| | | | - Harold Dion
- Clinique médicale l'Actuel, Montréal, Canada.
| | - Janie Houle
- Department of Psychology, Université du Québec à Montréal, Montréal, Canada.
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George S, Bergin C, Clarke S, Courtney G, Codd MB. Health-related quality of life and associated factors in people with HIV: an Irish cohort study. Health Qual Life Outcomes 2016; 14:115. [PMID: 27495166 PMCID: PMC4974803 DOI: 10.1186/s12955-016-0517-4] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Accepted: 07/29/2016] [Indexed: 12/22/2022] Open
Abstract
Background Considering the chronic and debilitating nature of HIV infection, health-related quality of life (HRQoL) is an important patient-reported clinical outcome to better understand the effects of this infection and its treatment on patients’ lives. The purpose of this study was to assess the HRQoL and its association with sociodemographic, behavioural, clinical, nutrition-related factors and social support in an Irish HIV cohort. Methods A cross-sectional, prospective study using the Medical Outcomes Study HIV Health survey assessed the 10 dimensions of HRQoL and summarised as Physical Health Summary (PHS) and Mental Health Summary (MHS) scores. Participants were categorised as having good or poor PHS and MHS using the standardised mean score of 50. The variables independently associated with PHS and MHS were identified using multivariable logistic regression models. Results Overall, 521 participants completed the HRQoL questionnaire. The median (IQR) PHS and MHS scores were 56 (47–60) and 51 (41–58) respectively. All the covariate groups had lower MHS than PHS. Participants with symptoms of HIV reported the lowest median (IQR) PHS score 44.7 (32.–54.5) and MHS score 36.1 (28.6–48.4). Of the 10 dimensions of HRQoL, the lowest scores were for the energy level and general health. Symptoms of HIV, co-morbidities, social support, employment and ethnicity had independent association with both PHS and MHS. Gender, education, alcohol intake and HIV-complications were associated with PHS. Age, illicit drugs, BMI and malnutrition were associated with MHS. However, CD4 count and viral load were not independently associated with PHS and MHS in multivariable regression models. Conclusion Overall, HIV-infected people in this cohort had an average level of HRQoL. However, it is impaired in people with symptoms and co-morbidities, and not independently associated with CD4 and viral load. Alleviating HIV symptoms and preventing co-morbidities are important in managing HIV. Providing psychosocial supports for behaviour modification and return to work or exploring new opportunities will help to improve HRQoL. Healthcare providers and policy makers need to plan and implement programs to routinely assess the HRQoL in a systematic method to facilitate a holistic management of HIV.
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Affiliation(s)
- Sherly George
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Woodview House, Belfield, Dublin 4, Ireland.
| | - Colm Bergin
- GUIDE Clinic, St James's Hospital Dublin, Dublin, Ireland.,Department of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Susan Clarke
- GUIDE Clinic, St James's Hospital Dublin, Dublin, Ireland
| | | | - Mary B Codd
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Woodview House, Belfield, Dublin 4, Ireland
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Yadav R, Yadav RK, Pandey RM, Kochar KP. Effect of a Short-Term Yoga-Based Lifestyle Intervention on Health-Related Quality of Life in Overweight and Obese Subjects. J Altern Complement Med 2016; 22:443-9. [DOI: 10.1089/acm.2015.0268] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Rashmi Yadav
- Department of Physiology, All India Institute of Medical Sciences, New Delhi, India
| | - Raj Kumar Yadav
- Department of Physiology, All India Institute of Medical Sciences, New Delhi, India
| | - Ravindra Mohan Pandey
- Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
| | - Kanwal P. Kochar
- Department of Physiology, All India Institute of Medical Sciences, New Delhi, India
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Torres KDP, Rosa MLG, Moscavitch SD. Gender and obesity interaction in quality of life in adults assisted by family doctor program in Niterói, Brazil. CIENCIA & SAUDE COLETIVA 2016; 21:1617-24. [PMID: 27166909 DOI: 10.1590/1413-81232015215.10832015] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2015] [Accepted: 11/16/2015] [Indexed: 11/21/2022] Open
Abstract
Obesity impacts the quality of life (HRQL). Studies about the effects of a possible interaction between gender and body mass are rare. The objective of the present paper is to estimate the biological interaction between gender and obesity on HRQL. This was a cross-sectional study based on data from CAMELIA study with population assisted by the Family Doctor Program of Niteroi visited between June 2006 and December 2007. HRQL was assessed by the SF-36. The exposure categories were: obese women, non-obese women, obese men and non-obese men, the reference category. Obese women showed higher percentages of low overall, physical and mental quality of life with the largest associations in the physical component. The excess risk due to interaction was statistically significant in physical dimension: RERI = 1.97 (0.40-3.52) and RERIa = 1,97 (0.40-1.7). Among the Brazilian population aged 20-64 years, obesity was independently associated with low HRQL. This association differed by gender, being significant for women. The possibility of the combined effect takes greater importance in the context of increasing incidence of obesity globally. Healthcare professionals in primary care settings should pay attention to gender differences in the impact of obesity on HRQL.
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Affiliation(s)
- Karla Dala Paula Torres
- Departamento de Epidemiologia e Bioestatística, Universidade Federal Fluminense, Niterói, RJ, Brasil,
| | - Maria Luiza Garcia Rosa
- Departamento de Epidemiologia e Bioestatística, Universidade Federal Fluminense, Niterói, RJ, Brasil,
| | - Samuel Datum Moscavitch
- Departamento de Epidemiologia e Bioestatística, Universidade Federal Fluminense, Niterói, RJ, Brasil,
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Audureau E, Pouchot J, Coste J. Gender-Related Differential Effects of Obesity on Health-Related Quality of Life via Obesity-Related Comorbidities: A Mediation Analysis of a French Nationwide Survey. Circ Cardiovasc Qual Outcomes 2016; 9:246-56. [PMID: 27166204 DOI: 10.1161/circoutcomes.115.002127] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Accepted: 04/08/2016] [Indexed: 12/13/2022]
Abstract
BACKGROUND Negative effects of obesity on health-related quality of life (HRQoL) have been reported, especially in women, but the relative contribution of cardiometabolic and other obesity-related comorbidities to such effects remains unclear. Our objective was to model the association by sex between body mass index and HRQoL and to precisely quantify the indirect effects mediated by obesity-related comorbidities. METHODS AND RESULTS Data were drawn from the latest French Decennial Health Survey, a nationwide cross-sectional study conducted in 2003 (21 239 adults aged 25-64 years analyzed). HRQoL was measured by the 36-item short-form health survey questionnaire. A mediation analysis based on the counterfactual framework was performed to quantify the proportion of obesity effects on HRQoL mediated by related comorbidities, including cardiometabolic risk factors (diabetes mellitus, hypertension, dyslipidemia) and diseases (ischemic heart disease, cerebrovascular, and peripheral vascular disease), musculoskeletal disorders, and asthma. After multiple linear regression, inverse associations were found between increasing body mass index category and physically oriented and most mentally oriented 36-item short-form health survey dimensions, with evidence of greater effects in women. Mediation analysis revealed that obesity effects were significantly mediated by several comorbidities, more apparently in men (eg, proportion of obesity class II total effect mediated via cardiometabolic factors: general health 27.0% [men] versus 13.6% [women]; proportion of obesity class II total effect mediated via total count of comorbidities: physical functioning 17.8% [men] versus 7.7% [women] and general health 37.1% [men] versus 20.3% [women]). CONCLUSIONS Women have a greater overall impact of obesity on HRQoL, but with proportionally lower effects mediated by cardiometabolic and other obesity-related conditions, suggesting the possible role of other specific psychosocial processes.
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Affiliation(s)
- Etienne Audureau
- From the Biostatistics and Epidemiology Unit, Assistance Publique-Hôpitaux de Paris, Hôtel Dieu, Paris, France (E.A., J.C.); Research unit APEMAC, EA 4360, Université Paris-Descartes, Sorbonne Paris Cité, Université de Lorraine, France (E.A., J.P., J.C.); and Department of Internal Medicine, Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Paris, France (J.P.).
| | - Jacques Pouchot
- From the Biostatistics and Epidemiology Unit, Assistance Publique-Hôpitaux de Paris, Hôtel Dieu, Paris, France (E.A., J.C.); Research unit APEMAC, EA 4360, Université Paris-Descartes, Sorbonne Paris Cité, Université de Lorraine, France (E.A., J.P., J.C.); and Department of Internal Medicine, Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Paris, France (J.P.)
| | - Joël Coste
- From the Biostatistics and Epidemiology Unit, Assistance Publique-Hôpitaux de Paris, Hôtel Dieu, Paris, France (E.A., J.C.); Research unit APEMAC, EA 4360, Université Paris-Descartes, Sorbonne Paris Cité, Université de Lorraine, France (E.A., J.P., J.C.); and Department of Internal Medicine, Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Paris, France (J.P.)
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Gauss A, Geiss T, Hinz U, Schaefert R, Zwickel P, Zawierucha A, Stremmel W, Klute L. Quality of Life Is Related to Fecal Calprotectin Concentrations in Colonic Crohn Disease and Ulcerative Colitis, but not in Ileal Crohn Disease. Medicine (Baltimore) 2016; 95:e3477. [PMID: 27100452 PMCID: PMC4845856 DOI: 10.1097/md.0000000000003477] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
To formulate therapy goals, we aimed to define the relationship between fecal calprotectin and health-related quality of life in inflammatory bowel diseases (IBDs). This retrospective single-center cross-sectional study included ambulatory IBD patients who had completed standardized questionnaires comprising items of health-related quality of life (Short Inflammatory Bowel Disease Questionnaire) and clinical disease activity scores, and who had provided stool samples for calprotectin determination within 30 days of questionnaire completion. Correlation analyses were performed between the indicated parameters. Post hoc analysis was conducted, taking into account only data from patients with fecal calprotectin concentrations measured within 3 days of questionnaire completion. One hundred ninety-seven patients with Crohn disease and 111 patients with ulcerative colitis were enrolled in the study. Lower fecal calprotectin concentrations were associated with better health-related quality of life. The correlations were weak, but stronger if only fecal calprotectin concentrations measured within 3 days of questionnaire completion were included (results for 3 days; Crohn disease: n = 86, rS = -0.419, P < 0.001; ulcerative colitis: n = 43, rS = -0.432, P = 0.004). In Crohn disease, a significant correlation between fecal calprotectin concentration and health-related quality of life was found in patients with colonic involvement (n = 59, rS = -0.470, P < 0.001), but not in patients with purely ileal disease (n = 27, rS = -0.268, P = 0.18). Correlations between fecal calprotectin concentrations and clinical disease activity were also only weak to moderate. Owing to its moderate correlation with fecal calprotectin concentrations in IBD patients with colonic involvement, health-related quality of life should be used in combination with other markers for IBD management. This is even more important in isolated ileal Crohn disease, where no significant correlation between fecal calprotectin concentration and health-related quality of life was found. Especially for use in research studies, care should be taken to keep the time between clinical evaluation of IBD patients and the determination of fecal calprotectin concentrations as short as possible.
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Affiliation(s)
- Annika Gauss
- From the Department of Gastroenterology and Hepatology (AG, TG, PZ, AZ, WS, LK), University of Heidelberg, Heidelberg, Germany; Unit for Documentation and Statistics of the Department of Surgery (UH), University of Heidelberg, Heidelberg, Germany; and Department of General Internal Medicine and Psychosomatics (RS), University of Heidelberg, Heidelberg, Germany
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Obesity and psychosocial impairment: mediating roles of health status, weight/shape concerns and binge eating in a community sample of women and men. Int J Obes (Lond) 2014; 39:346-52. [PMID: 24916789 DOI: 10.1038/ijo.2014.100] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2014] [Revised: 05/05/2014] [Accepted: 05/15/2014] [Indexed: 12/17/2022]
Abstract
OBJECTIVES We examined the relative importance of physical health status, weight/shape concerns and binge eating as mediators of the association between obesity and psychosocial impairment in a community sample of women and men. METHODS Self-report measures of eating disorder features, perceived physical health and psychosocial functioning were completed by a general population sample of women and men classified as obese or non-obese (women: obese=276, non-obese=1220; men: obese=169, non-obese=769). Moderated mediation analysis was used to assess the relative importance of each of the putative mediators in accounting for observed associations between obesity and each outcome measure and possible moderation of these effects by sex. RESULTS Weight/shape concerns and physical health were equally strong mediators of the association between obesity and psychosocial impairment. This was the case for both men and women and for each of three measures of psychosocial functioning-general psychological distress, life satisfaction and social support-employed. The effects of binge eating were modest and reached statistical significance only for the life satisfaction measure in men. CONCLUSIONS A greater focus on body acceptance may be indicated in obesity prevention and weight-management programs.
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Abstract
OBJECTIVES Overall obesity, as measured by body mass index (BMI), has been associated with a low level of health-related quality of life (HRQOL), but little is known about abdominal obesity. This cross-sectional study aimed to determine whether abdominal obesity, as measured by waist circumference (WC), would be significantly associated with HRQOL independent of overall obesity, and if so, whether the association would differ by gender among the Korean population. DESIGN Cross-sectional study. SETTING South Korea. PARTICIPANTS Using data from the 2007-2009 Korea National Health and Nutrition Examination Survey, a total of 13 754 men and women aged 19-65 years were selected, and information about height (cm), weight (kg), WC (cm) and the EuroQOL-5 Dimensions (EQ-5D) scores for HRQOL were taken. RESULTS Not only an overall obesity (as categorised into obese, overweight or non-overweight groups based on BMI) but also an abdominal obesity (defined by WC ≥90 cm for men and ≥85 cm for women) was significantly associated with lower EQ-5D scores, after adjusting for age, gender, socioeconomic variables and a number of comorbidities. Even after adjusting BMI effect, the association between abdominal obesity and lower EQ-5D scores remained significant for women, but not for men. CONCLUSIONS Among the Korean population aged 19-65 years, abdominal obesity was associated with impaired HRQOL, independently of overall obesity. Furthermore, this association differed by gender, being significant only for women. Therefore, primary healthcare professionals should pay attention to gender differences in the impact of obesity on HRQOL when evaluating population-based health programmes.
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Affiliation(s)
- Jina Choo
- College of Nursing, Korea University, Seoul, South Korea
| | - Seonhui Jeon
- Medical Division, Green Cross Corp, Yongin, South Korea
| | - Juneyoung Lee
- Department of Biostatistics, College of Medicine, Korea University, Seoul, South Korea
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Lo Coco G, Salerno L, Bruno V, Caltabiano ML, Ricciardelli LA. Binge eating partially mediates the relationship between body image dissatisfaction and psychological distress in obese treatment seeking individuals. Eat Behav 2014; 15:45-8. [PMID: 24411749 DOI: 10.1016/j.eatbeh.2013.10.006] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2013] [Revised: 08/01/2013] [Accepted: 10/09/2013] [Indexed: 10/26/2022]
Abstract
INTRODUCTION We compared the binge eating pathway linking body image dissatisfaction (BID) and psychological distress of obese adults entering and not entering psychological treatment for their weight problems. METHOD 90 obese participants seeking an integrated treatment (OB-IT) and 87 obese participants seeking only medical treatment (OB-MT) for their weight problems completed questionnaires on BID, binge eating and psychological well-being. RESULTS Only in the OB-IT group, binge eating behaviors mediated the relationship between BID and psychological distress. CONCLUSIONS Both BID and binge eating behaviors need to be addressed in the psychological and medical treatment for obesity to enhance psychological well-being.
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Affiliation(s)
- Gianluca Lo Coco
- Department of Psychology, Università degli Studi di Palermo, Viale delle Scienze, Edificio 15, 90128 Palermo, Italy.
| | - Laura Salerno
- Department of Psychology, Università degli Studi di Palermo, Viale delle Scienze, Edificio 15, 90128 Palermo, Italy
| | - Vincenzo Bruno
- Center of Eating Disorders Ce.Di.Al., ASP Palermo, Via Papa Sergio I, 90100 Palermo, Italy
| | - Marie Louise Caltabiano
- Department of Psychology, School of Arts and Social Sciences, James Cook University, Cairns, QLD 4811, Australia
| | - Lina A Ricciardelli
- School of Psychology, Deakin University, 221 Burwood Highway, Burwood, Victoria 3125, Australia
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Garrido D, Bush LM. Liver abscess as a complication of laparoscopic gastric banding bariatric surgery. Surg Infect (Larchmt) 2013; 14:464-9. [PMID: 23862560 DOI: 10.1089/sur.2012.023] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND The World Health Organization has identified the rapidly growing prevalence of obesity as one of today's serious health problems. Various surgical interventions categorized collectively as bariatric surgery now play an ever-increasing important role as the only known effective treatment for severe obesity. Laparoscopic gastric bypass is currently the most frequent bariatric surgical procedure performed. However, the laparoscopic adjustable gastric band (LAGB) is rapidly gaining in popularity as a minimally invasive surgical option with anticipated similarly efficacious outcomes. Gastric band erosion following LAGB is an uncommon yet potentially serious complication unique to this form of weight loss surgery. METHODS Case report and literature review. RESULTS We report a case of a pyogenic liver abscess related to a LAGB procedure. Apropos to this case, we review the presumed pathophysiologic mechanism of this particular infectious process, and discuss this and other complications associated with LAGB operations. CONCLUSIONS As LAGB bariatric procedures become more popular, clinicians need to be aware of uncommon, but potentially serious complications unique to this form of weight loss surgery.
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Affiliation(s)
- Danon Garrido
- 1 University of Miami Miller School of Medicine , JFK Medical Center, Atlantis, Florida
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Abstract
We examined the relative contribution of different forms of eating disorder (ED) pathology to impairment in mental and physical health-related quality of life (QOL) in women with a wide range of ED symptoms. Female participants from an outpatient ED clinic (n = 53) and the local community (n = 214) completed measures of ED features and mental and physical health-related QOL. Across the sample, ED features were significantly associated with most mental and physical domains of QOL. In multiple regression analyses controlling for age and body mass index, ED features significantly predicted impairment in mental and physical QOL. Extreme shape and weight concern significantly and independently predicted most QOL subscales (β range = 0.19-0.44). The prominent contribution of shape and weight concern to both mental and physical QOL impairment underlines the importance of addressing body dissatisfaction in the treatment and prevention of EDs.
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Korhonen PE, Seppälä T, Järvenpää S, Kautiainen H. Body mass index and health-related quality of life in apparently healthy individuals. Qual Life Res 2013; 23:67-74. [PMID: 23686578 DOI: 10.1007/s11136-013-0433-6] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/08/2013] [Indexed: 01/07/2023]
Abstract
PURPOSE Obesity is known to be associated with a range of chronic medical comorbidities, but little is known about the impact of overweight and obesity on health-related quality of life (HRQoL) in persons without chronic diseases. The aim of this study was to assess HRQoL, body mass index (BMI) and health behavior patterns in a community sample of subjects who had no long-lasting medical comorbidities METHODS We assessed HRQoL in 1,187 apparently healthy individuals (mean age 57 ± 7 years), of whom 24 % were classified as normal weight, 49 % as overweight, 20 % as obese and 7 % as very obese. Two different instruments of HRQoL were used: the generic Short-Form Health Survey (SF-36) questionnaire and the preference-based instrument EuroQol (EQ-5D). RESULTS All physical components of the SF-36 decreased linearly according to BMI categories in women. In men, only poorer physical functioning scale showed linearity with rising BMI. Scores on the mental components of the SF-36 did not differ by BMI categories in either gender. The EQ-5D index and EuroQol visual analogue scale scores decreased linearly with rising BMI only in women. CONCLUSIONS In apparently healthy middle-aged subjects, physical HRQoL decreases with increasing level of BMI and more so in women than in men. Mental components of HRQoL do not differ between the categories of BMI in either gender.
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Ul-Haq Z, Mackay DF, Fenwick E, Pell JP. Meta-analysis of the association between body mass index and health-related quality of life among adults, assessed by the SF-36. Obesity (Silver Spring) 2013; 21:E322-7. [PMID: 23592685 DOI: 10.1002/oby.20107] [Citation(s) in RCA: 185] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2012] [Accepted: 08/31/2012] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Obesity is associated with impaired overall health-related quality of life but individual studies suggest the relationship may differ for mental and physical quality of life. A systematic review using Medline, Embase, PsycINFO and ISI Web of Knowledge, and random effects meta-analysis was undertaken. DESIGN AND METHODS Studies were included in the meta-analysis if they were conducted on adults (defined as age >16 years), reported an overall physical and mental component score of the SF-36, and, or both. Heterogeneity was assessed using I(2) statistics and publication and small study biases using funnel plots and Egger's test. Between-study heterogeneity was explored using meta-regression. RESULTS Eight eligible studies provided 42 estimates of effect size, based on 43,086 study participants. Adults with higher than normal body mass index had significantly reduced physical quality of life with a clear dose-response relationship across all categories. Among class III obese adults, the score was reduced by 9.72 points (95% Confidence Interval 7.24, 12.20, P < 0.001). Mental quality of life was also significantly reduced among class III obese (-1.75, 95% confidence interval -3.33, -0.16, P = 0.031), but was not significantly different among obese (class I and class II) individuals, and was significantly increased among overweight adults (0.42, 95% confidence interval 0.17, 0.67, P = 0.001), compared to normal weight individuals. Heterogeneity was high in some categories, but there was no significant publication or small study bias. CONCLUSIONS Different patterns were observed for physical and mental HRQoL, but both were impaired in obese individuals. This meta-analysis provides further evidence on the impact of obesity on both aspects of health-related quality of life.
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Affiliation(s)
- Zia Ul-Haq
- Public Health, Institute of Health and Wellbeing, University of Glasgow, Glasgow G12 8RZ, UK
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Latner JD, Durso LE, Mond JM. Health and health-related quality of life among treatment-seeking overweight and obese adults: associations with internalized weight bias. J Eat Disord 2013; 1:3. [PMID: 24764526 PMCID: PMC3776203 DOI: 10.1186/2050-2974-1-3] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2012] [Accepted: 11/15/2012] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Weight bias is widespread and has numerous harmful consequences. The internalization of weight bias has been associated with significant psychological impairment. Other forms of discrimination, such as racial and anti-gay bias, have been shown to be associated with physical health impairment. However, research has not yet examined whether internalized weight bias is associated with physical as well as psychological impairment in health-related quality of life. METHODS Participants included 120 treatment-seeking overweight and obese adults (mean body mass index = 35.09; mean age = 48.31; 68% female; 59% mixed or Asian ethnicity). Participants were administered measures of internalized weight bias and physical and mental health-related quality of life, and they were assessed for the presence of chronic medical conditions, use of prescription and non-prescription medications, and current exercise. RESULTS Internalized weight bias was significantly correlated with health impairment in both physical (r = -.25) and mental (r = -.48) domains. In multivariate analyses controlling for body mass index, age, and other physical health indicators, internalized weight bias significantly and independently predicted impairment in both physical (β = -.31) and mental (β = -.47) health. CONCLUSIONS Internalized weight bias was associated with greater impairment in both the physical and mental domains of health-related quality of life. Internalized weight bias also contributed significantly to the variance in physical and mental health impairment over and above the contributions of BMI, age, and medical comorbidity. Consistent with the association between prejudice and physical health in other minority groups, these findings suggest a link between the effects of internalized weight-based discrimination and physical health. Research is needed on strategies to prevent weight bias and its internalization on both a societal and individual level.
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Affiliation(s)
- Janet D Latner
- University of Hawai‘i at Manoa, 2350 Dole Street, Sakamaki C400, Honolulu, HI, 96822, USA
| | - Laura E Durso
- The Williams Institute at UCLA School of Law, Box 951476, Los Angeles, CA, 90095, USA
| | - Jonathan M Mond
- Centre for Rural and Remote Mental Health, School of Medicine and Public Health, University of Newcastle, Orange, NSW, 2800, Australia
- School of Sociology, Australian National University, Canberra, ACT, 0200, Australia
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Striegel RH, Bedrosian R, Wang C. Comparing work productivity in obesity and binge eating. Int J Eat Disord 2012; 45:995-8. [PMID: 23044632 DOI: 10.1002/eat.22069] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/03/2012] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To examine productivity impairment in individuals with obesity and/or binge eating. METHOD Based on current weight and eating behavior, 117,272 employees who had completed a health risk appraisal and psychosocial functioning questionnaire were classified into one of four groups. Gender-stratified analyses compared groups on four measures: absenteeism, presenteeism, total work productivity impairment, and (non-work) activity impairment. RESULTS Overall group differences were statistically significant for all measures with lowest impairment in non-obese men and women without binge eating (n = 34,090, n = 39,198), higher levels in individuals without binge eating (n = 15,570, n = 16,625), yet higher levels in non-obese men and women with binge eating (n = 1,381, n = 2,674), and highest levels in obese men and women with binge eating (Group 4, n = 2,739, n = 4,176). DISCUSSION Health initiatives for obese employees should include screening and interventions for employees with binge eating.
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Affiliation(s)
- Ruth H Striegel
- Department of Psychology, Wesleyan University, Middletown, CT 06459, USA.
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Latner JD, Mond JM, Vallance JK, Gleaves DH, Buckett G. Body checking and avoidance in women: associations with mental and physical health-related quality of life. Eat Behav 2012; 13:386-9. [PMID: 23121794 DOI: 10.1016/j.eatbeh.2012.05.008] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2011] [Revised: 04/11/2012] [Accepted: 05/31/2012] [Indexed: 11/25/2022]
Abstract
Body checking and body avoidance have demonstrated clinical significance in a number of populations. However, the associations between these behaviors and mental and physical health-related quality of life have not been examined. This study investigated the associations between body checking and avoidance and quality of life in 214 community women. Body checking and body avoidance were significantly correlated with mental and physical quality of life, as well as with eating disturbances. Frequency of body checking significantly predicted impairment in mental quality of life, and frequency of body avoidance significantly predicted impairment in physical quality of life, over and above the contributions of depressive symptoms and related demographic characteristics. Targeting checking and avoidance in prevention and treatment programs may improve quality of life and reduce health-related functional impairment.
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Affiliation(s)
- Janet D Latner
- Department of Psychology, University of Hawaii at Manoa, Honolulu, HI, United States.
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Darlow S, Goodman MS, Stafford JD, Lachance CR, Kaphingst KA. Weight perceptions and perceived risk for diabetes and heart disease among overweight and obese women, Suffolk County, New York, 2008. Prev Chronic Dis 2012; 9:E81. [PMID: 22480610 PMCID: PMC3396554 DOI: 10.5888/pcd9.110185] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Introduction Many Americans fail to accurately identify themselves as overweight and underestimate their risk for obesity-related diseases. The purpose of this study was to investigate associations between weight perceptions and perceived risk for diabetes and heart disease among overweight or obese women. Methods We examined survey responses from 397 overweight or obese female health center patients on disease risk perceptions and weight perceptions. We derived odds ratios (ORs) and 95% confidence intervals (CIs) from multivariable logistic regression analyses to examine predictors of perceived risk for diabetes and heart disease. We further stratified results by health literacy. Results Perceiving oneself as overweight (OR, 2.78; 95% CI, 1.16-6.66), believing that being overweight is a personal health problem (OR, 2.46; 95% CI, 1.26-4.80), and family history of diabetes (OR, 3.22; 95% CI, 1.53-6.78) were associated with greater perceived risk for diabetes. Perceiving oneself as overweight (OR, 4.33; 95% CI, 1.26-14.86) and family history of heart disease (OR, 2.25; 95% CI, 1.08-4.69) were associated with greater perceived risk for heart disease. Among respondents with higher health literacy, believing that being overweight was a personal health problem was associated with greater perceived risk for diabetes (OR, 4.91; 95% CI, 1.68-14.35). Among respondents with lower health literacy, perceiving oneself as overweight was associated with greater perceived risk for heart disease (OR, 4.69; 95% CI, 1.02-21.62). Conclusion Our findings indicate an association between accurate weight perceptions and perceived risk for diabetes and heart disease in overweight or obese women. This study adds to research on disease risk perceptions in at-risk populations.
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Affiliation(s)
- Susan Darlow
- Cancer Prevention and Control Program, Fox Chase Cancer Center, Young Pavilion, Room P4159, 333 Cottman Ave, Philadelphia, PA 19111, USA.
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Abstract
BACKGROUND It has been shown that individuals with hypertension have poorer health-related quality of life (HRQoL) than normotensive individuals. However, little is known about the impact of high blood pressure and the awareness to have hypertension on HRQoL. METHODS In this cross-sectional population-based study, we evaluated 901 cardiovascular risk patients aged 45 to 70 years without serious comorbidities. Hypertension was detected in 497 (55%) of the patients, in whom 137 (28%) had previously undiagnosed hypertension confirmed with home blood pressure measurement. Before the diagnosis of hypertension was made, the patients filled Short-Form Health Survey (SF-36) to assess their HRQoL. Glucose homeostasis was assessed with 2 h oral glucose tolerance test. RESULTS Patients who were aware of their hypertension had lower scores in physical functioning and general health than patients without hypertension and patients who were unaware of hypertension. There were no differences for mental components of SF-36 between these study groups. The prevalence of obesity and newly diagnosed type 2 diabetes was higher in patients with known hypertension than among other study groups. CONCLUSION Impaired HRQoL in hypertensive patients might be secondary to the awareness of hypertension, adverse drug effects, newly diagnosed type 2 diabetes or obesity, not high blood pressure per se.
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Striegel RH, Bedrosian R, Wang C, Schwartz S. Why men should be included in research on binge eating: results from a comparison of psychosocial impairment in men and women. Int J Eat Disord 2012; 45:233-40. [PMID: 22031213 DOI: 10.1002/eat.20962] [Citation(s) in RCA: 116] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/01/2011] [Indexed: 12/19/2022]
Abstract
OBJECTIVE Prevalence of binge eating has been shown to be as common in men as in women, yet few studies have included men. Men are especially underrepresented in treatment studies, raising the question of whether men who binge eat experience less distress or impairment than women. This study compared demographic and clinical correlates of binge eating in a large employee sample of men and women. METHOD Cross-sectional data from 21,743 men and 24,608 women who participated in a health risk self assessment screening were used. Group differences in obesity, hypertension, dyslipidemia, Type 2 diabetes, depression, stress, sleep, sick days, work impairment, and nonwork activity impairment were tested using chi-square tests (categorical variables) and independent sample t-tests (continuous variables). RESULTS Effect size estimates indicate that men (n = 1,630) and women (n = 2,754) who binge eat experience comparable levels of clinical impairment. They also report substantially greater impairment when compared with men and women who do not binge eat. DISCUSSION The underrepresentation of men in treatment-seeking samples does not appear to reflect lower levels of impairment in men versus women. Efforts are needed to raise awareness of the clinical significance of binge eating in men so that this group can receive appropriate screening and treatment services.
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Affiliation(s)
- Ruth H Striegel
- Department of Psychology, Wesleyan University, Middletown, CT 06459, USA.
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Tanamas SK, Wluka AE, Berry P, Menz HB, Strauss BJ, Davies-Tuck M, Proietto J, Dixon JB, Jones G, Cicuttini FM. Relationship between obesity and foot pain and its association with fat mass, fat distribution, and muscle mass. Arthritis Care Res (Hoboken) 2012; 64:262-8. [DOI: 10.1002/acr.20663] [Citation(s) in RCA: 69] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Abstract
Obesity may be the most significant medical problem that health care providers will face over the coming decades. Physicians must aggressively address this chronic disease, providing both preventive and therapeutic care. Since this topic has not been traditionally taught in medical school or residency training, physicians and other health providers will need to acquire the knowledge, skills, and attitudes necessary to be effective obesity care providers. Performing a detailed initial assessment, including an obesity focused history, physical examination, and selected laboratory and diagnostic tests is fundamental to the process of care.
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Mond J, Rodgers B, Hay P, Owen C. Mental health impairment in underweight women: do body dissatisfaction and eating-disordered behavior play a role? BMC Public Health 2011; 11:547. [PMID: 21740596 PMCID: PMC3160375 DOI: 10.1186/1471-2458-11-547] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2011] [Accepted: 07/10/2011] [Indexed: 11/28/2022] Open
Abstract
Background We sought to evaluate the hypothesis that mental health impairment in underweight women, where this occurs, is due to an association between low body weight and elevated levels of body dissatisfaction and/or eating-disordered behaviour. Methods Subgroups of underweight and normal-weight women recruited from a large, general population sample were compared on measures of body dissatisfaction, eating-disordered behaviour and mental health. Results Underweight women had significantly greater impairment in mental health than normal-weight women, even after controlling for between-group differences in demographic characteristics and physical health. However, there was no evidence that higher levels of body dissatisfaction or eating-disordered behaviour accounted for this difference. Rather, underweight women had significantly lower levels of body dissatisfaction and eating-disordered behaviour than normal-weight women. Conclusions The findings suggest that mental health impairment in underweight women, where this occurs, is unlikely to be due to higher levels of body dissatisfaction or eating-disordered behaviour. Rather, lower levels of body dissatisfaction and eating-disordered behaviour among underweight women may counterbalance, to some extent, impairment due to other factors.
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Affiliation(s)
- Jonathan Mond
- School of Sociology, Australian National University, Canberra, Australia.
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Obesity, body dissatisfaction, and emotional well-being in early and late adolescence: findings from the project EAT study. J Adolesc Health 2011; 48:373-8. [PMID: 21402266 PMCID: PMC3214691 DOI: 10.1016/j.jadohealth.2010.07.022] [Citation(s) in RCA: 143] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2010] [Revised: 07/26/2010] [Accepted: 07/27/2010] [Indexed: 11/24/2022]
Abstract
PURPOSE We tested the hypothesis that, at two different stages of adolescence, impairment in emotional well-being associated with obesity is mediated by body dissatisfaction (BD). METHODS Self-reported measures of BD, emotional well-being (self-esteem, depressive mood), height and weight, and socio-demographic information were completed by the same female (n = 366) and male (n = 440) participants during early (mean age = 12.8 years) and late (17.3 years) adolescence. For each measure and at each time point, the hypothesis of mediation was tested using the methods suggested by Baron and Kenny (1986). RESULTS The conditions of complete mediation were satisfied in all the six cases for which an effect of obesity on emotional well-being was observed. That is, in each of these cases, obesity was no longer associated with lower self-esteem or with higher depressive mood after the effects of BD were statistically controlled. Among females, there was no association between obesity and depressive mood at either time point. CONCLUSION Impairment in the emotional well-being of overweight adolescents, where this is observed, may be primarily due to the effects of weight-related BD. This appears to be the case for both boys and girls and during both early and late adolescence. The findings are consistent with the view that BD is central to the health and well-being of children and adolescents who are overweight and that distress associated with negative body image may warrant greater attention in the context of obesity prevention and treatment programs.
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Grossi E, Tavano Blessi G, Sacco PL, Buscema M. The Interaction Between Culture, Health and Psychological Well-Being: Data Mining from the Italian Culture and Well-Being Project. JOURNAL OF HAPPINESS STUDIES 2011. [DOI: 10.1007/s10902-011-9254-x] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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Vincent HK, Omli MR, Day T, Hodges M, Vincent KR, George SZ. Fear of Movement, Quality of Life, and Self-Reported Disability in Obese Patients with Chronic Lumbar Pain. PAIN MEDICINE 2011; 12:154-64. [DOI: 10.1111/j.1526-4637.2010.01011.x] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Karlsen TI, Tveitå EK, Natvig GK, Tonstad S, Hjelmesæth J. Validity of the SF-36 in patients with morbid obesity. Obes Facts 2011; 4:346-51. [PMID: 22166753 PMCID: PMC6444791 DOI: 10.1159/000333406] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND The Medical Outcome Study 36-Item Short Form Health Survey (SF-36) is one of the most commonly applied generic quality of life instruments. The construct validity of the instrument in patients with morbid obesity is not established. PARTICIPANTS AND METHODS A total of 475 morbidly obese patients (68% women) with a mean (standard deviation) age of 44.7 (11.8) years, weight of 123.5 (24.1) kg and BMI of 41.7 (6.3) kg/m(2), who had been referred to a rehabilitation center, completed the SF-36 form. Exploratory factor analyses were performed to examine the underlying component structure of the questionnaire. Confirmatory factor analyses were performed to assess model fit. RESULTS The analysis suggested a 6-component structure rather than the 8-component structure used in the original SF-36. The first component consisted of items from the physical functioning subscale, the role physical subscale and the general health subscale, and explained 31% of the variance. The 6 components explained 61% of the total variance. The items loaded as expected in a physical and mental component. The assessment of model fit confirmed these findings. CONCLUSION The 2 summary scales of the SF-36 have satisfactory validity in patients with morbid obesity. However, the validity of the 8 subscales is questionable, and the subscales should be interpreted with care.
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Affiliation(s)
- Tor-Ivar Karlsen
- Morbid Obesity Center, Vestfold Hospital Trust, Tønsberg, Norway.
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Relation of health-related quality of life to metabolic syndrome, obesity, depression and comorbid illnesses. Int J Obes (Lond) 2010; 35:1087-94. [PMID: 21042326 DOI: 10.1038/ijo.2010.230] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Metabolic syndrome has been associated with impaired health-related quality of life (HRQoL) in several studies. Many studies used only one HRQoL measure and failed to adjust for important confounding variables, including obesity, depression and comorbid conditions. OBJECTIVE To investigate the relationship between metabolic syndrome and HRQoL using multiple measures. We also sought to determine whether increasing body mass index or diabetes status further modified this relationship. METHODS This cross-sectional study included 390 obese participants with elevated waist circumference and at least one other criterion for metabolic syndrome. Of these 390 participants, 269 had metabolic syndrome (that is, they met 3 out of the 5 criteria specified by the NCEP (National Cholesterol Education Program)) and 121 did not. Participants were enrolled in a primary care-based weight-reduction trial. HRQoL was assessed using two generic instruments, the Medical Outcomes Study Short-Form 12 and the EuroQol-5D, as well as an obesity-specific measure, the Impact of Weight on Quality of Life. Differences in HRQoL were compared among participants with and without metabolic syndrome. Multivariable linear regression was used to determine how HRQoL varied according to metabolic syndrome status, and whether factors including weight, depression and burden of comorbid disease modified this relationship. RESULTS Metabolic syndrome was not associated with HRQoL as assessed by any of the measures. In univariable analysis, depression, disease burden and employment status were significantly associated with worse HRQoL on all instruments. In multivariable models, only depression remained significantly associated with reduced HRQoL on all measures. Increasing obesity and diabetes status did not modify the relationship between metabolic syndrome and HRQoL. CONCLUSION In contrast to previous studies, metabolic syndrome was not associated with impaired HRQoL as assessed by multiple measures. This suggests that metabolic syndrome in itself is not associated with decreased HRQoL, but other factors such as obesity, depression and greater disease burden may significantly influence the quality of life in this population.
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van den Berg PA, Mond J, Eisenberg M, Ackard D, Neumark-Sztainer D. The link between body dissatisfaction and self-esteem in adolescents: similarities across gender, age, weight status, race/ethnicity, and socioeconomic status. J Adolesc Health 2010; 47:290-6. [PMID: 20708569 PMCID: PMC2923488 DOI: 10.1016/j.jadohealth.2010.02.004] [Citation(s) in RCA: 157] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2009] [Revised: 12/12/2009] [Accepted: 02/03/2010] [Indexed: 10/19/2022]
Abstract
PURPOSE The present study examined whether the cross-sectional association between body dissatisfaction and low self-esteem varies across gender, age, body weight status, race/ethnicity, and socioeconomic status (SES). We also examined the association longitudinally. METHODS A school-based survey of eating, weight, and related attitudes was conducted with a diverse sample of adolescents aged 11-18 years (N = 4,746). Height and weight were measured in the schools at Time 1. Participants were resurveyed through mails 5 years later (Time, 2; N = 2,516). RESULTS The relationship between body dissatisfaction and self-esteem was strong and significant in both boys and girls (all p values < .0001), and did not differ significantly between genders (p = .16), or between the middle school and high school cohorts in either boys (p = .79) or girls (p = .80). Among girls, the relationship between body dissatisfaction and self-esteem was strong, but did vary across weight status, race/ethnicity, and SES (all p values = .0001-.03). The relationship was nonsignificant in underweight girls (p = .36), and weaker but still significant among black, Asian, and low SES group girls (all p values < .0001) in comparison to white and high SES group girls. Among boys, the association did not differ significantly across demographic groups (all p values = .18-.79). In longitudinal analyses, the strength of the association did not change significantly as adolescents grew older. CONCLUSIONS Findings indicate that body dissatisfaction and self-esteem are strongly related among nearly all groups of adolescents. This suggests the importance of addressing body image concerns with adolescents of all backgrounds and ages.
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Affiliation(s)
| | - Jonathan Mond
- School of Biomedical and Health Sciences, University of Western Sydney, Campbelltown Australia
| | - Marla Eisenberg
- Division of Adolescent Health and Medicine, Department of Pediatrics, University of Minnesota, Minneapolis, MN, Division of Epidemiology & Community Health, School of Public Health, University of Minnesota, Minneapolis, MN
| | - Diann Ackard
- Division of Epidemiology & Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, Private Practice, Golden Valley, MN
| | - Dianne Neumark-Sztainer
- Division of Epidemiology & Community Health, School of Public Health, University of Minnesota, Minneapolis, MN
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Abstract
Obesity carries a unique disease burden on women and is influenced by a variety of biological, hormonal, environmental, and cultural factors. Reproductive transitions, such as pregnancy and menopause, increase the risk for obesity. Psychologically, obese women experience greater weight-related stigma and discrimination and are at increased risk for depression than obese men. Women are also particularly susceptible to psychological stress, sleep debt, and lack of physical activity, all of which are risk factors for the development of excess weight. Obesity risk is increased among women with psychiatric disorders and those who use certain psychotropic medications. Obesity treatment should take into consideration degree of obesity, health risks, past weight loss attempts, and individual differences in motivation and readiness for treatment.
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Renzaho A, Wooden M, Houng B. Associations between body mass index and health-related quality of life among Australian adults. Qual Life Res 2010; 19:515-20. [PMID: 20182918 DOI: 10.1007/s11136-010-9610-z] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/08/2010] [Indexed: 11/24/2022]
Abstract
OBJECTIVES To assess the relationship between body mass index (BMI) and health-related quality of life (HQoL), as measured by the Short Form Health Survey (SF-36) within a sample with broad population coverage. SUBJECTS AND METHODS Survey data incorporating the SF-36 questionnaire, height and weight were obtained from a nationally representative sample of 9,771 Australians aged 21 or older (4,649 men and 5,122 women). Linear multiple regression methods were employed to estimate the magnitude of association between BMI classes and HQoL variables, adjusting for disability and other covariates. RESULTS Less than 1% of men and just 3.5% of women were classified as underweight while 52.2% of women and 65.9% of men were classified as overweight or obese. For all SF-36 health dimensions, people with BMI scores in the healthy range reported, on average, higher health-related HQoL scores than underweight and obese people, and HQoL scores decreased with the degree of obesity. Although overweight and obesity were associated with decreasing levels of both physical and emotional well-being, the deterioration in health status was significantly more evident in the physical than in the mental, social or emotional dimensions. CONCLUSIONS Low and high BMIs were associated with decreasing levels of both physical and emotional well-being, but the deterioration in health status was more consistent in the physical than in other dimensions.
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Affiliation(s)
- Andre Renzaho
- Public Health Research, Evaluation and Policy Cluster, Deakin University, 221 Burwood HWY, Burwood 2125, VIC, Australia.
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