Illness perception in overweight and obesity and impact on bio-functional age
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Obesity is pandemic. Yet, the success of most weight loss programmes is poor. The aim of the study was to assess illness perception in overweight/obese people and its impact on bio-functional age (BFA) reflecting physical, mental, emotional and social functioning.
75 overweight/obese subjects from the cross-sectional Bern Cohort Study 2014 were included. Participants followed a validated “bio-functional status” test battery amended by the validated questionnaires Patiententheoriefragebogen (illness perception) and AD-EVA (eating and movement behaviour). BFA was calculated in subjects aged ≥ 35 years (n = 56).
(1) Mental occupation with the cause of overweight/obesity was generally moderate to high, but decreasing with age. (2) The predominant theories for being overweight/obese were health behaviour (58.7%) and psychosocial factors (33.3%). (3) Overweight/obese people with psychosocial theories on illness causes were more likely to have emotional or disinhibited eating patterns. (4) Cognitive control of eating patterns increased with age in both sexes. (5) Overweight/obese people were still bio-functionally younger than their chronological age (8.6 ± 0.8 year equivalents), although (6) quality of life was below average and (7) the risk for functional pro-aging was increased in those being especially mentally occupied with causes for overweight/obesity (r = 0.38, p < 0.001) and those having psychosocial (r = 0.32, p < 0.05) or naturalistic theories (r = 0.47, p > 0.001).
Consciously perceived psychosocial stress was found to be a main factor to disturb health and promote unhealthy cognitive patterns regulating eating and moving habits. Thus, successful weight reduction programmes should integrate subjective illness perceptions to not only improve the therapeutic outcome, but also functioning (BFA).
KeywordsIllness perception Bio-functional age (BFA) Ageing Obesity/overweight Bern Cohort Study 2014 Psychological stress
Interdisciplinary test system for the diagnostic and evaluation of adiposity and other with eating and movement behaviour influenceable diseases
Active and healthy aging
Bern Cohort Study 2014
Body Mass Index
Difference between calendaric and bio-functional age
General Single scale
Hospital Anxiety and Depression Scale
Health Behavioural scale
International Classification of Functioning, Disability and Health
Naturalistic External scale
Naturalistic Internal scale
Psychosocial External scale
Psychosocial Internal scale
Short Form Gesundheitsfragebogen
Trier Inventar zum chronischen Stress
The authors would like to thank J. D. Wanner and D. Gafner, study nurses, for their administrative assistance during the study. Also, the authors are thankful to the medical students N. Ammann and M. Moser for conducting the assessments.
Contributions to the manuscript are as follows: LM: statistical analysis with support of Dr. Bitterlich, writing the manuscript. NB: statistics. MW: discussion of results, advise on manuscript. FM: discussion of results, advise on manuscript. DP: discussion of results. PS: principle investigator, responsible for study idea, design, finances, supervision of doctoral student and finalizing the manuscript.
The study was supported by an unrestricted Grant by Merck Sharp & Dohme Corp. and Burgergemeinde Bern.
Compliance with ethical standards
Conflict of interest
L. Mathieu, P. Stute, M. von Wolff and N. Bitterlich declare to have no conflict of interest in context of this manuscript. F. Meissner is the managing director of Vital Services and D. Poethig is member of the scientific board of Vital Services, which provides the technology for BFS/BFA measuring. F. Meissner has no involvements that might raise the question of bias in the work reported or in the conclusions, implications, or opinions stated.
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