Illness perception in overweight and obesity and impact on bio-functional age
- 64 Downloads
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.
- 2.Arnold M, Jiang L, Stefanick M, Johnson K, Lane D, LeBlanc E, Prentice R, Rohan T, Snively B, Vitolins M, Zaslavsky O, Soerjomataram I, Anton-Culver H (2015) Duration of adulthood overweight, obesity, and caner risk in the women’s health initiative: a longitudinal study from the United States. PLoS Med 13(8):e1002081CrossRefGoogle Scholar
- 3.Patel S, Ali M, Alam D, Yan L, Levitt N, Bernabe-Ortiz A, Checkley W, Wu Y, Irazola V, Gutierrez L, Rubinstein A, Shivashankar R, Li X, Miranda J, Chowdhury M, Siddiquee A, Gaziano T, Kadir M, Prabhakaran D (2016) Obesity and its relation with diabetes and hypertension. A cross-sectional study across 4 geographical regions. Glob Heart 11(1):71–79CrossRefPubMedPubMedCentralGoogle Scholar
- 4.Francoeur R (2016) Symptom profiles os subsyndromal depression in disease clusters of diabetes, excess weight, and progressive cerebrovascular conditions: a promising new type of finding from a reliable innovation to estimate exhaustively specified multiple indicators-multiple causes (MIMC) models. Diabetes Metab Syndr Obes 9:391–416CrossRefPubMedPubMedCentralGoogle Scholar
- 8.Zenz H, Bischoff C, Hrabal V (1996) Patiententheoriefragebogen (PATEF). Hogrefe Verlag für Psychologie, GöttingenGoogle Scholar
- 9.Leventhal H, Nerenz DR, Steele DJ (1984) Illness representations and coping with health threats. Erlbaum, HillsdaleGoogle Scholar
- 10.Ardelt-Gattinger E, Meindl M (2010) AD-EVA. Interdisziplinäres Testsystem zur Diagnostik und Evaluation bei Adipositas und anderen durch Ess- und Bewegungsverhalten beeinflussbaren Krankheiten (Modul 1). Verlag Hans Huber, Hoegrefe AG, BernGoogle Scholar
- 11.Ardelt-Gattinger E, Ring-Dimitriou S, Hofmann J, Paulmichl K, Zsoldos F, Weghuber D (2015) Geschlechtsunterschiede bei psychologischen, ernährungs- und sportwissenschaftlichen Einflussfaktoren auf Adipositas/Übergewicht bei Kindern und Jugendlichen in Österreich. Wien Med Wochenschr 166:111–116CrossRefGoogle Scholar
- 16.Bullinger M, Kirchberger I, Ware J (1995) Der deutsche SF-36 Health Survey. Übersetzung und psychometrische Testung eines krankheitsübergreifenden Instrumentes zur Erfassung der gesundheitsbezogenen Lebensqualität. Zeitschrift fuer Gesundheitswissenschaften 1:21–36Google Scholar
- 17.Schulz P, Schlotz W, Becker P (2004) Trierer Inventar zum chronischen Stress (TICS). Hogrefe, GöttingenGoogle Scholar
- 18.Ardelt-Gattinger E, Meindl M (2010) AD-EVA. Interdisziplinäres Testsystem zur Diagnostik und Evaluation bei Adipositas und anderen durch Ess- und Bewegungsverhalten beeinflussbaren Krankheiten. Huber, BernGoogle Scholar
- 19.Zenz H, Bischoff C, Hrabal V (1996) Patiententheorienfragebogen (PATEF). Handanweisung. Hogrefe, GöttingenGoogle Scholar
- 20.Poethig D (1984) Experimental development of a clinical diagnostic model objectifying bio-functional age(ing) of human beings. Habilitation thesis. German National Library, LeipzigGoogle Scholar
- 22.Dean W (1988) Biological aging measurement: clinical applications. The German test bettery. University of Leipzig, The Center for Bio Gerontology Los Angeles, pp 175–187Google Scholar
- 23.Meissner-Poethig D, Michalak U (1997) Vitalität und ärztliche Intervention. Hippokrates Verlag, StuttgartGoogle Scholar
- 25.Schulz P, Schlotz W, Becker P (2004) Trierer Inventar zum chronischen Stress (TICS). Hogrefe, GöttingenGoogle Scholar