Quality of Life Research

, Volume 16, Issue 10, pp 1595–1603

The association between body mass index and health-related quality of life: data from CaMos, a stratified population study

  • Wilma M. Hopman
  • Claudie Berger
  • Lawrence Joseph
  • Susan I. Barr
  • Yongjun Gao
  • Jerilynn C. Prior
  • Suzette Poliquin
  • Tanveer Towheed
  • Tassos Anastassiades
  • CaMos Research Group
Article

Abstract

Background

Deviation from normal weight is associated with health risks, but less is known about the association between weight and health-related quality of life (HRQOL). We investigated this in the context of a population-based study, using a standard five-category weight classification system based on body mass index (BMI).

Methods

The Canadian Multicentre Osteoporosis Study is a randomly selected sample of men and women over 25 years of age from nine centres across Canada. Data were obtained by interview, and height and weight were measured and used to calculate BMI. HRQOL was measured using the SF-36. Multivariable linear regression was used to identify the association between BMI category and SF-36 scores after controlling for potential confounders.

Results

Complete data were available for 6302 women and 2792 men. Mean BMI for every age and gender group exceeded healthy weight guidelines. For women, being underweight, overweight or obese was associated with poorer HRQOL in most SF-36 outcomes while for men, this was associated with poorer HRQOL in some domains and with higher HRQOL in others.

Conclusions

A significant proportion of the population may be putting their health at risk due to excess weight, which may have a substantial negative effect on HRQOL, particularly in women. This underscores the need for continued public health efforts aimed at combating overweight and obesity.

Keywords

BMI Body mass index Epidemiology SF-36 

Abbreviations

HRQOL

Health-related quality of life

SF-36

Medical Outcomes Trust 36-item Health Survey

BMI

Body mass index

CaMos

Canadian Multicentre Osteoporosis Study

PCS

Physical component summary of the SF-36

MCS

Mental component summary of the SF-36

DXA

Dual-energy X-ray absorptiometry

BMD

Bone mineral density

CI

Confidence interval

References

  1. 1.
    Tjepkema, M. (2006). Adult obesity in Canada: Measured height and weight. Statistics Canada. Available at: http://www.statcan.ca/english/research/82-620-MIE/2005001/articles/adults/aobesity.htm (accessed August 9, 2007).
  2. 2.
    Health Canada. (2003). Canadian guidelines for body weight classification in adults. Ottawa: Health Canada Publications Centre, Publication ID 4645.Google Scholar
  3. 3.
    Raine, K. D. (2002). Overweight and obesity in Canada: A population health perspective. Ottawa: Canadian Institute for Health Information.Google Scholar
  4. 4.
    Trakas, K., Lawrence, K., & Shear, N. H. (1999). Utilization of health care resources by obese Canadians. CMAJ, 160, 1457–1462.PubMedGoogle Scholar
  5. 5.
    Ogden, C. L., Carroll, M. D., & Flegal, K. M. (2003). Epidemiologic trends in overweight and obesity. Endocrinology and Metabolism Clinics of North America, 32, 741–760.PubMedCrossRefGoogle Scholar
  6. 6.
    Katzmarzyk, P. T, Craig, C. L., & Bouchard, C. (2001). Underweight, overweight and obesity: Relationships with mortality in the 13-year follow-up of the Canadian Fitness Survey. Journal of Clinical Epidemiology, 54, 916–920.PubMedCrossRefGoogle Scholar
  7. 7.
    Flegal, K. M., Graubard, B. I., Williamson, D. F., & Gail, M. H. (2005). Excess deaths associated with underweight, overweight and obesity. JAMA, 293, 1861–1867.PubMedCrossRefGoogle Scholar
  8. 8.
    Rich-Edwards, J. W., Goldman, M. B., Willett, W. C., Hunter, D. J., Stampfer, M. J., Colditz, G. A., et al. (1994). Adolescent body mass index and infertility caused by ovulatory disorder. American Journal of Obstetrics and Gynecology, 171, 171–177.PubMedGoogle Scholar
  9. 9.
    Gilmore, J. (1999). Body mass index and health. Statistics Canada Catalogue 82-003. Health Reports, 11, 31–43.PubMedGoogle Scholar
  10. 10.
    De Laet, C., Kanis, J. A., Odén, A., Johanson, H., Johnell, O., Delmas, P., et al. (2005). Body mass index as a predictor of fracture risk: A meta-analysis. Osteoporosis International, 16, 1330–1338.PubMedCrossRefGoogle Scholar
  11. 11.
    Maciejewski, M. L., Patrick, D. L., & Williamson, D. E. (2005). A structured review of randomized controlled trials of weight loss showed little improvement in health-related quality of life. Journal of Clinical Epidemiology, 58, 568–578.PubMedCrossRefGoogle Scholar
  12. 12.
    Bish, C. L., Michels Blanck, H., Maynard, L. M., Serdula, M. K., Thompson, N. J., & Ketter Khan, L. (2006). Health-related quality of life and weight loss among overweight and obese adults, 2001 to 2002. Obesity, 14, 2042–2053.PubMedGoogle Scholar
  13. 13.
    Kruger, J., Bowles, H. R., Jones, D. A., Ainsworth, B. E., & Kohl, H. W. (2007). Health-related quality of life, BMI and psychical activity among US adults (≥118 years): National physical activity and weight loss survey. International Journal of Obesity, 31, 321–327.PubMedCrossRefGoogle Scholar
  14. 14.
    Fine, J. T., Colditz, G. A., Coakley, E. H., Moseley, G., Manson, J. E., Willett, W. C., & Kawachi, I. (1999). A prospective study of weight change and health-related quality of life in women. JAMA, 282, 2136–2142.PubMedCrossRefGoogle Scholar
  15. 15.
    Han, T. S., Tijhuis, M. A. R., Lean, M. E. J., & Seidell, J. C. (1998). Quality of life in relation to overweight and body fat distribution. American Journal of Public Health, 88, 1814–1820.PubMedCrossRefGoogle Scholar
  16. 16.
    World Health Organization. (2000) Obesity: Preventing and managing the global epidemic. Report of a WHO consultation on obesity. Geneva: World Health Organization.Google Scholar
  17. 17.
    Larsson, U., Karlsson, J., & Sullivan, M. (2002). Impact of overweight and obesity on health-related quality of life—A Swedish population study. International Journal of Obesity and Related Metabolic Disorders, 26, 417–424.PubMedCrossRefGoogle Scholar
  18. 18.
    Lean, M. E., Hans, T. S., & Seidell, J. C. (1999). Impairment of health and quality of life using new US federal guidelines for the identification of obesity. Archives of Internal Medicine, 159, 837–843.PubMedCrossRefGoogle Scholar
  19. 19.
    Le Pen, C., Levy, E., Loos, F., Banzet, M. N., & Basdevant, A. (1998). “Specific” scale compared with “generic” scale: A double measurement of the quality of life in a French community sample of obese subjects. Journal of Epidemiology and Community Health, 52, 445–450.PubMedGoogle Scholar
  20. 20.
    Huang, I-C., Frangakis, C, & Wu, A. W. (2006). The relationship of excess body weight and health-related quality of life: Evidence from a population study in Taiwan. International Journal of Obesity, 30, 1250–1259.PubMedCrossRefGoogle Scholar
  21. 21.
    Swallen, K. C., Reither, E. N., Haas, S. A., & Meier, A. M. (2005). Overweight, obesity and health-related quality of life among adolescents: The national longitudinal study of adolescent health. Pediatrics, 115, 340–347.PubMedCrossRefGoogle Scholar
  22. 22.
    Brown, W. J., Mishra, G., Kenardy, J., & Dobson, A. (2000). Relationships between body mass index and well-being in young Australian women. International Journal of Obesity and Related Metabolic Disorders, 24, 1360–1368.PubMedCrossRefGoogle Scholar
  23. 23.
    Yan, L. L., Daviglus, M. L., Liu K., Pirzada, A., Garside, D. B., Schiffer, L., Dyer, A. R., & Greenland, P. (2004). BMI and health-related quality of life in adults 65 years and older. Obesity Research, 12, 69–76.PubMedGoogle Scholar
  24. 24.
    Borowiak, E., & Kostka, T. (2004). Predictors of quality of life in older people living at home and in institutions. Aging Clinical and Experimental Research, 16, 212–220.PubMedGoogle Scholar
  25. 25.
    Lopez-Garcia, E., Banegas, J. R., Gutierrez-Fisac, J. L., Perez-Regadera, A. G., Ganan, L. D., & Rodriguez-Artalejo, F. (2003). Relationship between body weight and health-related quality of life among the elderly in Spain. International Journal of Obesity and Related Metabolic Disorders, 27, 701–709.PubMedCrossRefGoogle Scholar
  26. 26.
    Ford, E. S., Moriarty, D. G., Zack, M. M., Mokdad, A. H., & Chapman, D. P. (2001). Self-reported body mass index and health-related quality of life: Findings from the behavioral risk factor surveillance system. Obesity Research, 9, 21–31.PubMedGoogle Scholar
  27. 27.
    Hassan, M. K., Joshi, A. V., Madhavan, S. S., Amonkar, M. M. (2003). Obesity and health-related quality of life: A cross-sectional analysis of the US population. International Journal of Obesity, 27, 1227–1232.PubMedCrossRefGoogle Scholar
  28. 28.
    Gorber, S. C., Tremblay, M., Moher, D., & Gorber, B. (2007). A comparison of direct versus self-report measures for assessing height, weight and body mass index: A systematic review. Obesity Reviews, 8, 307–326.PubMedCrossRefGoogle Scholar
  29. 29.
    Danubio, M. E., Miranda, G., Vinciguerra, M. G., Vecchi, E., & Rufo, F. (2007). Comparison of self-reported and measured height and weight: Implications for obesity research among young adults. Economics and Human Biology, Apr 8 [Epub ahead of print].Google Scholar
  30. 30.
    McAdams, M. A., Van Dam, R. M., & Hu, F. B. (2007). Comparison of self-reported and measured BMI as correlates of disease markers in US adults. Obesity, 15, 188–196. PubMedCrossRefGoogle Scholar
  31. 31.
    Kreiger, N., Tenenhouse, A., Joseph, L., MacKenzie, T., Poliquin, S., Brown, J. P., Prior, J. C., & Rittmaster, R. S. (1999). The Canadian Multicentre Osteoporosis Study (CaMos): Background, rationale, methods. Canadian Journal on Aging, 18, 376–387.Google Scholar
  32. 32.
    Hopman, W. M., Towheed, T., Anastassiades, T., Tenenhourse, A., Poliquin, S., Berger, C., Joseph, L., et al. (2000). Canadian normative data for the SF-36 health survey. CMAJ, 163, 265–271.PubMedGoogle Scholar
  33. 33.
    Nadalin, V., Bentvelson, K., & Krieger, N. (2004). Reliability of self-reports: Data from the Canadian Multicentre Osteoporosis Study (CaMos). Chronic Diseases in Canada, 25, 28–31.PubMedGoogle Scholar
  34. 34.
    Ware, J. E. (1993). SF-36 health survey manual and interpretation guide. Boston: The Health Institute, New England Medical Centre.Google Scholar
  35. 35.
    Ware, J. E., Kosinski, M., & Keller, S. D. (1994). SF-36 physical and mental health summary scales: A user’s manual. Boston: The Health Institute, New England Medical Centre.Google Scholar
  36. 36.
    Hopman, W. M., Berger, C., Joseph, L., Towheed, T., van den Kerkhof, E., et al. (2006). The natural progression of health-related quality of life: Results of a five-year prospective study of SF-36 scores in a normative population from the Canadian Multicentre Osteoporosis Study (CaMos). Quality of Life Research, 15, 527–536.PubMedCrossRefGoogle Scholar
  37. 37.
    Jia, H., & Lubetkin, E. I. (2005). The impact of obesity on health-related quality of life in the general adult US population. Journal of Public Health, 27, 156–164.PubMedCrossRefGoogle Scholar
  38. 38.
    Doll, H. A., Peterson, S. E., & Stewart-Brown, S. L. (2000). Obesity and physical and emotional well-being: Associations between body mass index, chronic illness and the physical and mental components of the SF-36 questionnaire. Obesity Research, 8, 160–170.PubMedGoogle Scholar
  39. 39.
    Sach, T. H., Barton, G. R., Doherty, M., Muir, K. R., Jenkinson, C., & Avery, A. J. (2007). The relationship between body mass index and health-related quality of life: Comparing the EQ-5D, EuroQuol VAS and SF-6D. International Journal of Obesity, 31, 189–196.PubMedCrossRefGoogle Scholar
  40. 40.
    Singer, M. A., Hopman, W. M., & MacKenzie, T. A. (1999). Psychological adjustment in four chronic medical conditions. Quality of Life Research, 8, 687–691.PubMedCrossRefGoogle Scholar
  41. 41.
    Heo, M., Faith, M. S., & Pietrobelli, A. (2002). Resistance to change of adult body mass index. International Journal of Obesity, 26, 1404–1405.PubMedCrossRefGoogle Scholar
  42. 42.
    Le Petit, C., & Berthelot, J. M. (2005). Obesity: A growing issue. Healthy today, health tomorrow? Findings from the National Population Health Survey 2005 (Catalogue 82618MWE2005003). Ottawa: Statistics Canada.Google Scholar
  43. 43.
    Hopman, W. M., Leroux, C., Berger, C., Joseph, L., Barr, S. I., et al. (2007). Changes in body mass index in Canadians over a five-year period: Results of a prospective, population-based study. BMC Public Health, 7(1), 150 [Epub ahead of print].Google Scholar
  44. 44.
    Daviglus, M. L., Liu, K., Yan, L. L., Pirzada, A., Garside, D. B., Schiffer, L., Dyer, A. R., Greenland, P., & Stamler, J. (2003). Body mass index in middle age and health-related quality of life in older age: The Chicago heart association detection project in industry study. Archives of Internal Medicine, 163, 2448–2455.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media B.V. 2007

Authors and Affiliations

  • Wilma M. Hopman
    • 1
    • 2
  • Claudie Berger
    • 3
  • Lawrence Joseph
    • 4
  • Susan I. Barr
    • 5
  • Yongjun Gao
    • 3
  • Jerilynn C. Prior
    • 6
  • Suzette Poliquin
    • 7
  • Tanveer Towheed
    • 2
    • 8
  • Tassos Anastassiades
    • 8
  • CaMos Research Group
  1. 1.Clinical Research CentreKingston General HospitalKingstonCanada
  2. 2.Department of Community Health and EpidemiologyQueen’s UniversityKingstonCanada
  3. 3.CaMos Methods CentreMcGill UniversityMontrealCanada
  4. 4.Department of Epidemiology and BiostatisticsMcGill UniversityMontrealCanada
  5. 5.Human NutritionUniversity of British ColumbiaVancouverCanada
  6. 6.Division of Endocrinology, Department of MedicineUniversity of British Columbia VancouverCanada
  7. 7.CaMos National Coordinating CentreMcGill UniversityMontrealCanada
  8. 8.Division of Rheumatology, Department of MedicineQueen’s UniversityKingstonCanada

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