A bi-directional association between weight change and health-related quality of life: evidence from the 11-year follow-up of 9916 community-dwelling adults

  • Berhe W. SahleEmail author
  • Shameran Slewa-Younan
  • Yohannes Adama Melaku
  • Li Ling
  • Andre M. N. Renzaho



To examine the prospective associations between body mass index (BMI) and health-related quality of life (HRQoL).


Data were extracted from a longitudinal, nationally representative sample of 9916 men and women aged 18 years and over who were followed annually between 2006 and 2016 in the Household, Income and Labour Dynamics in Australia (HILDA) survey. HRQoL was assessed using the self-administered SF-36 questionnaire annually between 2006 (baseline) and 2016. BMI was calculated from self-reported height and weight and was classified into the following four categories of baseline BMI: underweight (< 18.5 kg/m2), normal weight (18.5–24.9 kg/m2), overweight (25–29.9 kg/m2) and obese (≥ 30 kg/m2). We used linear mixed-effects regression models to investigate the associations between change in BMI (kg/m2) and concurrent changes in HRQoL scores over 11 years.


BMI gain was associated with deterioration of Physical Component Summary (PCS) (P < 0.001), but not with change in Mental component summary (MCS) over the 11-year period. BMI gain was inversely associated (P < 0.001) with five of the eight HRQoL domains (physical functioning, role physical, bodily pain, general health and vitality) with a significant graded association according to baseline BMI category. Over the 11-year study period, every unit increase in PCS was associated with a decrease of 0.02 (P < 0.001), 0.03 (P < 0.001) and 0.04 (P < 0.001) BMI units per year among participants who were normal, overweight and obese at baseline, respectively. Five of the eight domains of HRQoL (physical functioning, role physical, bodily pain, general health and vitality) were inversely associated with BMI (P < 0.001) with a significant graded association according to baseline BMI category.


Weight gain was not only associated with deterioration of HRQoL, and vice versa. The bi-directional association was stronger for physical than mental domains of HRQoL.


Weight gain Body mass index Quality of life Longitudinal 



We thank the National Centre for Longitudinal Data (NCLD) for allowing us to access the HILDA dataset. The HILDA project was initiated and is funded by the Australian Government Department of Families, Housing, Community Services and Indigenous Affairs (FaHCSIA) and is managed by the Melbourne Institute of Applied Economic and Social Research (Melbourne Institute).

Authors contributions

Study concept and design: BWS. Acquisition of data: BWS. Analysis and interpretation of data: BWS. Drafting the manuscript: BWS. Critical revision of the manuscript for important intellectual content: BWS, SS, YAM, LL and AMNR. BWS is the guarantor of this work and, as such, had full access to all of the data in the study and takes responsibility for the integrity of data and the accuracy of data analysis.


The authors received no specific funding for this work.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Supplementary material

11136_2020_2423_MOESM1_ESM.docx (28 kb)
Supplementary file1 (DOCX 28 kb)


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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.School of Social SciencesWestern Sydney UniversitySydneyAustralia
  2. 2.Centre for Mental Health, Melbourne School of Population and Global HealthUniversity of MelbourneMelbourneAustralia
  3. 3.Mental Health, School of Medicine, Translational Health Research InstituteWestern Sydney UniversitySydneyAustralia
  4. 4.Adelaide Institute for Sleep Health, Flinders UniversityAdelaideAustralia
  5. 5.Center for Migrant Health Policy, School of Public HealthSun Yat-Sen UniversityGuangzhouChina
  6. 6.Translational Health Research InstituteWestern Sydney UniversitySydneyAustralia

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