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Quality of life as a mediator in the association between body mass index and negative emotionality in overweight and obese non-clinical sample

  • Alessandra Pokrajac-Bulian
  • Miljana Kukić
  • Nina Bašić-Marković
Original Article

Abstract

Purpose

The present study investigates the differences in physical health-related quality of life (HRQoL) among overweight and obese people, as well as the correlates of HRQoL in this population and the association between BMI, depression, anxiety, and potential mediating effects of HRQoL.

Methods

The research was conducted on a sample of overweight and obese adults who visited their primary care physician. A total of 143 women and 130 men were enrolled in the study, 43 % of the subjects were overweight, and 57 % of the subjects were obese. The subjects ranged in age between 21 and 60 years. Depression and anxiety were assessed using the Hospital Anxiety and Depression Scale, and HRQoL was evaluated using the Medical Outcome Study Short-Form 36.

Results

The analysis of variance results showed that women in comparison to men have lower physical HRQoL (e.g. worst physical functioning, more bodily pain), and that severely obese patients have lower physical HRQoL in comparison to overweight ones. The regression analysis results indicated that some of the aspects of physical HRQoL (e.g. physical functioning, role limitations) mediate the relationship between BMI and depression only in women. The higher level of body mass decreased the physical HRQoL, which became a potential risk factor for the development of depressive symptoms.

Conclusions

The results from the present study show that a different pattern of functioning exists between men and women. It is important to identify the factors that can effectively motivate and stimulate obese people to change their lifestyle and to consider the differences in psychological functioning between women and men.

Keywords

Health-related quality of life Depression Anxiety BMI 

Notes

Compliance with ethical standards

Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Ethical approval

This study was approved by Ethical committee of Faculty of Humanities and Social Sciences in Rijeka, Croatia.

Informed consent

Informed consent was obtained from all individual participants included in the study.

References

  1. 1.
    Croatian Obesity Society. Retrieved from: http://hdd-hlz.org/epidemiologija-debljine/
  2. 2.
    Pi-Sunyer FX (2002) The obesity epidemic: pathophysiology and consequences of obesity. Obes Res 10:S97–S104. doi: 10.1038/oby.2002.202 CrossRefGoogle Scholar
  3. 3.
    Greenberg I, Perna F, Kaplan M, Sullivan MA (2005) Behavioral and psychological factors in the assessment and treatment of obesity surgery patients. Obes Res 13:244–249. doi: 10.1038/oby.2005.33 CrossRefPubMedGoogle Scholar
  4. 4.
    Kolotkin RL, Head S, Hamilton M, Tse CJ (1995) Assessing impact of weight on quality of life. Obes Res 3:49–56. doi: 10.1002/j.1550-8528.1995.tb00120.x CrossRefPubMedGoogle Scholar
  5. 5.
    Doll HA, Petersen SEK, Stewart-Brown SL (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. Obes Res 8:160–170. doi: 10.1038/oby.2000.17 CrossRefPubMedGoogle Scholar
  6. 6.
    Petry NM, Barry D, Pietrzak RH, Wagner JA (2008) Overweight and obesity are associated with psychiatric disorders: results from the national epidemiologic survey on alcohol and related conditions. Psychosom Med 70:288–297. doi: 10.1097/PSY.0b013e3181651651 CrossRefPubMedGoogle Scholar
  7. 7.
    Atlantis E, Baker M (2008) Obesity effects on depression: systematic review of epidemiological studies. Int J Obes 32:881–891. doi: 10.1038/ijo.2008.54.pmid:18414420 CrossRefGoogle Scholar
  8. 8.
    Stunkard AJ, Sobal J (1995) Psychosocial consequences of obesity. In: Brownell KD, Fairburn CG (eds) Eating disorders and obesity. Guilford Press, New York, pp 417–421Google Scholar
  9. 9.
    Roberts R, Strawbridge W, Kaplan G (2002) Are the fat more jolly? Ann Behav Med 24:169–180. doi: 10.1207/S15324796ABM2403_02 CrossRefPubMedGoogle Scholar
  10. 10.
    Fezeu LK, Batty DG, Gale CR, Kivimaki M, Hercberg S, Czernichow S (2015) Is the relationship between common mental disorder and adiposity bidirectional? PloS one, Prospective analyses of a UK general population-based study. doi: 10.1371/journal.pone.0119970 Google Scholar
  11. 11.
    Onyike CU, Crum RM, Lee HB, Lyketsos C, Eaton W (2003) Is obesity associated with major depression? Results from the Third National Health and Nutrition Examination Survey. Am J Epidemiol 158:1139–1147. doi: 10.1093/aje/kwg275 CrossRefPubMedGoogle Scholar
  12. 12.
    Barry D, Pietrzak RH, Petry NM (2008) Gender differences in associations between body mass index and DSM-IV mood and anxiety disorders: results from the national epidemiologic survey on alcohol and related conditions. Ann Epidemiol 18:458–466. doi: 10.1016/j.annepidem.2007.12.009 PubMedCentralCrossRefPubMedGoogle Scholar
  13. 13.
    Wadden TA, Sarwer DB (2006) Behavioral assessment of candidates for bariatric surgery: a patient-oriented approach. Obes 14:53S–62S. doi: 10.1038/oby.2006.283 CrossRefGoogle Scholar
  14. 14.
    Yancy WS, Olsen MK, Westman EC, Bosworth HB, Edelman B (2002) Relationship between obesity and health-related quality of life in men. Obes Res 10:1057–1064. doi: 10.1038/oby.2002.143 CrossRefPubMedGoogle Scholar
  15. 15.
    Jagielski AC, Brown A, Hosseini-Araghi M, Thomas GN, Taheri S (2014) The association between adiposity, mental well-being, and quality of life in extreme obesity. PLoS One 9(3):e92859. doi: 10.1371/journal.pone.0092859 PubMedCentralCrossRefPubMedGoogle Scholar
  16. 16.
    Laaksonen M, Sarlio-Lähteenkorva S, Leino-Arjas P, Martikainen P, Lahelma E (2005) Body weight and health status: importance of socioeconomic position and working conditions. Obes Res 13:2169–2177. doi: 10.1038/oby.2005.269 CrossRefPubMedGoogle Scholar
  17. 17.
    Herpertz S, Kielmann R, Wolf AM, Hebebrand J, Senf W (2004) Do psychosocial variables predict weight loss or mental health after obesity surgery? A systematic review. Obes Res 12:1554–1569. doi: 10.1038/oby.2004.195 CrossRefPubMedGoogle Scholar
  18. 18.
    Barney LJ, Griffiths KM, Banfield MA (2011) Explicit and implicit information needs of people with depression: a qualitative investigation of problems reported on an online depression support forum. BMC Psychiat 11:88. doi: 10.1186/1471-244X-11-88 CrossRefGoogle Scholar
  19. 19.
    Callahan EJ, Bertakis KD, Azari R, Robbins JA, Helms LJ, Leigh JP (2002) Association of higher costs with symptoms and diagnosis of depression. J Fam Pract 51:540–544PubMedGoogle Scholar
  20. 20.
    Zigmond A, Snaith R (1983) The hospital anxiety and depression scale. Acta Psychiat Scand 67:361–370. doi: 10.1111/j.1600-0447.1983.tb09716.x CrossRefPubMedGoogle Scholar
  21. 21.
    Ware JE, Sherbourne CD (1992) The MOS 36-Item Short-Form Health Survey (SF-36): I. Conceptual framework and item selection. Med Care 30:473–483CrossRefPubMedGoogle Scholar
  22. 22.
    Bromberger JT, Lanza di Scalea T (2009) Longitudinal associations between depression and functioning in midlife women. Maturitas 64:145–159. doi: 10.1016/j.maturitas.2009.09.017 PubMedCentralCrossRefPubMedGoogle Scholar
  23. 23.
    Baron RM, Kenny DA (1986) The moderator-mediator variable distinction in social psychological research: conceptual, strategic and statistical considerations. J Pers Soc Psycho 51:1173–1182. doi: 10.1037/0022-3514.51.6.1173 CrossRefGoogle Scholar
  24. 24.
    Jarvinen O, Julkunen J, Tarkka MR (2007) Impact of obesity on outcome and changes in quality of life after coronary artery bypass grafting. World J Surg 31:318–325. doi: 10.1007/s00268-006-0183-5 CrossRefPubMedGoogle Scholar
  25. 25.
    Oreopoulos A, Padwal R, McAlister FA, Ezekowitz J, Sharma AM, Kalantar-Zadeh K et al (2010) Association between obesity and health-related quality of life in patients with coronary artery disease. Int J Obes 34:1434–1441. doi: 10.1038/ijo.2010.73 CrossRefGoogle Scholar
  26. 26.
    De Smedt D, Clays E, Annemans L, Doyle F, Kotseva K, Pająk A et al (2013) Health related quality of life in coronary patients and its association with their cardiovascular risk profile: results from the EUROASPIRE III survey. Int J Cardiol 168:898–903. doi: 10.1016/j.ijcard.2012.10.053 CrossRefPubMedGoogle Scholar
  27. 27.
    Chun H (2006) Gender as a social determinant of health: a Korean perspective. Seoul National UniversityGoogle Scholar
  28. 28.
    Unruh AM (1996) Gender variations in clinical pain experience. Pain 65:123–167. doi: 10.1016/0304-3959(95)00214-6 CrossRefPubMedGoogle Scholar
  29. 29.
    Fillingim RB, King CD, Ribeiro-Dasilva MC, Rahim-Williams B, Riley JL (2009) Sex, gender, and pain: a review of recent clinical and experimental findings. J Pain 10:447–485. doi: 10.1016/j.jpain.2008.12.001 PubMedCentralCrossRefPubMedGoogle Scholar
  30. 30.
    Stone A, Broderick JE (2012) Obesity and pain are associated in the United States. Obes 20:1491–1495. doi: 10.1038/oby.2011.397 CrossRefGoogle Scholar
  31. 31.
    Lean ME, Han TS, Seidell JC (1999) Impairment of health and quality of life using new US Federal guidelines for the identification of obesity. Arch Intern Med 159:837–843. doi: 10.1001/archinte.159.8.837 CrossRefPubMedGoogle Scholar
  32. 32.
    Wang J, Sereika SM, Styn MA, Burke LE (2013) Factors associated with health-related quality of life among overweight or obese adults. J Clin Nurs 22:2172–2182. doi: 10.1111/jocn.12280 PubMedCentralCrossRefPubMedGoogle Scholar
  33. 33.
    Corica F, Corsonello A, Apolone G, Lucchetti M, Melchionda N, Marchesini G (2006) Construct validity of the Short Form-36 Health Survey and its relationship with BMI in obese outpatients. Obes 14:1429–1437. doi: 10.1038/oby.2006.162 CrossRefGoogle Scholar
  34. 34.
    Kolotkin RL, Crosby RD, Gress RE, Hunt SC, Engel SG, Adams TD (2008) Health and health-related quality of life: differences between men and women who seek gastric bypass surgery. Surg Obes Relat Dis 4:651–658. doi: 10.1016/j.soard.2008.04.012 PubMedCentralCrossRefPubMedGoogle Scholar
  35. 35.
    Fabricatore AN, Wadden TA, Sarwer DB, Faith MS (2005) Health-related quality of life and symptoms of depression in extremely obese persons seeking bariatric surgery. Obes Surg 15:304–309. doi: 10.1381/0960892053576578 CrossRefPubMedGoogle Scholar
  36. 36.
    Kolotkin RL, Crosby RD, Williams GR (2002) Health-related quality of life varies among obese subgroups. Obes Res 10:748–756CrossRefPubMedGoogle Scholar
  37. 37.
    Buscemi S, Castellini G, Batsis JA, Ricca V, Sprini D, Galvano F, Grosso G, Rosafio G, Caravello M, Rini GB (2013) Psychological and behavioural factors associated with long-term weight maintenance after a multidisciplinary treatment of uncomplicated obesity. Eat Weight Disord 18:351–358. doi: 10.1007/s.40519-013-0059-2 CrossRefPubMedGoogle Scholar
  38. 38.
    Barrett AE, Robbins C (2008) The multiple sources of women’s aging anxiety and their relationship with psychological distress. J Aging Health 20:32–65. doi: 10.1177/0898264307309932 CrossRefPubMedGoogle Scholar
  39. 39.
    Mannucci E, Ricca V, Barciulli E, Di Bernardo M, Travaglini R, Cabras PL et al (1999) Quality of life and overweight: the obesity related well-being (Orwell 97) questionnaire. Addict Behav 24:345–357. doi: 10.1016/S0306-4603(98)00055-0 CrossRefPubMedGoogle Scholar
  40. 40.
    Sullivan M, Karlsson J, Sjöström L, Backman L, Bengtsson C, Bouchard C et al (1993) Swedish obese subjects (SOS)—an intervention study of obesity. Baseline evaluation and psychosocial functioning in the first 1743 subjects examined. Int J Obes Rel Metab Dis 17:503–512Google Scholar
  41. 41.
    Foster GD, Wadden TA (1994) The psychology of obesity, weight loss, and weight regain: research and clinical findings. In: Blackburn GL, Kanders BD (eds) Obesity: pathophysiology, psychology and treatment. Chapman, New York, pp 140–159Google Scholar
  42. 42.
    Mannucci E, Petroni ML, Villanova N, Rotella CM, Apolone G, Marchesini G et al (2010) Clinical and psychological correlates of health related quality of life in obese patients. Health Qual Life Outcomes 8:90. doi: 10.1186/1477-7525-8-90 PubMedCentralCrossRefPubMedGoogle Scholar
  43. 43.
    Ricca V, Mannucci E, Moretti S, Di Bernardo M, Zucchi T, Cabras PL et al (2000) Screening for binge eating disorder in obese outpatients. Compr Psychiatry 41:111–115. doi: 10.1016/S0010-440X(00)90143-3 CrossRefPubMedGoogle Scholar
  44. 44.
    Murphy JM, Horton NJ, Burke JD, Monson RR, Laird NM, Lesage A, Sobol AM (2009) Obesity and weight gain in relation to depression: findings from the Stirling Country Study. Int J Obes 33(3):335–341. doi: 10.1038/ijo.2008.273 CrossRefGoogle Scholar
  45. 45.
    Preiss K, Brennan L, Clarke D (2003) A systematic review of variables associated with the relationship between obesity and depression. Obes Rev 14:906–918. doi: 10.1111/obr.12052 CrossRefGoogle Scholar
  46. 46.
    Kolotkin RL, Westman EC, Østbye T, Crosby RD, Eisenson HJ, Binks M (2004) Does binge eating disorder impact weight-related quality of life? Obes Res 12:999–1005. doi: 10.1038/oby.2004.122 CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2015

Authors and Affiliations

  • Alessandra Pokrajac-Bulian
    • 1
  • Miljana Kukić
    • 1
  • Nina Bašić-Marković
    • 2
  1. 1.Department of Psychology, Faculty of Humanities and Social SciencesUniversity of RijekaRijekaCroatia
  2. 2.Familiy medicine practiceRijekaCroatia

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