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Race and gender associations between obesity and nine health-related quality-of-life measures

Quality of Life Research volume 20, pages 665–674 (2011)Cite this article

Abstract

Purpose

To assess how health-related quality of life (HRQoL) varies by body mass index (BMI) category among gender and racial subgroups using nine HRQoL measures.

Methods

Among 3,710 US adults, we evaluated self-reported height, weight, and HRQoL that was measured by six indexes (EQ-5D; HUI2; HUI3; SF-6D; QWB-SA; HALex) and three summary measures (theta; PCS; MCS). Mean HRQoL was estimated by weighted regression for normal, overweight, and obese subgroups (BMI: 18.5–24.9 kg/m2; 25–29.9; and 30–50).

Results

HRQoL was significantly lower (P < 0.0001) with increasing BMI category except for MCS. Obese individuals were 5.3 units lower on PCS (1–100 scale) and 0.05–0.11 lower on the HRQoL indexes (0–1 scale) than those with normal weight. MCS scores were significantly lower for obese than normal-weight among women (P = 0.04) but not men (P = 0.11). Overweight blacks had higher HRQoL than blacks in other BMI categories (P = 0.033).

Conclusions

Six commonly used HRQoL indexes and two of three health status summary measures indicated lower HRQoL with obesity and overweight than with normal BMI, but the degree of decrement varied by index. The association appeared driven primarily by physical health, although mental health also played a role among women. Counter to hypotheses, blacks may have highest HRQoL when overweight.

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Fig. 1

Abbreviations

BMI:

Body mass index

HRQoL:

Health-related quality of life

EQ-5D:

EuroQol–5 dimensions

HUI2:

Health utilities index mark 2

HUI3:

Health utilities index mark 3

SF-6D:

Short-form–6 dimensions

QWB-SA:

Quality of well-being scale—self-administered

HALex:

Health and activities limitations index

kg:

Kilogram

m:

Meter

PCS:

Physical component score of SF-36v2™

MCS:

Mental component score of SF-36v2™

N:

Total number

CI:

Confidence interval

CID:

Clinically important difference

SE:

Standard error

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Acknowledgments

This work was supported by grant #P01-AG020679 from National Institute on Aging to University of Wisconsin. Dasha Cherepanov was supported by a grant (T32 HS000046) to the University of California, Los Angeles, and the RAND Corporation (Santa Monica, CA) from the Agency for Healthcare Research and Quality for a postdoctoral fellowship in health services research.

Conflict of interest

David Feeny has a proprietary interest in Health Utilities Incorporated, Dundas, Ontario, Canada. HUInc. Distributes copyrighted Health Utilities Index (HUI) materials and provides methodological advice on the use of HUI. None of the other authors declare a conflict of interest.

Author information

Affiliations

  1. Partnership for Health Analytic Research, LLC, 280 South Beverly Drive #404, Beverly Hills, CA, 90212, USA

    Tanya G. K. Bentley

  2. RAND Corporation, Santa Monica, CA, USA

    Dasha Cherepanov

  3. Department of Population Health Sciences, University of Wisconsin, Madison, WI, USA

    Mari Palta, Adam J. Paulsen, Nancy Cross Dunham & Dennis G. Fryback

  4. Department of Health Services, University of California, Los Angeles, CA, USA

    Dasha Cherepanov & Robert M. Kaplan

  5. Center for Health Research, Kaiser Permanente Northwest Region, Portland, OR, USA

    David Feeny

  6. Health Utilities Incorporated, Dundas, ON, Canada

    David Feeny

Authors
  1. Tanya G. K. Bentley
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  2. Mari Palta
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  3. Adam J. Paulsen
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  4. Dasha Cherepanov
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  5. Nancy Cross Dunham
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  6. David Feeny
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  7. Robert M. Kaplan
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  8. Dennis G. Fryback
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Correspondence to Tanya G. K. Bentley.

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Bentley, T.G.K., Palta, M., Paulsen, A.J. et al. Race and gender associations between obesity and nine health-related quality-of-life measures. Qual Life Res 20, 665–674 (2011). https://doi.org/10.1007/s11136-011-9878-7

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Keywords

  • Body mass index
  • Obesity
  • Health-related quality of life
  • Health status
  • EQ-5D
  • SF-6D