Health-Related Quality of Life in Patients with Class II and Class III Obesity

Background: Severe obesity may substantially impact quality of life. We estimated the health-related quality of life (HRQoL) in patients with class II and class III obesity, and explored the impact of patient characteristics and co-morbidities on quality of life. Methods: 110 patients with BMI ≥ 35 kg/m² presenting for evaluation for bariatric surgery were asked to complete the EuroQoL questionnaire. Co-morbidities of the patients were recorded, including coxarthralgia, gonarthralgia, foot problems (pain and arthrosis), diabetes, dyslipidemia, hypertension, infertility, coronary heart disease, low back pain, peptic esophagitis, sleep apnea syndrome, urinary stress incontinence, and venous insufficiency. The determinants of HRQoL on the EQ-VAS score and EQ-5D index (both ranging from 0-100) were analyzed in a univariate and multivariate linear regression model. Results: The mean EQ-5D index (societal perspective) was 76, whereas the mean EQ-VAS (patient perspective) was 66 (P<0.0001). The mean number of comorbidities was 4.9 (range 0-11). Dyslipidemia (68%), low back pain (63%) and venous insufficiency (57%) were the 3 most frequent co-morbidities. However, low back pain (β= -11.4) and foot problems (β= -8.5) were significantly associated with a reduction in the EQ-VAS score, whereas low back pain (β= -8.4) and coronary heart disease (β= -24.9) were significantly associated with a reduction in the EQ-5D index. Conclusion: The number and type of co-morbidities determine HRQoL in patients with severe obesity. Within our study population, a higher BMI, however, was not associated with a lower quality of life.