This paper is a preliminary report on the development of a new instrument., the Impact of Weight on Quality of Life (IWQOL) questionnaire, that assesses the effects of weight on various areas of life. We conducted two studies utilizing subjects in treatment for obesity at Duke University Diet and Fitness Center. The fwst study describes item development, assesses reliability, and compares pre-and post-treatment scores on the IWQOL. In the second study we examined the effects of body mass index (BML), gender, and age on subjects' perceptions of impact of weight on quality of life. Results indicate adequate pychometric properties with test-retest reliabilities averagding .75 for single items, and .89 for scales. Scale internal consistency averaged .87. Post-treatment scores differed significantly from pre-treatment scores on all scales, indicating that treatment produced positive changes in impact of weight on quality of life. The results of the second study indicate that the impact of weight generally worsened as the patients' size increased. However for women there was no association between BMI and impact of weight on Self-Esteem and Sexual Life. Even at the lowest BMI tertile studied, women reported that weight had a substantial impact in these areas. There were also significant gender differences, with women showing greater impact of weight on SelfEsteem and Sexual Life compared with men. The impact of age was a bit surprising, with some areas showing positive changes and others showing no change.

These results suggest that NES represents a subcategory among the obese, which also overlaps with binge eaters. In addition, anxiety distinguished individuals who met criteria for both disorders from patients who were diagnosed with either NES or BED.

KOLOTKIN, RONETTE L, SUSAN HEAD, ALAN BROOKHART. Construct validity of the Impact of Weight on Quality of Life questionnaire. Obes Res. 1997; 54-41. The Impact of Weight on Quality of Life questionnaire (IWQOL) is a 74-item self-report, condition-specific instrument that (1) assesses the effect of weight on quality of life in eight key areas, and (2) may be used as a treatment outcome measure and/or an evaluation tool for healthcare policy makers and third-party payers. This study explores IWQOL construct validity and provides new information on internal consistency, treatment effects, and differences between men and women. IWQOL total scores correlated highly with other measures of overall quality of life, and subscale scores correlated well with counterparts in the assessment battery. Internal consistency estimates for the IWQOL scales generally were high. For the women, 4-week participants, and the total sample, pretreatment-posttreatment differences were significant for all IWQOL scales and total score. For men, treatment differences were significant for the total score and all subscales except for Work and Mobility. Treatment differences for 2-week participants were significant for all scales except for Work. Consistent with previous JWQOL study results, the Comfort With Food scale scores reflected more discomfort at posttreatment as compared with pretreatment. The IWQOL, already translated into French and Italian, currently is demonstrating clinical and research utility as a quality-of-life outcome measure for clinical trials of antiobesity drugs and surgical treatments for patients with obesity. (15), such that we now warehouse (9) and index (3) these measures. Furthermore, measures of quality of life increasingly are being used by policy analysts and healthcare providers to compare costs and benefits of different health care services and to make decisions about healthcare policy and third-party payments (16).The three well-known health-related quality-of-life instruments mentioned above are generic measures of quality of life. Generic measures are used in general populations to assess functional health across a wide range of domains, health states, and diseases and are particularly useful for comparing the relative burden of different diseases or the relative benefit of different treatments (11). On the other hand, disease-specific instruments, which focus on the domains most relevant to the diseasekondition under study and the characteristics of patients in whom the conditions are most prevalent, are particularly useful in clinical trials in which specific therapeutic interventions for spec$c diseaseskonditions are being evaluated (1 1,15). Diseasespecific outcome measures have been developed for use in numerous medical populations, including human immunodeficiency virus, respiratory diseases, diabetes, and cancer.With respect to obesity, a serious condition with associated health risks, the gold standard for successful treatment outcome typically has been weight loss itself. Although clinici...