Impact of Weight Loss and Regain on Quality of Life: Mirror Image or Differential Effect?

Engel, Scott G.; Crosby, Ross D.; Kolotkin, Ronette L.; Hartley, Guilford G.; Williams, G. Rhys; Wonderlich, Stephen A.; Mitchell, James E.

doi:10.1038/oby.2003.166

Cited by 67 publications

(56 citation statements)

References 23 publications

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“…To date, only one earlier study has examined the effect of weight regain on HRQL in persons treated for obesity. Engel et al 29 analyzed The SOS study: 10-year follow-up of quality of life J Karlsson et al the relationship between change in weight and HRQL in 122 participants in a weight reduction program who had been followed for about 1-3 years. Their results suggest that weight loss and regain are equally significant determinants for HRQL change.…”

Section: Discussionmentioning

confidence: 99%

Ten-year trends in health-related quality of life after surgical and conventional treatment for severe obesity: the SOS intervention study

et al. 2007

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Objective: To examine trends and effects of weight loss treatment on health-related quality of life (HRQL) in the severely obese over 10 years. Design: Swedish obese subjects (SOS) intervention study is a controlled, longitudinal trial of the health effects of weight loss in the severely obese. Subjects: A total of 655 of 851 surgically treated and 621 of 852 conventionally treated obese men (body mass index, BMIX34) and women (BMIX38) who completed 10 years of the study. Measurements: HRQL was assessed before treatment and after 0.5, 1, 2, 3, 4, 6, 8 and 10 years. Results: HRQL change during the 10-year observation period largely followed phases of weight loss, weight regain and weight stability. Improvements and deteriorations in HRQL were associated with the magnitude of weight loss or regain, except regarding anxiety. Peak improvements in the surgical group were observed during the first year of weight loss, whereas the weight regain phase (mainly between 1-and 6-year follow-up) was accompanied by a gradual decline in HRQL. The period from 6-to 10-year follow-up was characterized by relatively stable observations in both weight and HRQL. At 10 years, net gains were noted in all HRQL domains compared to baseline. Comparisons of treatment effects on HRQL in the surgical vs conventional group after 10 years showed significantly better outcome in the surgical group on current health perceptions, social interaction, psychosocial functioning and depression, whereas no significant differences were found for overall mood and anxiety. Long-term results of the study suggest that a maintained weight loss of about 10% is sufficient for positive long-term effects on HRQL, a limit that was reached in about two-thirds of the surgically treated patients who completed 10 years of the study. Conclusion: Long-lasting weight reduction in the severely obese has a general long-standing positive outcome on HRQL. Bariatric surgery is a favorable option for the treatment of severe obesity, resulting in long-term weight loss and HRQL improvements in a majority of patients. However, difficulties among some surgical patients to control and maintain weight loss over time should not be ignored. Future research should study if the long-term efficacy of bariatric surgery may be further enhanced by implementing lifestyle modification techniques in the postoperative management of patients.

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Section: Discussionmentioning

confidence: 99%

Ten-year trends in health-related quality of life after surgical and conventional treatment for severe obesity: the SOS intervention study

et al. 2007

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“…Importantly, weight loss has been associated with improved health-related quality of life (36), but to date, the effect of interventions to control weight in RA is not known.…”

Section: Discussionmentioning

confidence: 99%

Association of obesity with worse disease severity in rheumatoid arthritis as well as with comorbidities: A long‐term followup from disease onset

Ajeganova

Andersson

Hafström

2012

Arthritis Care & Research

196

158

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Objective. To determine the association of obesity, defined as a body mass index (BMI) >30 or >28 kg/m 2 or by waist circumference (WC), with disease activity and severity, as well as its relationship to comorbidities in rheumatoid arthritis (RA). 9% at baseline and 15.8% at followup. In multivariable regression, BMI and obesity, defined as a BMI >30 or >28 kg/m 2 , at both inclusion and the time of the survey were independently associated with higher disease activity, fewer patients in sustained remission, higher HAQ score, more pain, and worse general health. Also, BMI and obesity independently conferred to higher odds for being diagnosed with hypertension, diabetes mellitus, and chronic pulmonary disease. Further, BMI and WC were independently associated with angina pectoris/acute myocardial infarction/coronary revascularization. In contrast, none of the examined obesity variables was associated with the prevalence of stroke or transient ischemic attack. Lifestyle changes during the observational period, such as quitting smoking or diet change, had no impact on the outcomes. Conclusion. Obesity was associated with worse RA disease outcomes and a higher prevalence of comorbidities. Body measurements are recommended to improve prediction of the disease course.

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“…Finally, it is possible that the HRQoL benefits resulted from the so-called "regression to the mean," where individuals with worse HRQoL at baseline get the greatest benefits from the weight management intervention, as previously reported. 28,37 In our study, we adjusted for baseline values of each HRQoL measurement, in addition to the participant demographic characteristics, baseline weight and physical activity, and the presence of medical and psychological co-morbidities. In summary, our study demonstrates that lifestyle modification characterized by intentional weight loss and increased physical activity has an independent but small to modest association with better HRQoL in overweight or obese participants at high risk for T2D.…”

Section: Discussionmentioning

confidence: 99%

Impact of Lifestyle Intervention and Metformin on Health-Related Quality of Life: the Diabetes Prevention Program Randomized Trial

et al. 2012

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BACKGROUND: Adults at high risk for diabetes may have reduced health-related quality of life (HRQoL). OBJECTIVE: To assess changes in HRQoL after interventions aimed at diabetes risk reduction. DESIGN, SETTING, AND PARTICIPANTS: A randomized clinical trial, the Diabetes Prevention Program, was conducted in 27 centers in the United States, in 3,234 non-diabetic persons with elevated fasting and postload plasma glucose, mean age 51 years, mean BMI 34 Kg/m²; 68 % women, and 45 % members of minority groups. INTERVENTIONS: Intensive lifestyle (ILS) program with the goals of at least 7 % weight loss and 150 min of physical activity per week, metformin (MET) 850 mg twice daily, or placebo (PLB). MEASUREMENTS: HRQoL using the 36-Item ShortForm (SF-36) health survey to evaluate health utility index (SF-6D), physical component summaries (PCS) and mental component summaries (MCS). A minimally important difference (MID) was met when the mean of HRQoL scores between groups differed by at least 3 %. RESULTS: After a mean follow-up of 3.2 years, there were significant improvements in the SF-6D (+0.008, p=0.04) and PCS (+1.57, p<0.0001) scores in ILS but not in MET participants (+0.002 and +0.15, respectively, p=0.6) compared to the PLB group. ILS participants showed improvements in general health (+3.2, p< 0.001), physical function (+3.6, p<0.001), bodily pain (+1.9, p= 0.01), and vitality (+2.1, p= 0.01) domain scores. Treatment effects remained significant after adjusting sequentially for baseline demographic factors, and for medical and psychological comorbidities. Increased physical activity and weight reduction mediated these ILS treatment effects. Participants who experienced weight gain had significant worsening on the same HRQoL specific domains when compared to those that had treatment-related (ILS or MET) weight loss. No benefits with ILS or MET were observed in the MCS score. CONCLUSION: Overweight/obese adults at high risk for diabetes show small improvement in most physical HRQoL and vitality scores through the weight loss and increased physical activity achieved with an ILS intervention.KEY WORDS: quality of life; lifestyle; metformin; diabetes risk; weight loss.

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Impact of Weight Loss and Regain on Quality of Life: Mirror Image or Differential Effect?

Cited by 67 publications

References 23 publications

Ten-year trends in health-related quality of life after surgical and conventional treatment for severe obesity: the SOS intervention study

Ten-year trends in health-related quality of life after surgical and conventional treatment for severe obesity: the SOS intervention study

Association of obesity with worse disease severity in rheumatoid arthritis as well as with comorbidities: A long‐term followup from disease onset

Impact of Lifestyle Intervention and Metformin on Health-Related Quality of Life: the Diabetes Prevention Program Randomized Trial

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