Pain in the obese: Impact on Health-Related Quality-of-Life

Barofsky, Ivan; Fontaine, Kevin R.; Cheskin, Lawerence J.

doi:10.1007/bf02895160

Cited by 118 publications

(85 citation statements)

References 7 publications

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“…2,9,10,[13][14][15]37 We are also in agreement with others who have found that obese patients have lower levels of HRQL, [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15] and that the estimated loss of HRQL associated with obesity is reduced (although not eliminated) when levels of co-morbidity are controlled for. [12][13][14][15] Similarly, others have also found that pre-obese individuals do not have a significantly lower HRQL than patients with a normal BMI after other factors are controlled for.…”

Section: Discussionsupporting

confidence: 92%

“…[1][2][3][4][5][6][7][8][9][10][11][12][13][14][15] To our knowledge, only one study has shown that utility measures, which are designed to estimate and compare the benefits of many interventions on a common scale (where zero equals death and full health equals one), can detect the loss in HRQL associated with obesity. 15 The necessity for such utility measures is demonstrated by the fact that both the United States (US) Public Health Service Panel on Costeffectiveness in Health and Medicine and the United Kingdom (UK) National Institute for Health and Clinical Excellence (NICE) prefer utility measures to be used when assessing the cost-effectiveness of new, and current, interventions.…”

Section: Introductionmentioning

confidence: 99%

“…Previous studies 1,2,6,7,[9][10][11][12][13][14][15] have controlled, to varying degrees, for potentially confounding variables when assessing the relationship between BMI and HRQL. We seek to build upon these studies by estimating the relationship between obesity and HRQL after adjusting for a number of socio-demographic variables and obesity-related co-morbidities.…”

Section: Introductionmentioning

confidence: 99%

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The relationship between body mass index and health-related quality of life: comparing the EQ-5D, EuroQol VAS and SF-6D

et al. 2006

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Background: No other studies have compared the relationship between body mass index (BMI) and health-related quality of life (HRQL) on more than one utility measure. Estimating the HRQL effects of obesity on a (common) utility scale enables the relative cost-effectiveness of interventions designed to alleviate obesity to be estimated. Objective: To examine the relationship between BMI and HRQL according to the EQ-5D, EuroQol visual analogue scale (EQ-VAS) and SF-6D. Methods: Patients aged X45 years at one UK general practice were asked to complete the EQ-5D, EQ-VAS, SF-36 questionnaire (used to derive the SF-6D), and information on their characteristics and co-morbidity. Body mass index was categorized according to the World Health Organization (WHO) recommendations. Regression analysis was used to compare the HRQL of normal BMI patients to the HRQL of patients in other BMI categories, while controlling for patient characteristics and comorbidity. Results: A total of 1865 patients responded (67%), mean BMI 26.0 kg/m 2 , 16% obese (BMIX30). Patients with back pain, hip pain, knee pain, asthma, diabetes or osteoarthritis were also significantly more likely to be obese. After controlling for other factors, compared to normal BMI patients, obese patients had a lower HRQL according to the EQ-5D (Po0.01), EQ-VAS (Po0.001) and SF-6D (Po0.001). Pre-obese patients were not estimated to have a significantly lower HRQL, and underweight patients were only estimated to have a significantly lower HRQL according to the SF-6D. These results arose because, on the EQ-5D, obese patients were found to have significantly more problems with mobility and pain, compared to physical functioning, social functioning and role limitations on the SF-6D. Whereas, according to the SF-6D, underweight patients had significantly more problems on the dimension of role limitation. Conclusion: The EQ-5D, EQ-VAS and SF-6D were in agreement that, relative to a normal BMI, obesity is associated with a lower HRQL, even after controlling for patient characteristics and co-morbidity. These three measures are thereby sensitive to the HRQL effects of obesity and can be used to estimate the cost-effectiveness of interventions designed to alleviate obesity.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The relationship between body mass index and health-related quality of life: comparing the EQ-5D, EuroQol VAS and SF-6D

et al. 2006

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“…A correlation, whenever present, is limited to a few, but not all, physical aspects of obesity, namely Physical Functioning 13 or Bodily Pain. 31 This was also found in the present series, where Bodily Pain was the sole scale of SF-36 whose changes paralleled CBT-induced changes in BMI.…”

Section: Discussionsupporting

confidence: 87%

Effects of cognitive–behavioural therapy on health-related quality of life in obese subjects with and without binge eating disorder

et al. 2002

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OBJECTIVE:To measure the effects of cognitive -behavioural therapy on health-related quality of life (HRQL) in obese patients, in relation to binge eating disorder. DESIGN: Longitudinal, clinical intervention study consisting of structured sessions of cognitive -behavioural therapy, preceded by sessions chaired by a psychologist in subjects with binge eating. SUBJECTS: Two groups of obese patients (92 treated by cognitive -behavioural therapy (77 females); 76 untreated controls (67 female), selected from the waiting list (control group)). Of 92 treated patients, 46 had a binge eating disorder at psychometric testing and structured clinical interview. MEASUREMENTS: Health-related quality of life by means of Short-Form 36 questionnaire at baseline and after 3 -5 months. RESULTS: Cognitive -behavioural treatment produced an average weight loss of 9.4 AE 7.5 kg, corresponding to a BMI reduction of 3.48 AE 2.70 kg=m 2 . No changes were observed in the control group. All scales of HRQL improved in treated subjects (by 5 -19%). In obese subjects with binge eating weight loss was lower in comparison to non-bingers (7.7 AE 8.1 vs 11.1 AE 6.6; P ¼ 0.034). However, the improvement in HRQL was on average larger, and significantly so for Role Limitation -Physical (P ¼ 0.006), Role Limitation -Emotional (P ¼ 0.002), Vitality (P ¼ 0.003), Mental Health (P ¼ 0.032) and Social Functioning (P ¼ 0.034). Bodily Pain was the sole scale whose changes paralleled changes in body weight. CONCLUSIONS: The positive effects of cognitive -behavioural therapy, mainly in subjects with binge eating, largely outweigh the effects on body weight, resulting in a significant change in self-perceived health status.

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“…5,6 The higher fatigability suffered by obese subjects, which are constrained to carry more weight than lean individuals as a consequence of added inert fat mass, has been attributed to several different factors, including chronic physical inactivity, concomitant diseases and chronic pain, as well as poor selfesteem. [7][8][9] Nonetheless, it has been demonstrated that obese patients actually display major motor limitations due to a reduction of both aerobic and anaerobic capabilities, which can be evidenced with adequate functional motor tests suitable for this disabled condition. [10][11][12][13] While reductions in aerobic power interfere with the capability to sustain relatively intense and prolonged exercise, anaerobic power is related to the accomplishment of short and vigorous movements more directly involved in everyday life activities (ie rapidly climbing up a flair of stairs or running to catch a bus) or even in brisk postural adjustments to prevent falls and accidental crushes.…”

Section: Introductionmentioning

confidence: 99%

Influence of gender, age and BMI on lower limb muscular power output in a large population of obese men and women

et al. 2003

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OBJECTIVE:To depict the general trends of muscle anaerobic performance in obese subjects within a wide range of age and body weight. DESIGN: Cross-sectional study for the measurement of lower limb maximal anaerobic power output with a modification of the Margaria stair climbing test in a large population of obese subjects of both genders within a wide span of age (18-80 y) and body mass index (BMI, 30-68 kg m À2 ). Furthermore, body composition was also determined by bioimpedance analysis in a representative subgroup, in order to evaluate the relationships between fat-free mass (FFM) and power output. SUBJECTS: A total of 1298 obese subjects (486 males, 812 females) from an Italian population seeking medical support for body weight reduction. Within this sample, a consistent subgroup of 193 subjects (59 males, 134 females) was also selected for accessory study of body composition. RESULTS: In general, male subjects developed significantly higher lower limb power output ( . W) than female subjects (Po0.001-0.01), both in absolute terms and per unit body mass. In both genders, . W was influenced negatively by age (Po0.001) and positively by BMI (Po0.001). While the effect of age was similar in both genders, BMI had a different positive effect in male and in female subjects, being more definite in male subjects. In the subgroup, FFM was found to depend both on age and BMI, in a fashion comparable with that displayed by .W. The gender-related differences in . W disappeared when expressed per unit FFM and a significant linear correlation was found between FFM and . W, both in male and female subjects (R 2 ¼ 0.32-0.51, Po0.001). CONCLUSIONS: The lower limb maximal power output is significantly higher in obese male subjects than in female subjects, being negatively influenced by age but positively related to BMI. Female subjects appear to be at a greater disadvantage for effect of obesity, the major motor limitations being suffered by older women with higher BMI. These gender differences in ageand BMI-dependent .W changes seem to be related to changes in FFM in the subgroup in whom body composition was studied.

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Pain in the obese: Impact on Health-Related Quality-of-Life

Cited by 118 publications

References 7 publications

The relationship between body mass index and health-related quality of life: comparing the EQ-5D, EuroQol VAS and SF-6D

The relationship between body mass index and health-related quality of life: comparing the EQ-5D, EuroQol VAS and SF-6D

Effects of cognitive–behavioural therapy on health-related quality of life in obese subjects with and without binge eating disorder

Influence of gender, age and BMI on lower limb muscular power output in a large population of obese men and women

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