Psychosocial profile of the metabolically healthy but obese postmenopausal woman

Karelis, AD; Fontaine, J L; Rabasa‐Lhoret, Rémi; Prud’homme, Denis; Doucet, Éric; Blanchard, Chris M.; Garrel, Dominique R.; Strychar, Irène

doi:10.1016/s1262-3636(07)70254-9

Cited by 10 publications

(7 citation statements)

References 6 publications

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“…It is important to note that even if individuals with MHO are not at increased risk for all-cause mortality, they are still at risk for other complications of obesity such as osteoarthritis [85], poorer functional ability [50], lower quality of life, higher perceived stress, lower self-esteem, and poorer body image [86]. Individuals with MHO are also subject to the same social stigma to which metabolically unhealthy obese individuals are resulting in increased stress, risk of psychological disorders, substandard health care, and decreased health care utilization [87].…”

Section: Discussionmentioning

confidence: 99%

All-Cause Mortality Risk of Metabolically Healthy Obese Individuals in NHANES III

2012

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Mortality risk across metabolic health-by-BMI categories in NHANES-III was examined. Metabolic health was defined as: (1) homeostasis model assessment-insulin resistance (HOMA-IR) <2.5; (2) ≤2 Adult Treatment Panel (ATP) III metabolic syndrome criteria; (3) combined definition using ≤1 of the following: HOMA-IR ≥1.95 (or diabetes medications), triglycerides ≥1.7 mmol/L, HDL-C <1.04 mmol/L (males) or <1.30 mmol/L (females), LDL-C ≥2.6 mmol/L, and total cholesterol ≥5.2 mmol/L (or cholesterol-lowering medications). Hazard ratios (HR) for all-cause mortality were estimated with Cox regression models. Nonpregnant women and men were included (n = 4373, mean ± SD, age 37.1 ± 10.9 years, BMI 27.3 ± 5.8 kg/m2, 49.4% female). Only 40 of 1160 obese individuals were identified as MHO by all definitions. MHO groups had superior levels of clinical risk factors compared to unhealthy individuals but inferior levels compared to healthy lean groups. There was increased risk of all-cause mortality in metabolically unhealthy obese participants regardless of definition (HOMA-IR HR 2.07 (CI 1.3–3.4), P < 0.01; ATP-III HR 1.98 (CI 1.4–2.9), P < 0.001; combined definition HR 2.19 (CI 1.3–3.8), P < 0.01). MHO participants were not significantly different from healthy lean individuals by any definition. While MHO individuals are not at significantly increased risk of all-cause mortality, their clinical risk profile is worse than that of metabolically healthy lean individuals.

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Section: Discussionmentioning

confidence: 99%

All-Cause Mortality Risk of Metabolically Healthy Obese Individuals in NHANES III

2012

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“…In the eight studies that had examined this relationship, [32][33][34][35][36][37][38][39] overall, it was found that obesity appeared to be associated with a poor HRQoL in postmenopausal women. For example, Yan et al 32 measured the relationship between BMI and HRQoL in 3981 males and 3099 females aged .65 years (mean age of the women in 1996 was 74.3 [SD ¼ 6.0]), who were surviving participants from the Chicago Heart Association Detection Project in Industry (1967)(1968)(1969)(1970)(1971)(1972)(1973).…”

Section: Methodsmentioning

confidence: 99%

Quality of life in obese postmenopausal women

Jones¹,

Sutton²

2008

Menopause International

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The aim of this review was to identify the ways in which obesity affects the health-related quality of life (HRQoL) of postmenopausal women. This was considered important because a growing body of literature has identified obesity as a significant predictor for a poor psychological wellbeing and negative HRQoL, particularly in women, and because during the transition through the menopause women tend to accumulate more body weight. After searching eight electronic databases, only nine papers appeared meaningful. Although a meta-analysis was not possible, we found that a body mass index (BMI) > 30 kg/m2 was associated with a poor HRQoL in postmenopausal women; particularly in the areas associated with physical functioning, energy and vitality, and health perceptions. Thus, clinical management of obese postmenopausal women should focus on weight reduction and exercise in an attempt to improve wellbeing in these areas. However, the paucity of research, the different instruments chosen to measure HRQoL and the methodological limitations of the studies identified, prevented firm conclusions being made about whether the relationship between BMI and HRQoL is linear in postmenopausal women. Further research is needed to explore this relationship; particularly in comparison with underweight postmenopausal women and obese premenopausal women, where a few papers have identified these women as having a worse HRQoL than their obese postmenopausal counterparts. Other measures of central adiposity, including waist circumference and waist-hip ratio are recommended as useful supplemental measures to BMI in future studies.

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“…Karelis et al 39 have proposed that some psychological traits could distinguish metabolically normal obese from the 'at-risk' population. Unfortunately, these authors could not provide evidence of any specific characteristics, in terms of quality of life, self-esteem or perceived stress.…”

Section: Psychological Traitsmentioning

confidence: 99%

Open questions about metabolically normal obesity

2010

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Subsets of obese subjects without any cardiometabolic risk factors have been repeatedly described. This raises questions whether obesity 'per se' enhances the risk for cardiovascular or metabolic diseases and whether healthy obese subjects would benefit from a medical treatment. In order to answer these questions, as a first step, an expert consensus should be reached for the definition of metabolic normality. In fact, up to now, different parameters related to the metabolic syndrome and/or to insulin sensitivity have been utilized across studies. Once an agreement is reached, population-based studies should be undertaken to establish the incidence of metabolic normality among obese subjects. Furthermore, many other parameters such as age, sex, race, fat distribution and physical activity should be monitored to obtain results representative of a general population. Longitudinal studies aimed at investigating the evolution of the cardiometabolic profile of healthy obese subjects are also needed. In conclusion, data from the literature strongly suggest that a regular surveillance of the cardiometabolic parameters and a prevention of any further weight gain should be applied to healthy obese individuals, whereas possible benefits of a weight loss treatment are still a matter of debate.

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Psychosocial profile of the metabolically healthy but obese postmenopausal woman

Cited by 10 publications

References 6 publications

All-Cause Mortality Risk of Metabolically Healthy Obese Individuals in NHANES III

All-Cause Mortality Risk of Metabolically Healthy Obese Individuals in NHANES III

Quality of life in obese postmenopausal women

Open questions about metabolically normal obesity

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