The association between excess weight and self-rated health and psychological distress in women in Spain

Abstract

Objective: To investigate the associations between obesity and self-rated health and psychological well-being in Spanish women. Design: Cross-sectional study. Three dependent variables were defined: self-rated health; self-declared diagnosis of psychiatric disorders or use of psychiatric drugs; and General Health Questionnaire-12 (GHQ-12) score. A set of variables (sociodemographic, morbidity and lifestyle) were used to adjust for possible confounding effects. Setting: The National Health Survey was conducted in Spain in 2006. Subjects: A total of 15 099 women aged $18 years. Participants were classified into groups according to their BMI. Results: In all, 55?4 % of the women had normal weight, 29?4 % were overweight and 15?2 % were obese. Self-perception of poor health in obese women was 57?8 %, a significantly higher value than in women of normal weight (28?8 %). Prevalence of psychiatric disease was 35?5 % in obese women and 18?9 % in women of normal weight. In multivariate analysis, obese women had 34 % higher odds of declaring poor self-perception of health (OR 5 1?34; 95 % CI 1?12, 1?61), 18 % higher odds of self-reporting psychiatric disease (OR 5 1?18; 95 % CI 1?02, 1?38) and 26 % higher odds (OR 5 1?26; 95 % CI 1?02, 1?55) of having an abnormal outcome ($3) on the GHQ-12 than women of normal weight. Conclusions: The present study highlights that obese Spanish women have worse self-rated health and psychological health than those with normal weight. These aspects are relevant because of the growing importance placed on the functionality of patients and their mental health within the obesity epidemic. Keywords Obesity and overweightSelf-rated health Psychological distress Psychiatric diseases General Health WHO has defined obesity as a 21st century epidemic because of its proportions over recent decades and its overwhelming impact on morbidity and mortality and quality of life. Thus, obesity presents a significant challenge to public health (1)(2)(3)(4) . Obesity is associated with many factors aside from the purely biological ones. Previous studies have shown demographic and socio-economic influences on the prevalence of weight problems (5) . The greater prevalence of obesity in groups with a lower socio-economic status and those with associated comorbidity (5,6) is noteworthy. In Europe, the prevalence of obesity ranges from 5 % to 23 % among men and between 7 % and 36 % among women (7) . In Spain, overall, prevalence is estimated at 15?5 % in adults, higher in women (17?5 %) than in men (13?2 %) (1) . In previous studies, it has been described that obesity is more prevalent in women (5,6,8) . In addition, it has been found that women suffer more psychiatric disorders (9,10) , musculoskeletal disorders (8) and CVD (11) than do men, with this difference being even greater when the women are also obese (4,12) . Furthermore, scientific literature reports poor self-rated health more frequently in women than in men (13)

Psychological distress as a determinant of changes in body mass index over a period of 10years

“…Previous (cross-sectional) studies found no association (Han et al, 1998;Huang et al, 2006;Lopez-Garcia et al, 2003;Vasiljevic et al, 2008;Istvan et al, 1992) between psychological distress and overweight, with the exception of the study of Martin-Lopez et al (2011). The latter study found a statistically significant association between psychological distress, as assessed by the general Health Questionnaire (Jackson, 2007), and overweight among a large female study sample (N = 15,099).…”

“…Measured using the Mental Health Inventory (MHI-5), almost 14% (point prevalence) of the Dutch population deals with psychological distress, which is comparable to other European countries (TNS eurobarometer 2006). Previous studies on the association between psychological distress and overweight/weight gain were mostly cross-sectional (Garcia-Mendizabal et al, 2009;Han et al, 1998;Huang et al, 2006;Lopez-Garcia et al, 2003;Vasiljevic et al, 2008) and used different measurements to assess for psychological distress (Istvan et al, 1992;Martin-Lopez et al, 2011;Rumpel et al, 1994). One longitudinal study examined whether weight gain was related to the development of psychological distress (MHI-5) (Fine et al, 1999).…”

Contribution of the Economic Crisis to the Risk Increase of Poor Mental Health in a Region of Spain

“…Despite this, it is necessary to highlight the starting high prevalence in women, possibly explained by factors such as the status of women in society, their workload, lower economic resources, lack of autonomy, lack of social support, and in some cases, the violence, overburden and stress that they experience and that contribute to their poor health [32]. Studies in Spain have shown worse mental health in older women, immigrants from a low-income country [29], from rural areas [33], with increase in family burden [34], with obesity [35], and who have experienced different types of intimate partner violence [36]. It is necessary to take into account this aspect since in Spain a greater impact of the crisis has been described in women with higher rates of unemployment, part-time employment, precarious and lower incomes in comparison with men's similar working hours [37] Second, this study has demonstrated the importance of the contribution of the socioeconomic variables most affected by the onset of the economic crisis (employment situation and income) on changes in the prevalence of the risk of poor mental health between 2005 and 2010 in the population of the VC.…”

Weight Status and Psychological Distress in a Mediterranean Spanish Population: A Symmetric U-Shaped Relationship

“…Almost all the works focused on studying overweight and obese individuals, found positive associations between BMI and different measurements of psychological distress [3,15,18,34,35,36,37,38]. Nevertheless, among those studies that considered all the BMI categories (from underweight to obese), it is not clear what is the category with a worse psychological status (underweight or obese).…”