Marchesini G, Solaroli E, Baraldi L, Natale S, Migliorini S, Visani F, Forlani G, Melchionda N
Servizio di Malattie del Metabolismo, Università di Bologna, Azienda Ospedaliera S. Orsola-Malpighi, Italy.
Diabetes Nutr Metab. 2000 Jun;13(3):156-64.
A poor health-related quality of life (HRQL) has been repeatedly documented in obesity. Overweight per se and associated diseases affect physical fitness, whereas mental well-being depends on social, cultural and behavioural components. Very few studies are available on HRQL in obese persons in relation to eating behaviour. We measured HRQL by means of Short-Form-36 questionnaire in 183 obese subjects, seeking specific treatment at a University-based weight management center. Only half had a Body Mass Index exceeding 35 kg/m2. Data were compared to age- and gender-adjusted normative values of the Italian population (2031 subjects). The Binge Eating Scale (BES) and the Three-Factor Eating Questionnaire (TFEQ) were used to assess eating behaviour. Most domains of HRQL were impaired in obese subjects, more severely in younger subjects and in females. The severity of overweight progressively affected physical fitness, but had a minor effect on mental status. In over 50% of subjects, BES and TFEQ identified a binge eating pattern, more frequently in females. A positive BES, as well as lower restriction, higher disinhibition and hunger values at TFEQ, identified subjects with poorer HRQL. Logistic regression analysis identified in a positive BES the variable more closely associated with low scores in mental domains of perceived HRQL. Waist-to-hip ratio, degree of obesity, osteoarticular and respiratory diseases, but also positive BES, were selected as variables more closely associated with poor physical fitness. HRQL is variably impaired in obese persons seeking treatment for their disease, mainly in patients with binge eating. Treatment of binge eating may be as important as any weight-reducing intervention for the overall well-being of the majority of obese persons.
肥胖人群健康相关生活质量（HRQL）较差已被多次证实。超重本身及相关疾病会影响身体健康，而心理健康则取决于社会、文化和行为因素。关于肥胖人群HRQL与饮食行为关系的研究非常少。我们通过简短健康调查问卷（Short-Form-36 questionnaire）对183名肥胖受试者进行了HRQL测量，这些受试者在一家大学附属的体重管理中心寻求特定治疗。只有一半人的体重指数超过35kg/m²。数据与意大利人群（2031名受试者）经年龄和性别调整后的标准值进行了比较。使用暴饮暴食量表（Binge Eating Scale，BES）和三因素饮食问卷（Three-Factor Eating Questionnaire，TFEQ）来评估饮食行为。肥胖受试者的大多数HRQL领域都受到损害，在年轻受试者和女性中更为严重。超重的严重程度逐渐影响身体健康，但对心理状态影响较小。超过50%的受试者中，BES和TFEQ识别出暴饮暴食模式，女性中更为常见。BES呈阳性，以及TFEQ中较低的克制、较高的去抑制和饥饿值，表明HRQL较差。逻辑回归分析确定，BES呈阳性是与感知HRQL心理领域低分最密切相关的变量。腰臀比、肥胖程度、骨关节和呼吸系统疾病，以及BES呈阳性，被选为与身体健康不佳最密切相关的变量。寻求疾病治疗的肥胖者的HRQL受到不同程度的损害，主要是暴饮暴食的患者。对于大多数肥胖者的整体健康而言，治疗暴饮暴食可能与任何减肥干预同样重要。
