Fontaine K R, Barofsky I
Division of Gerontology, Department of Medicine, University of Maryland School of Medicine, Geriatric Research Education and Clinical Center (GRECC), Baltimore VA Medical Center, Baltimore, MD, USA.
Obes Rev. 2001 Aug;2(3):173-82. doi: 10.1046/j.1467-789x.2001.00032.x.
Although it is well documented that obesity is strongly associated with morbidity and mortality, less is known about the impact of obesity on functional status and health-related quality of life (HRQL). However, in recent years research has been conducted to estimate the impact of obesity on HRQL, and to determine the effects of weight reduction on HRQL. The majority of published studies indicate that obesity impairs HRQL, and that higher degrees of obesity are associated with greater impairment. Obesity-associated decrements on HRQL tend to be most pronounced on physical domains of functioning. Studies of the effect of obesity surgery among morbidly obese patients indicate that this procedure produces significant and sustained improvements in the majority of HRQL indices; among mild-to-moderately obese persons, modest weight reduction derived from lifestyle modification also appears to improve HRQL, at least in the short term. Additional research is needed to (1) further characterize the effect that obesity has on HRQL; (2) estimate the short- and long-term effects of various methods of weight reduction (e.g. surgery, lifestyle modification) on HRQL; (3) improve both the conceptualization and measurement of HRQL to incorporate the personal preferences and values of the patient; and (4) develop ways to enhance and sustain positive changes in HRQL, even if weight maintenance is elusive.
尽管有充分的文献记载表明肥胖与发病率和死亡率密切相关，但关于肥胖对功能状态和健康相关生活质量（HRQL）的影响却知之甚少。然而，近年来已经开展了一些研究来评估肥胖对HRQL的影响，并确定体重减轻对HRQL的作用。大多数已发表的研究表明，肥胖会损害HRQL，而且肥胖程度越高，损害越大。肥胖对HRQL的相关影响在身体功能领域往往最为明显。对病态肥胖患者进行肥胖手术效果的研究表明，该手术能使大多数HRQL指标得到显著且持续的改善；在轻度至中度肥胖者中，通过生活方式改变实现的适度体重减轻似乎也能改善HRQL，至少在短期内如此。还需要进一步开展研究，以（1）进一步明确肥胖对HRQL的影响特征；（2）评估各种减肥方法（如手术、生活方式改变）对HRQL的短期和长期影响；（3）改进HRQL的概念化和测量方法，以纳入患者的个人偏好和价值观；以及（4）即便难以维持体重，也要找到增强和维持HRQL积极变化的方法。
