Bish Connie L, Blanck Heidi Michels, Maynard L Michele, Serdula Mary K, Thompson Nancy J, Khan Laura Kettel
Nutrition and Health Science Program, Graduate Division of Biological and Biomedical Sciences, Graduate School of Arts and Sciences, Emory University, Atlanta, Georgia, USA.
MedGenMed. 2007 May 14;9(2):35.
Trying to lose weight is a concern for many Americans, but motivation for weight loss is not fully understood. Clinical assessment for obesity treatment is primarily based on measures of body size and physical comorbidities; however, these factors may not be enough to motivate individuals to lose weight. Health-related quality of life (HRQOL) may have a role in an individual's decision to try to lose weight. The objective of this study was to examine the prevalence and association of HRQOL measures as independent moderators of weight loss practices among overweight and obese men and women.
Data were from the 2003 Behavioral Risk Factor Surveillance System, an annual state-based telephone survey of the civilian noninstitutionalized population of adults 20 years of age or older with BMI > or = 25.0 kg/m2 (n = 111,456) who responded to 4 standard HRQOL measures that assessed general health status, physical health, mental health, and activity limitation in the past 30 days.
Among men with BMI 25-34.9 kg/m2, the odds of trying to lose weight increased for the moderate vs best category of HRQOL but not for the poorest vs best category, and no associations were noted for men with BMI > or = 35 kg/m2. Women with BMI 25-34.9 kg/m2 had reduced odds and decreasing associated trends in the prevalence of trying to lose weight with poorer general health, increased physically unhealthy days, and increased activity limitation days. Conversely, women with 1-13 vs 0 mentally unhealthy days had greater odds of trying to lose weight. Among those trying to lose weight, reducing calories was common (52%-69%, men; 56%-69%, women). Among men, with the exception of recent mental health, poorer levels of HRQOL measures were associated with diminished attainment of recommended physical activity levels. Among women, poorer general health status was associated with diminished attainment of recommended physical activity levels.
With the exception of recent mental health, HRQOL was differentially associated with trying to lose weight among men and women. Specifically, moderately poor HRQOL among men and better HRQOL among women were associated with trying to lose weight. Consideration of these influences on weight loss may be useful in the treatment and support of obese patients.
试图减肥是许多美国人关心的问题,但减肥的动机尚未完全明了。肥胖治疗的临床评估主要基于身体尺寸和身体合并症的测量;然而,这些因素可能不足以促使个体减肥。健康相关生活质量(HRQOL)可能在个体决定尝试减肥中发挥作用。本研究的目的是检查HRQOL测量作为超重和肥胖男性及女性减肥行为的独立调节因素的患病率及相关性。
数据来自2003年行为危险因素监测系统,这是一项基于州的年度电话调查,对象是年龄在20岁及以上、BMI≥25.0kg/m²的非机构化成年平民人口(n = 111,456),他们对4项标准HRQOL测量进行了回应,这些测量评估了过去30天的总体健康状况、身体健康、心理健康和活动受限情况。
在BMI为25 - 34.9kg/m²的男性中,与HRQOL最佳类别相比,中等类别者尝试减肥的几率增加,但与最差类别相比则未增加;对于BMI≥35kg/m²的男性,未发现相关性。BMI为25 - 34.9kg/m²的女性,随着总体健康状况变差、身体不健康天数增加和活动受限天数增加,尝试减肥的患病率几率降低且呈下降相关趋势。相反,心理健康天数为1 - 13天的女性与心理健康天数为0天的女性相比,尝试减肥的几率更大。在试图减肥的人群中,减少热量摄入很常见(男性为52% - 69%;女性为56% - 69%)。在男性中,除了近期心理健康外,较差的HRQOL水平与达到推荐身体活动水平的程度降低有关。在女性中,较差的总体健康状况与达到推荐身体活动水平的程度降低有关。
除了近期心理健康外,HRQOL在男性和女性尝试减肥方面存在差异相关。具体而言,男性中HRQOL中等较差和女性中HRQOL较好与尝试减肥有关。考虑这些对减肥的影响可能有助于肥胖患者的治疗和支持。