Jagielski Alison C, Brown Adrian, Hosseini-Araghi Marzieh, Thomas G Neil, Taheri Shahrad
Birmingham and Black Country NIHR CLAHRC, Birmingham, United Kingdom.
Specialist Weight Management Services, Heart of England NHS Foundation Trust, Birmingham, United Kingdom.
PLoS One. 2014 Mar 26;9(3):e92859. doi: 10.1371/journal.pone.0092859. eCollection 2014.
To explore the cross-sectional association between adiposity, mental well-being, and quality of life in extreme obese individuals entering a UK specialist weight management service prior to treatment commencement.
The sample comprised 263 extreme obese individuals who were referred to the service as a result of having a body mass index (BMI) ≥40 kg/m2 or ≥35 kg/m2 with a co-morbid health condition. In a retrospective analysis, routinely collected baseline clinical examination data and self-report questionnaires (Impact of Weight on Quality of Life: IWQOL-Lite, EQ5D-3L, and Hospital Anxiety and Depression Scale: HADS) were analysed to examine the cross-sectional association between adiposity and quality of life.
The sample was predominantly female (74.8%) with mean BMI 47.0±7.9 kg/m2. Increasing adiposity was significantly negatively associated with quality of life, with an increase of 1 BMI unit associated with decreases of 1.93 in physical function (95% CI -2.86 - -1.00, p<0.001), 1.62 in self-esteem (95% CI -2.67 - -0.57, p<0.05), 2.69 in public distress (95% CI -3.75 - -1.62, p<0.001), 1.33 in work (95% CI -2.63 - -0.02, p<0.05), and 1.79 in total IWQOL-Lite scores (95% CI -2.65 - -0.93, p<0.001). Adiposity was associated with significantly increased risk of problems in mobility (OR = 3.44, 95% CI 1.47-8.05), and performing usual activities (OR = 2.45, 95% CI 1.10-5.46) in highest relative to lowest BMI tertile. The prevalence of experience of symptoms of anxiety (70.3%) and depression (66.2%) as measured by HADS was consistently high.
We identified a high prevalence of psychological co-morbidity, including widespread experience of symptoms of anxiety and depressive disorders and reduced quality of life among these extreme obese individuals seeking weight management treatment. Clinical implications include the need for the incorporation of strategies to improve mental well-being into multi-disciplinary weight management interventions.
探讨在开始治疗前进入英国专科体重管理服务的极度肥胖个体中，肥胖、心理健康与生活质量之间的横断面关联。
样本包括263名极度肥胖个体，他们因体重指数（BMI）≥40kg/m²或≥35kg/m²且伴有共病健康状况而被转诊至该服务机构。在一项回顾性分析中，对常规收集的基线临床检查数据和自我报告问卷（体重对生活质量的影响：IWQOL-Lite、EQ5D-3L和医院焦虑抑郁量表：HADS）进行分析，以检验肥胖与生活质量之间的横断面关联。
样本以女性为主（74.8%），平均BMI为47.0±7.9kg/m²。肥胖程度增加与生活质量显著负相关，BMI每增加1个单位，身体功能下降1.93（95%CI -2.86 - -1.00，p<0.001），自尊下降1.62（95%CI -2.67 - -0.57，p<0.05），公众困扰下降2.69（95%CI -3.75 - -1.62，p<0.001），工作下降1.33（95%CI -2.63 - -0.02，p<0.05），IWQOL-Lite总得分下降1.79（95%CI -2.65 - -0.93，p<0.001）。与BMI最低三分位数相比，肥胖与行动能力问题（OR = 3.44，95%CI 1.47 - 8.05）和进行日常活动问题（OR = 2.45，95%CI 1.10 - 5.46）的风险显著增加相关。根据HADS测量，焦虑症状（70.3%）和抑郁症状（66.2%）的发生率一直很高。
我们发现这些寻求体重管理治疗的极度肥胖个体中，心理共病的患病率很高，包括广泛存在的焦虑和抑郁障碍症状以及生活质量下降。临床意义包括需要将改善心理健康的策略纳入多学科体重管理干预措施中。
