Université de Paris, INSERM U1266, Paris, France; Department of Psychiatry, AP-HP, Louis Mourier Hospital, Colombes, France.
Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP UMRS 1136), Paris, France.
Ann Epidemiol. 2020 May;45:61-68. doi: 10.1016/j.annepidem.2020.03.004. Epub 2020 Apr 2.
The association of obesity with a large range of physical conditions and numerous psychiatric disorders has been extensively studied. Our study sought the extent to which physical conditions or psychiatric disorders associated with obesity mediate the association of obesity with unemployment or disability.
Using data from the National Epidemiologic Survey on Alcohol and Related Conditions-III (NESARC-III, 2012-2013), we estimated the prevalence of unemployment as a function of obesity taking into account these comorbidities. Data on self-reported height and weight were available for 35,725 respondents. Clinician-diagnosed physical conditions were self-reported and lifetime psychiatric disorders were assessed with a semistructured interview.
The adjusted prevalence of obesity was 30.4%. Participants with obesity were more likely than participants without obesity to report at least one of the 31 assessed physical conditions (64.46% vs. 46.87%; P < .001). Participants with obesity were more likely to report at least one of the 24 assessed psychiatric diagnoses than respondents without obesity (60.57 vs. 56.75%; P < .001). The rates of unemployment were higher in participants with obesity than in those without obesity (15.75% vs. 11.26%; P < .001). Similarly, participants with obesity reported higher rates of disability than those without obesity. Although the number of physical conditions and psychiatric disorders partly explains this association, obesity remained significantly associated with unemployment and greater disability when controlling for the number of physical conditions and psychiatric disorders.
Obesity is associated with high rates of unemployment and with high disability. This is not explained solely by the high rate of physical conditions and psychiatric disorders associated with obesity.
肥胖与广泛的身体状况和许多精神障碍密切相关，这一现象已经得到了广泛研究。我们的研究旨在探讨与肥胖相关的身体状况或精神障碍在多大程度上可以调节肥胖与失业或残疾之间的关联。
我们利用来自国家酒精流行病学调查-III（NESARC-III，2012-2013 年）的数据，考虑到这些合并症，根据肥胖状况来估计失业的流行率。共有 35725 名受访者报告了他们的身高和体重数据。医生诊断的身体状况为自我报告，而终生精神障碍则通过半结构化访谈进行评估。
调整后的肥胖患病率为 30.4%。与非肥胖者相比，肥胖者更有可能报告至少一种 31 种评估的身体状况（64.46%比 46.87%；P<0.001）。与非肥胖者相比，肥胖者更有可能报告至少一种 24 种评估的精神诊断（60.57%比 56.75%；P<0.001）。肥胖者的失业率高于非肥胖者（15.75%比 11.26%；P<0.001）。同样，肥胖者报告的残疾率也高于非肥胖者。尽管身体状况和精神障碍的数量在一定程度上解释了这种关联，但在控制了身体状况和精神障碍的数量后，肥胖仍然与失业和更高的残疾率显著相关。
肥胖与高失业率和高残疾率有关。这不仅仅是由于肥胖与身体状况和精神障碍的高发生率有关。
