Department of Clinical Epidemiology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, the Netherlands.
Department of Radiology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, the Netherlands.
Int J Obes (Lond). 2022 Feb;46(2):417-426. doi: 10.1038/s41366-021-01014-x. Epub 2021 Nov 6.
To understand how individuals (self-)manage obesity, insight is needed into how patients perceive their condition and how this perception translates into health outcomes (e.g., health-related quality of life, HRQOL). Our objectives were (1) to examine illness perceptions in individuals with overweight and obesity, and (2) to investigate associations of these perceptions with physical and mental HRQOL.
In a cross-sectional analysis of the Netherlands Epidemiology of Obesity Study (n = 6432; 52% women), illness perceptions were assessed using the Brief Illness Perception Questionnaire, and HRQOL was assessed using the 36-Item Short-Form Health Survey. Illness perceptions were calculated for different categories of overall, abdominal, and metabolically unhealthy obesity. We investigated associations of illness perceptions with HRQOL using BMI-stratified multivariable linear regression analyses.
Compared to individuals with normal weight, individuals with obesity believed to a higher extent that their condition had more serious consequences [Mean Difference (95%CI): 1.8 (1.6-2.0)], persisted for a longer time [3.4 (3.2-3.6)], manifested in more symptoms [3.8 (3.6-4.0)], caused more worry [4.2 (3.9-4.4)] and emotional distress [2.0 (1.8-2.2)], but was more manageable with medical treatment [3.1 (2.9-3.4)]. They perceived to a lesser extent that they had personal control [-2.2 (-2.4, -2.0)] and understanding [-0.3 (-0.5, -0.1)] regarding their condition. These negative perceptions were less pronounced in individuals with abdominal obesity. Behaviour/Lifestyle was attributed by 73% of participants to be the cause of their obesity. Stronger negative illness perceptions were associated with impaired HRQOL, particularly the physical component.
Individuals with obesity perceived their conditions as threatening, and this seemed somewhat stronger in individuals with overall obesity than those with abdominal obesity. Behaviour/Lifestyle is a crucial target intervention and empowering self-management behaviour to achieve a healthy body weight may deliver promising results. In addition, strategies that aim to change negative perceptions of obesity into more adaptive ones may improve HRQOL.
为了了解个体如何（自我）管理肥胖，需要深入了解患者如何看待自己的病情，以及这种看法如何转化为健康结果（例如，与健康相关的生活质量，HRQOL）。我们的目标是：（1）研究超重和肥胖个体的疾病认知，以及（2）研究这些认知与身体和心理 HRQOL 的关联。
在荷兰肥胖症流行病学研究（n=6432；52%为女性）的横断面分析中，使用简要疾病认知问卷评估疾病认知，使用 36 项简短健康调查问卷评估 HRQOL。根据总体、腹部和代谢不健康肥胖的不同类别计算疾病认知。我们使用 BMI 分层多变量线性回归分析来研究疾病认知与 HRQOL 的关联。
与体重正常的个体相比，肥胖个体认为他们的病情后果更严重[平均差异（95%CI）：1.8（1.6-2.0）]，持续时间更长[3.4（3.2-3.6）]，表现出更多的症状[3.8（3.6-4.0）]，引起更多的担忧[4.2（3.9-4.4）]和情绪困扰[2.0（1.8-2.2）]，但通过医疗治疗更容易控制[3.1（2.9-3.4）]。他们对自己的病情的个人控制[2.2（2.4-2.0）]和理解[0.3（0.5-0.1）]程度较低。这些负面认知在腹部肥胖的个体中不太明显。73%的参与者认为行为/生活方式是导致他们肥胖的原因。更强的负面疾病认知与 HRQOL 受损相关，尤其是身体成分。
肥胖个体认为自己的病情具有威胁性，而在整体肥胖个体中这种认知似乎比腹部肥胖个体更强烈。行为/生活方式是一个关键的干预目标，增强自我管理行为以达到健康体重可能会带来有前景的结果。此外，旨在将肥胖的负面认知转变为更适应的认知的策略可能会提高 HRQOL。
