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HSR&D 2004 National Meeting Abstracts


1014. Association of Body Weight with Disease-Specific Quality of Life
David E Arterburn, MD, MPH, HSR&D Cincinnati VAMC and University of Cincinnati Medical Center and Institute for Health Policy and HSR, University of Cincinnat, MB McDonell, Northwest HSR&D Center for Excellence, VA Puget Sound Healthcare System,, SC Hedrick, Northwest HSR&D Center for Excellence, VA Puget Sound Healthcare System and University of Washington, P Diehr, Northwest HSR&D Center for Excellence, VA Puget Sound Healthcare System and University of Washington, SD Fihn, Northwest HSR&D Center for Excellence, VA Puget Sound Healthcare System and University of Washington

Objectives: Obesity has important effects on health and health-care costs. We hypothesized that obese adults with coronary heart disease, obstructive lung disease, or depression would report greater impairments in health-related quality of life (HRQOL) due to their angina, dyspnea, or depression symptoms than those with normal body mass index (BMI).

Methods: We performed a cross-sectional analysis of data from the Ambulatory Care Quality Improvement Project (ACQUIP), a multicenter study of veterans enrolled in General Internal Medicine clinics. BMI was self-reported, and HRQOL was assessed using the SF-36 and condition-specific measures for symptomatic coronary heart disease, obstructive lung disease, and depression. We used multiple linear and logistic regression to assess the associations between BMI and individual HRQOL domains.

Results: We found statistically significant inverse-U-shaped relationships between BMI and HRQOL scores in all 15 domains we examined. Underweight patients (BMI < 18.5 kilograms/meter squared) and patients with class III obesity (BMI 40 and over) reported the worst HRQOL scores. Compared with normal weight patients (BMI 18.5 to 24.9), those who were overweight (BMI 25 to 29.9) reported significantly better HRQOL scores in 10 out of 15 domains.

Conclusions: BMI was strongly associated with generic- and condition-specific HRQOL. Overweight patients reported better HRQOL than those in other weight categories.

Impact: Our results suggest that, when considering HRQOL outcomes among veterans, the optimal BMI may be above the “normal” range. Further research is needed to test the validity of the 1998 NIH BMI categories as predictors of health outcomes among veterans.