Skip to main content

Advertisement

Log in

The longitudinal association between weight change and health-related quality of life: the KORA S4/F4 cohort study

  • Original Article
  • Published:
International Journal of Public Health

Abstract

Objectives

Despite the increasing importance of patient-centered perspectives, the impact of weight change on the health-related quality of life (HRQL) has remained unclear. This work aims to investigate this longitudinal relationship.

Methods

Data was collected from a population-based cohort study of 3,080 Germans. Anthropometrics and HRQL were assessed at baseline and after a 7-year follow-up period. Using linear regression the average change in HRQL scores was calculated among 5 mutually exclusive weight change groups. Multilevel growth modeling was conducted to differentiate between interpersonal (cross-sectional) and intrapersonal (longitudinal) associations between body mass index (BMI)/BMI change and HRQL.

Results

Heavy weight gain (≥10 % body weight) was associated with impairments in physical health among women (−2.82 points, CI: −4.29, −1.34) and obese men (−4.33 points, CI: −7.62, −1.04) and with improvements in mental health among women (+3.20 points, CI: +1.37, +5.02). Results from the multilevel models were consistent, showing negative associations between BMI change and physical health, positive associations between BMI change and mental health and a high degree of similarity between interpersonal and intrapersonal associations.

Conclusions

Weight gain leads to clinically relevant impairments in physical health. More research is needed to clarify the antipodal effects of weight change on physical and mental health components.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

  • Ackermann RT et al (2009) Changes in health state utilities with changes in body mass in the Diabetes Prevention Program. Obesity (Silver Spring) 17(12):2176–2181. doi:10.1038/oby.2009.114

    Article  Google Scholar 

  • Alonso J et al (2004) Health-related quality of life associated with chronic conditions in eight countries: results from the International Quality of Life Assessment (IQOLA) Project. Qual Life Res 13(2):283–298

    Article  PubMed  Google Scholar 

  • Calle EE, Thun MJ (2004) Obesity and cancer. Oncogene 23(38):6365–6378. doi:10.1038/sj.onc.1207751

    Article  CAS  PubMed  Google Scholar 

  • CDC (2011) Healthy Weight—it’s not a diet, it’s a lifestyle! CDC 24/7 Saving Lives. Protecting People. http://www.cdc.gov/healthyweight/losing_weight/index.html. Accessed 15 June 2013

  • Dolan P (2000) The measurement of health-related quality of life for use in resource allocation decisions in health care. In: Anthony JC, Joseph PN (eds) Handbook of Health Economics. Elsevier, Amsterdam, pp 1723–1760

    Google Scholar 

  • Engel SG et al (2003) Impact of weight loss and regain on quality of life: mirror image or differential effect? Obes Res 11(10):1207–1213. doi:10.1038/oby.2003.166

    Article  PubMed  Google Scholar 

  • Fine JT et al (1999) A prospective study of weight change and health-related quality of life in women. JAMA 282(22):2136–2142. doi:10.1001/jama.282.22.2136

    Article  CAS  PubMed  Google Scholar 

  • Fitzmaurice GM, Laird NM, Ware JH (2004) Applied longitudinal analysis. Wiley, Hoboken

    Google Scholar 

  • Flegal KM, Graubard BI, Williamson DF, Gail MH (2005) Excess deaths associated with underweight, overweight, and obesity. JAMA 293(15):1861–1867. doi:10.1001/jama.293.15.1861

    Article  CAS  PubMed  Google Scholar 

  • Fontaine KR, Barofsky I (2001) Obesity and health-related quality of life. Obes Rev 2(3):173–182

    Article  CAS  PubMed  Google Scholar 

  • Gandek B et al (1998) Cross-validation of item selection and scoring for the SF-12 Health Survey in nine countries: results from the IQOLA Project. International Quality of Life Assessment. J Clin Epidemiol 51(11):1171–1178

    Article  CAS  PubMed  Google Scholar 

  • Garner RE et al (2011) Bodyweight, gender, and quality of life: a population-based longitudinal study. Qual Life Res 21(5):813–825. doi:10.1007/s11136-011-9989-1

    Article  PubMed Central  PubMed  Google Scholar 

  • Guh D, Zhang W, Bansback N, Amarsi Z, Birmingham CL, Anis A (2009) The incidence of co-morbidities related to obesity and overweight: a systematic review and meta-analysis. BMC Public Health 9(1):88

    Article  PubMed Central  PubMed  Google Scholar 

  • Hedeker D (2004) An introduction to growth modeling. In: Kaplan D (ed) The Sage Handbook of Quantitative Methodology for the Social Sciences. Sage Publications, Inc., Thousands Oaks, pp 215–234

    Google Scholar 

  • Hopman WM et al (2007) The association between body mass index and health-related quality of life: data from CaMos, a stratified population study. Qual Life Res 16(10):1595–1603. doi:10.1007/s11136-007-9273-6

    Article  PubMed  Google Scholar 

  • Huang IC, Frangakis C, Wu AW (2006) The relationship of excess body weight and health-related quality of life: evidence from a population study in Taiwan. Int J Obes (Lond) 30(8):1250–1259. doi:10.1038/sj.ijo.0803250

    Article  Google Scholar 

  • Hubert HB, Feinleib M, McNamara PM, Castelli WP (1983) Obesity as an independent risk factor for cardiovascular disease: a 26-year follow-up of participants in the Framingham Heart Study. Circulation 67(5):968–977

    Article  CAS  PubMed  Google Scholar 

  • Hunger M et al (2011) Multimorbidity and health-related quality of life in the older population: results from the German KORA-age study. Health Qual Life Outcomes 9:53. doi:10.1186/1477-7525-9-53

    Article  PubMed Central  PubMed  Google Scholar 

  • Jenkinson C, Layte R (1997) Development and testing of the UK SF-12 (short form health survey). J Health Serv Res Policy 2(1):14–18

    CAS  PubMed  Google Scholar 

  • Jenkinson C et al (1997) A shorter form health survey: can the SF-12 replicate results from the SF-36 in longitudinal studies? J Public Health Med 19(2):179–186

    Article  CAS  PubMed  Google Scholar 

  • Jia H, Lubetkin EI (2005) The impact of obesity on health-related quality-of-life in the general adult US population. J Public Health (Oxford, England) 27(2):156–164. doi:10.1093/pubmed/fdi025

    Article  Google Scholar 

  • Kaukua J, Pekkarinen T, Sane T, Mustajoki P (2002) Health-related quality of life in WHO class II-III obese men losing weight with very-low-energy diet and behaviour modification: a randomised clinical trial. Int J Obes Relat Metab Disord 26(4):487–495

    Article  CAS  PubMed  Google Scholar 

  • Kolotkin RL, Davidson LE, Crosby RD, Hunt SC, Adams TD (2012) Six-year changes in health-related quality of life in gastric bypass patients versus obese comparison groups. Surg Obes Relat Dis 8(5):625–633. doi:10.1016/j.soard.2012.01.011

    Article  PubMed Central  PubMed  Google Scholar 

  • Larsson U, Karlsson J, Sullivan M (2002) Impact of overweight and obesity on health-related quality of life—a Swedish population study. Int J Obes Relat Metab Disord 26(3):417–424. doi:10.1038/sj.ijo.0801919

    Article  CAS  PubMed  Google Scholar 

  • Leon-Munoz LM et al (2005) Changes in body weight and health-related quality-of-life in the older adult population. Int J Obes (Lond) 29(11):1385–1391. doi:10.1038/sj.ijo.0803049

    Article  CAS  Google Scholar 

  • Lopez-Garcia E, Banegas Banegas JR, Gutierrez-Fisac JL, Perez-Regadera AG, Ganan LD, Rodriguez-Artalejo F (2003) Relation between body weight and health-related quality of life among the elderly in Spain. Int J Obes Relat Metab Disord 27(6):701–709. doi:10.1038/sj.ijo.0802275

    Article  CAS  PubMed  Google Scholar 

  • Maciejewski ML, Patrick DL, Williamson DF (2005) A structured review of randomized controlled trials of weight loss showed little improvement in health-related quality of life. J Clin Epidemiol 58(6):568–578. doi:10.1016/j.jclinepi.2004.10.015

    Article  PubMed  Google Scholar 

  • Puhan MA, Ahuja A, Van Natta ML, Ackatz LE, Meinert C (2011) Interviewer versus self-administered health-related quality of life questionnaires—does it matter? Health Qual Life Outcomes 9:30. doi:10.1186/1477-7525-9-30

    Article  PubMed Central  PubMed  Google Scholar 

  • Rathmann W et al (2003) High prevalence of undiagnosed diabetes mellitus in Southern Germany: target populations for efficient screening. The KORA survey 2000. Diabetologia 46(2):182–189. doi:10.1007/s00125-002-1025-0

    CAS  PubMed  Google Scholar 

  • Rawlins MD, Culyer AJ (2004) National Institute for Clinical Excellence and its value judgments. BMJ 329(7459):224–227. doi:10.1136/bmj.329.7459.224

    Article  PubMed Central  PubMed  Google Scholar 

  • Redon J (2001) Hypertension in obesity. Nutr Metab Cardiovasc Dis 11(5):344–353

    CAS  PubMed  Google Scholar 

  • Schunk M et al (2012) Health-related quality of life in subjects with and without Type 2 diabetes: pooled analysis of five population-based surveys in Germany. Diabet Med 29(5):646–653. doi:10.1111/j.1464-5491.2011.03465.x

    Article  CAS  PubMed  Google Scholar 

  • Soltoft F, Hammer M, Kragh N (2009) The association of body mass index and health-related quality of life in the general population: data from the 2003 Health Survey of England. Qual Life Res 18(10):1293–1299. doi:10.1007/s11136-009-9541-8

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  • Sullivan PW, Ghushchyan VH, Ben-Joseph R (2008) The impact of obesity on diabetes, hyperlipidemia and hypertension in the United States. Qual Life Res 17(8):1063–1071. doi:10.1007/s11136-008-9385-7

    Article  PubMed  Google Scholar 

  • Van Breukelen GJP (2006) ANCOVA versus change from baseline had more power in randomized studies and more bias in nonrandomized studies. J Clin Epidemiol 59(9):920–925

    Article  PubMed  Google Scholar 

  • Verkleij SP, Adriaanse MC, Wendel-Vos GC, Schuit AJ (2012) Longitudinal relation between weight change and quality of life in a community-based population: a prospective cohort study. Eur J Public Health. doi:10.1093/eurpub/cks058

    PubMed  Google Scholar 

  • Ware JE, Kosinski M, Keller SD (1995) SF-12®: How to Score the SF-12® Physical and Mental Health Summary Scales, 2nd edn. The Health Institute, New England Medical Center, Boston

    Google Scholar 

  • Ware J Jr, Kosinski M, Keller SD (1996) A 12-Item Short-Form Health Survey: construction of scales and preliminary tests of reliability and validity. Med Care 34(3):220–233

    Article  PubMed  Google Scholar 

  • WHO (2000) Obesity: preventing and managing the global epidemic. Report of a WHO consultation. World Health Organ Tech Rep Ser 894(i–xii):1–253

    Google Scholar 

Download references

Acknowledgments

This work was supported by the German Competence Network Obesity, which is funded by the Federal Ministry of Education and Research (Grant No. 01GI1127). The KORA research platform (KORA, Cooperative Research in the Region of Augsburg) was initiated and financed by the Helmholtz Zentrum München—German Research Centre for Environmental Health, which is funded by the German Federal Ministry of Education and Research and by the State of Bavaria.

Conflict of interest

The authors declare no conflict of interest.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Michael Laxy.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (PDF 85 kb)

Rights and permissions

Reprints and permissions

About this article

Cite this article

Laxy, M., Holle, R., Döring, A. et al. The longitudinal association between weight change and health-related quality of life: the KORA S4/F4 cohort study. Int J Public Health 59, 279–288 (2014). https://doi.org/10.1007/s00038-013-0506-x

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00038-013-0506-x

Keywords

Navigation