The association between excess weight and comorbidity and self-rated health in the Italian population

Abstract

Purpose

To evaluate the association of obesity with comorbidity and with subjective health perception in a large sample representative of the Italian population and how the association differs by age and gender.

Methods

Cross-sectional data were obtained from nine waves of the “Multipurpose Household Survey,” conducted by the Italian National Institute of Statistics. Self-reported height and weight, six weight-associated diseases and self-rated health (SRH) were evaluated on 352,020 subjects aged 20 to 89 years. Comorbidity was defined as the presence of two or more diseases.

Results

The prevalence of comorbidity was significantly different between obese and normal weight subjects in all age categories. SRH was worse in obese subjects than in those of normal weight; this difference persisted, at least in females, into older ages.

Conclusions

Obesity is associated with comorbidity and self-rated health; this association varies across ages and genders. The results found for obese subjects of a given age category were similar to (or worse than) those found for older normal weight subjects of the next age class. For comorbidity, this was true both in males and in females of all the considered age categories; for SRH, this was true in particular for females and younger males.

Introduction

An epidemic of obesity has been observed in the last few years in the United States [1], as well as in Europe [2], [3], and even extends into older ages. Although obesity, mainly visceral obesity, in adult ages has been shown to be related to hypertension, type 2 diabetes, cardiovascular diseases morbidity, and mortality [4], [5], the prognostic importance of excess weight in elderly persons is questioned by some authors [6], [7], [8].

Further, some evidence shows that excess body weight may determine a lower self-rated general health perception [9]. Self-rated health (SRH) is a global summary measure of general health status that encompasses physical, mental, and social well-being [10]; it is known that it is associated with many health conditions and it predicts mortality [11], [12], [13]. Given the association between SRH and health outcomes, understanding the link between obesity and SRH could be valuable in developing strategies to improve overall health [10]. Some evidence exists that links obesity with SRH [10], [14], even if this link is not clear [10]. Furthermore, in the National Health Interview Survey it has been shown that the degree of association varies across ages and gender [14] and in the Atherosclerosis Risk in Communities Study, age, lower education, smoking, and obesity contributed to the decline in SRH over time [15]. However, studies concerning the relation between overweight, obesity, comorbidity, and SHR in subjects older than 80 years are not frequent in the literature.

The aim of the present study was to analyze the gender- and age-specific association between excess weight and comorbidity and SRH in a very large sample representative of the Italian population, comprehensive of a large number of older subjects.