The relationship between changes in body weight and changes in psychosocial functioning

Prevalence of Weight Concerns and Obesity Among Smokers Calling a Quitline

BACKGROUND: Cessation-related weight gain and weight concerns are common among smokers and have a negative impact on quitting. Obese smokers tend to gain more than the average amount of weight and also have lower quit rates. This article describes the prevalence of obesity and weight concerns among smokers calling a state quitline in the United States. RESULTS: Among 3972 smokers using a state quitline, 33.3% were obese, 30.2% overweight, 33.3% normal weight and 3.2% underweight; a total of 60.6% were concerned about cessation-related weight gain. Compared with non-obese callers, obese callers were more likely to be female, Hispanic, non-White and heavier smokers. CONCLUSIONS: This is the first study to report data on body weight and weight concerns of smokers calling a national quitline. Given the lower quit rates among obese and weight-concerned smokers, and the burden of smoking and obesity, there is an opportunity to develop new treatment approaches for this at-risk population.

Índice de massa corporal, percepção do peso corporal e transtornos mentais comuns entre funcionários de uma universidade no Rio de Janeiro

OBJETIVO: Foi testada a hipótese de que a autopercepção inadequada do peso corporal, com ou sem obesidade, estaria associada aos transtornos mentais comuns (TMC). MÉTODO: Foram analisados dados de um corte transversal de 4.030 funcionários de uma universidade no Rio de Janeiro, que participaram da Fase 1 (1999) de um estudo longitudinal (Estudo Pró-Saúde). Os participantes (de 22 a 59 anos) preencheram um questionário, que incluiu a avaliação da presença de transtornos mentais comuns através do General Health Questionnaire (GHQ-12). O índice de massa corporal (IMC=kg/m²) foi calculado com base em medidas de massa corporal e estatura, e os participantes classificaram seu peso corporal nas seguintes categorias: muito acima do ideal, um pouco acima do ideal, ideal, um pouco abaixo do ideal, muito abaixo do ideal. RESULTADOS: Entre as mulheres, 58,3% daquelas com índice de massa corporal menor que 25,0 kg/m² consideraram-se acima do peso ideal; entre os homens, esse percentual foi de 23,5%. Através da análise multivariada por regressão logística ajustada por idade, renda, atividade física recreativa, morbidade auto-referida e índice de massa corporal, observou-se uma forte associação entre a presença de transtornos mentais comuns e a percepção de peso muito acima do ideal entre as mulheres (OR=1,84, IC 95%=1,22-2,76). Entre as mulheres, o índice de massa corporal apresentou uma tendência de associação com a presença de transtornos mentais comuns (p da tendência=0,05) que não persistiu após o ajuste por renda e morbidade auto-referida. CONCLUSÃO: A percepção inadequada do peso corporal, independente do índice de massa corporal, esteve associada à presença dos transtornos mentais comuns nas mulheres, mas não nos homens. Uma possível explicação para essa associação está relacionada à maior pressão sociocultural disseminada entre as mulheres para se enquadrarem ao ideal de magreza vigente.

Changes in eating behavior during the aging process

The changing demographics of the world population necessitate a review of normative eating behavior in order to better differentiate eating pathologies from age-associated changes. This review examines the psychological, social, and physiological changes in aging as they affect eating behavior. Neurochemical and neurophysiological bases of appetite, psychobehavioral models of eating, and concomitant variables of depression, bereavement, and social interactions are examined. As many sensory systems decline with aging, these declines influence food choice and acceptability and may manifest conditions such as geriatric anorexia. Special circumstances of centenarians are discussed to provide further insights into pathological, normative, and superlative aging.

Obesity and health-related quality of life

Although it is well documented that obesity is strongly associated with morbidity and mortality, less is known about the impact of obesity on functional status and health-related quality of life (HRQL). However, in recent years research has been conducted to estimate the impact of obesity on HRQL, and to determine the effects of weight reduction on HRQL. The majority of published studies indicate that obesity impairs HRQL, and that higher degrees of obesity are associated with greater impairment. Obesity-associated decrements on HRQL tend to be most pronounced on physical domains of functioning. Studies of the effect of obesity surgery among morbidly obese patients indicate that this procedure produces significant and sustained improvements in the majority of HRQL indices; among mild-to-moderately obese persons, modest weight reduction derived from lifestyle modification also appears to improve HRQL, at least in the short term. Additional research is needed to (1) further characterize the effect that obesity has on HRQL; (2) estimate the short- and long-term effects of various methods of weight reduction (e.g. surgery, lifestyle modification) on HRQL; (3) improve both the conceptualization and measurement of HRQL to incorporate the personal preferences and values of the patient; and (4) develop ways to enhance and sustain positive changes in HRQL, even if weight maintenance is elusive.

Obesity and physical and emotional well-being: associations between body mass index, chronic illness, and the physical and mental components of the SF-36 questionnaire

OBJECTIVE

To clarify the associations between obesity and health-related quality of life by exploring the associations between physical and emotional well-being in relation to obesity and the presence of other chronic illness.

RESEARCH METHODS AND PROCEDURES

The study data were collected as part of a postal-survey within the old Oxford Regional Health Authority of England in 1997. Completed questionnaires were returned by 8889 of 13,800 randomly selected adults aged 18 to 64 years. The main outcome measures were body mass index in five categories (underweight, normal weight, overweight, moderately obese, morbidly obese); chronic illness status (any vs. none and number of such illnesses 0, 1 to 2, 3+); and mean SF-36 questionnaire score in two summary component measures reflecting physical and emotional well-being.

RESULTS

Of the subjects, 31% were overweight and an additional 11% were obese. Body mass index was significantly associated with health status, but the pattern varied according to whether the measure reflected physical or emotional well-being. Physical, but not emotional, well-being deteriorated markedly with increasing degree of overweight and was limited in subjects who were obese but had no other chronic condition; subjects with chronic illnesses other than obesity were compromised in both dimensions. In terms of the number of chronic illnesses reported, the additional presence of obesity was associated with a significant deterioration in physical but not emotional well-being.

DISCUSSION

Overweight and obesity are associated with poor levels of subjective health status, particularly in terms of physical well-being. The limitations in emotional well-being that are reported here and in other studies may be a result of confounding by the presence of accompanying chronic illness.