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      A systematic review of reviews: exploring the relationship between obesity, weight loss and health‐related quality of life

      review-article
      1 , 2 , 3 , 4 , 5 , , 3 , 4
      Clinical Obesity
      Blackwell Publishing Ltd
      Obesity, quality of life, weight loss, weight management

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          Summary

          This is the first systematic review of reviews to assess the effect of obesity and weight loss on health‐related quality of life ( HRQoL). We identified 12 meta‐analyses/systematic reviews published between January 2001 and July 2016. They addressed the following themes: (i) the relationship between weight/body mass index and HRQoL (baseline/pre‐intervention; n = 2). (ii) HRQoL after weight loss (varied interventions and/or study design; n = 2). (iii) HRQoL after weight loss (randomized controlled trials only; n = 2). (iv) HRQoL after bariatric surgery ( n = 6). We found that in all populations, obesity was associated with significantly lower generic and obesity‐specific HRQoL. The relationship between weight loss and improved HRQoL was consistently demonstrated after bariatric surgery, perhaps due to a greater than average weight loss compared with other treatments. Improved HRQoL was evident after non‐surgical weight loss, but was not consistently demonstrated, even in randomized controlled trials. This inconsistency may be attributed to variation in quality of reporting, assessment measures, study populations and weight‐loss interventions. We recommend longer‐term studies, using both generic and obesity‐specific measures, which go beyond HRQoL in isolation to exploring mediators of HRQoL changes and interactions with other variables, such as comorbidities, fitness level and body image.

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          Most cited references65

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          Overweight, obesity, and mortality in a large prospective cohort of persons 50 to 71 years old.

          Obesity, defined by a body-mass index (BMI) (the weight in kilograms divided by the square of the height in meters) of 30.0 or more, is associated with an increased risk of death, but the relation between overweight (a BMI of 25.0 to 29.9) and the risk of death has been questioned. We prospectively examined BMI in relation to the risk of death from any cause in 527,265 U.S. men and women in the National Institutes of Health-AARP cohort who were 50 to 71 years old at enrollment in 1995-1996. BMI was calculated from self-reported weight and height. Relative risks and 95 percent confidence intervals were adjusted for age, race or ethnic group, level of education, smoking status, physical activity, and alcohol intake. We also conducted alternative analyses to address potential biases related to preexisting chronic disease and smoking status. During a maximum follow-up of 10 years through 2005, 61,317 participants (42,173 men and 19,144 women) died. Initial analyses showed an increased risk of death for the highest and lowest categories of BMI among both men and women, in all racial or ethnic groups, and at all ages. When the analysis was restricted to healthy people who had never smoked, the risk of death was associated with both overweight and obesity among men and women. In analyses of BMI during midlife (age of 50 years) among those who had never smoked, the associations became stronger, with the risk of death increasing by 20 to 40 percent among overweight persons and by two to at least three times among obese persons; the risk of death among underweight persons was attenuated. Excess body weight during midlife, including overweight, is associated with an increased risk of death. Copyright 2006 Massachusetts Medical Society.
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            SF-36 health survey update.

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              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.
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                Author and article information

                Contributors
                rkolotkin@qualityoflifeconsulting.com
                Journal
                Clin Obes
                Clin Obes
                10.1111/(ISSN)1758-8111
                COB
                Clinical Obesity
                Blackwell Publishing Ltd (Chichester, UK )
                1758-8103
                1758-8111
                10 July 2017
                October 2017
                : 7
                : 5 ( doiID: 10.1111/cob.2017.7.issue-5 )
                : 273-289
                Affiliations
                [ 1 ] Quality of Life Consulting, PLLC Durham NC USA
                [ 2 ] Department of Community and Family Medicine Duke University School of Medicine Durham NC USA
                [ 3 ] Faculty of Health Studies Western Norway University of Applied Sciences Førde Norway
                [ 4 ] Førde Hospital Trust Førde Norway
                [ 5 ] Morbid Obesity Centre Vestfold Hospital Trust Tønsberg Norway
                Author notes
                [*] [* ]Address for correspondence: RL Kolotkin, Quality of Life Consulting, PLLC, 732 Ninth Street #563, Durham, NC 27705, USA. E‐mail: rkolotkin@ 123456qualityoflifeconsulting.com
                Article
                COB12203
                10.1111/cob.12203
                5600094
                28695722
                15d3753f-6183-4576-9acc-e452b2078cab
                © 2017 The Authors. Clinical Obesity published by John Wiley & Sons Ltd on behalf of World Obesity Federation

                This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial‐NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.

                History
                : 22 March 2017
                : 19 May 2017
                : 23 May 2017
                Page count
                Figures: 3, Tables: 1, Pages: 17, Words: 10734
                Funding
                Funded by: Eisai
                Funded by: Janssen
                Funded by: Novo Nordisk
                Funded by: University of Utah
                Award ID: DK055006
                Funded by: National Institutes of Health/The National Institute of Diabetes and Digestive and Kidney Diseases
                Categories
                Review
                Reviews
                Custom metadata
                2.0
                cob12203
                cob12203-hdr-0001
                October 2017
                Converter:WILEY_ML3GV2_TO_NLMPMC version:5.1.9 mode:remove_FC converted:15.09.2017

                obesity,quality of life,weight loss,weight management
                obesity, quality of life, weight loss, weight management

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