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      Body mass index and subjective well-being in young adults: a twin population study

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          Abstract

          Background

          Body mass index (BMI) is associated with subjective well-being. Higher BMI is believed to be related with lower well-being. However, the association may not be linear. Therefore, we investigated whether a nonlinear (U-shaped) trend would better describe this relationship, and whether eating disorders might account for the association in young adults.

          Methods

          FinnTwin16 study evaluated multiple measures of subjective well-being, including life satisfaction, General Health Questionnaire (GHQ-20), satisfaction with leisure time, work, and family relationships, and satisfaction with sex life in young adulthood in the 1975–79 birth cohorts of Finnish twins (n=5240). We studied the relationship between indicators of subjective well-being and BMI both in full birth cohorts and in subgroups stratified by lifetime DSM-IV eating disorders.

          Results

          We found an inverse U-shaped relationship between all indicators of subjective well-being and BMI in men. There was no overall association between BMI and subjective well-being in women. However, there was an inverse U-shaped relationship between BMI and indicators of subjective well-being in women with a lifetime eating disorder and their healthy female co-twins. Subjective well-being was optimal in the overweight category.

          Conclusions

          Both underweight and obesity are associated with impaired subjective well-being in young men. The BMI reflecting optimal subjective well-being of young men may be higher than currently recognized. Categorization of body weight in terms of BMI may need to be reassessed in young men. BMI and subjective well-being are related in women with a lifetime eating disorder, but not in the general population of young women.

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          Most cited references34

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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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            The impact of obesity on health-related quality-of-life in the general adult US population.

            The US Preventive Services Task Force recently recommended screening all adult patients for obesity due in part to the strong association between obesity and numerous chronic diseases. However, how obesity affects health-related quality-of-life (HRQL), particularly for persons without any chronic diseases, is less clear. The relationship between obesity and HRQL was examined using data from the 2000 Medical Expenditure Panel Survey. Respondents > or =18 years were classified as underweight, normal weight, overweight, class I obesity, and class II obesity based on their BMI. HRQL was measured by the 12-item Short Form physical and mental summary scores (PCS-12 and MCS-12, respectively) and EuroQol EQ-5D index and visual analogue scale (EQ VAS). The impact of obesity on HRQL was examined through multivariate regression, adjusting for sociodemographics and disease status. After adjustment, HRQL decreased with increasing level of obesity. Compared to normal weight respondents, persons with severe obesity had significantly lower scores with scores on the PCS-12, MCS-12, EQ-5D index, and EQ VAS being 4.0, 1.1, 0.073, and 4.8 points lower, respectively. Such decrements of HRQL for severe obesity were similar to the decrements seen for diabetes or hypertension. Persons with moderate obesity or who were overweight also had significantly lower HRQL scores, particularly on the PCS-12 and EQ-5D index. Underweight persons also had lower MCS-12 and EQ VAS scores. Persons with obesity had significantly lower HRQL than those who were normal weight and such lower scores were seen even for persons without chronic diseases known to be linked to obesity.
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              The epidemiology of eating disorders in six European countries: results of the ESEMeD-WMH project.

              Few data are available to estimate the prevalence of eating disorders (EDs) and their correlates in the community. This paper reports data on EDs obtained in the framework of the ESEMeD project, aimed at investigating the prevalence of non-psychotic mental disorders in six European countries (Belgium, France, Germany, Italy, the Netherlands and Spain), using a new version of the Composite International Diagnostic Interview. The ESEMeD study was a general population cross-sectional household survey. In total, 21,425 respondents aged 18 or older provided data for the project between January 2001 and August 2003. A subsample (N=4139) underwent a detailed investigation on EDs. Lifetime estimated prevalence of anorexia nervosa, bulimia nervosa, binge eating disorder, sub-threshold binge eating disorder, and any binge eating were 0.48%, 0.51%, 1.12%, 0.72%, and 2.15%, respectively, and they were 3-8 times higher among women for all EDs. However, since people under 18 were excluded from this study, our prevalence should be taken as lower-bound estimate of real frequencies. Indeed, cumulative lifetime prevalence analysis showed that the majority of eating disorders had their initial onset between 10 and 20 years of age. Role impairment and comorbidity with other mental disorders were highly common, yet only small proportions of patients with a lifetime diagnosis of EDs requested medical treatment. It still has to be proven whether early diagnostic identification and access to specialized care can reduce the burden caused by these disorders.
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                Author and article information

                Journal
                BMC Public Health
                BMC Public Health
                BMC Public Health
                BioMed Central
                1471-2458
                2013
                16 March 2013
                : 13
                : 231
                Affiliations
                [1 ]Hjelt Institute, Department of Public Health, University of Helsinki, Helsinki, Finland
                [2 ]Institute for Molecular Medicine, Helsinki, Finland
                [3 ]Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, Helsinki, Finland
                [4 ]Department of Adolescent Psychiatry, Helsinki University Central Hospital, Helsinki, Finland
                [5 ]Department of Psychiatry, Helsinki University Central Hospital, Helsinki, Finland
                Article
                1471-2458-13-231
                10.1186/1471-2458-13-231
                3691623
                23496885
                804d6485-029d-48ad-9a47-db3015294042
                Copyright ©2013 Linna et al.; licensee BioMed Central Ltd.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 11 July 2012
                : 27 February 2013
                Categories
                Research Article

                Public health
                body mass index,eating disorders,ghq-20,life satisfaction,subjective well-being,twin study

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