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Published in: Health and Quality of Life Outcomes 1/2009

Open Access 01-12-2009 | Research

One-year health-related quality of life outcomes in weight loss trial participants: comparison of three measures

Authors: Ronette L Kolotkin, Josephine M Norquist, Ross D Crosby, Shailaja Suryawanshi, Pedro J Teixeira, Steven B Heymsfield, Ngozi Erondu, Allison M Nguyen

Published in: Health and Quality of Life Outcomes | Issue 1/2009

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Abstract

Background

The literature on changes in health-related quality of life (HRQOL) in weight loss studies is inconsistent, and few studies use more than one type of measure. The purpose of the current study was to compare one-year changes in HRQOL as a function of weight change using three different measures: a weight-related measure (Impact of Weight on Quality of Life-Lite [IWQOL-Lite)]) and two generic measures (SF-36; EQ-5D).

Methods

Data were obtained from 926 participants (mean Body Mass Index (BMI) (kg/m2) = 35.4; 84% female; mean age = 49.5 years) in a placebo-controlled randomized trial for weight loss. At baseline and one-year, participants completed all three HRQOL measures. HRQOL was compared across weight change categories (≥ 5% and 0–4.9% gain, 0–4.9%, 5.0–9.9% and ≥ 10% loss), using effect sizes.

Results

The weight-related measure of HRQOL exhibited greater improvements with one-year weight loss than either of the generic instruments, with effect sizes ranging from 0.24 to 0.62 for 5–9.9% weight reductions and 0.44 to 0.95 for ≥ 10% reductions. IWQOL-Lite Self-Esteem also showed a small improvement with weight gain. Changes in the two generic measures of HRQOL were inconsistent with each other, and in the case of the SF-36, variable across domains. For participants gaining ≥ 5% of weight, the greatest reductions in HRQOL occurred with respect to SF-36 Mental Health, MCS, and Vitality, with effect sizes of -0.82, -0.70, and -0.63 respectively.

Conclusion

This study found differences between weight-related and generic measures of health-related quality of life in a one-year weight loss trial, reflecting the potential value of using more than one measure in a trial. Although weight loss was generally associated with improved IWQOL-Lite, physical SF-36 subscale and EQ-5D scores, a small amount of weight gain was associated with a slight improvement on weight-specific HRQOL and almost no change on the EQ-5D, suggesting the need for further research to more fully study these relationships. We believe our findings have relevance for weight loss patients and obesity clinicians/researchers in informing them of likely HRQOL outcomes associated with varying amounts of weight loss or gain.
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Literature
1.
go back to reference Hays RD: Generic versus disease-targeted instruments. In Assessing Quality of Life in Clinical Trials: Methods and Practice. Edited by: Fayers PM, Hays RD. New York: Oxford University Press; 2005. Hays RD: Generic versus disease-targeted instruments. In Assessing Quality of Life in Clinical Trials: Methods and Practice. Edited by: Fayers PM, Hays RD. New York: Oxford University Press; 2005.
2.
go back to reference van Nunen AM, Wouters EJ, Vingerhoets AJ, Hox JJ, Geenen R: The health-related quality of life of obese persons seeking or not seeking surgical or non-surgical treatment: a meta-analysis. Obes Surg 2007,17(10):1357–1366. 10.1007/s11695-007-9241-9PubMedCentralCrossRefPubMed van Nunen AM, Wouters EJ, Vingerhoets AJ, Hox JJ, Geenen R: The health-related quality of life of obese persons seeking or not seeking surgical or non-surgical treatment: a meta-analysis. Obes Surg 2007,17(10):1357–1366. 10.1007/s11695-007-9241-9PubMedCentralCrossRefPubMed
3.
go back to reference Ware J, Snow K, Kosinski M, Gandek B: SF-36 Health Survey: Manual and Interpretation Guide. Boston: The Health Institute, New England Medical Center; 1993. Ware J, Snow K, Kosinski M, Gandek B: SF-36 Health Survey: Manual and Interpretation Guide. Boston: The Health Institute, New England Medical Center; 1993.
4.
go back to reference Kolotkin RL, Crosby RD, Kosloski KD, Williams GR: Development of a brief measure to assess quality of life in obesity. Obes Res 2001, 9: 102–111. 10.1038/oby.2001.13CrossRefPubMed Kolotkin RL, Crosby RD, Kosloski KD, Williams GR: Development of a brief measure to assess quality of life in obesity. Obes Res 2001, 9: 102–111. 10.1038/oby.2001.13CrossRefPubMed
5.
go back to reference Kolotkin RL, Crosby RD: Manual for the Impact of Weight on Quality of Life Measure (IWQOL and IWQOL-Lite). Durham, NC: Obesity and Quality of Life Consulting; 2008. Kolotkin RL, Crosby RD: Manual for the Impact of Weight on Quality of Life Measure (IWQOL and IWQOL-Lite). Durham, NC: Obesity and Quality of Life Consulting; 2008.
6.
go back to reference Maciejewski ML, Patrick DL, Williamson DF: A structured review of randomized controlled trials of weight loss showed little improvement in health-related quality of life. J Clin Epidemiol 2005,58(6):568–578. 10.1016/j.jclinepi.2004.10.015CrossRefPubMed Maciejewski ML, Patrick DL, Williamson DF: A structured review of randomized controlled trials of weight loss showed little improvement in health-related quality of life. J Clin Epidemiol 2005,58(6):568–578. 10.1016/j.jclinepi.2004.10.015CrossRefPubMed
7.
go back to reference Kaukua J, Pekkarinen T, Sane T, Mustajoki P: 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 2002,26(4):487–495. 10.1038/sj.ijo.0801953CrossRef Kaukua J, Pekkarinen T, Sane T, Mustajoki P: 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 2002,26(4):487–495. 10.1038/sj.ijo.0801953CrossRef
8.
go back to reference Sullivan M, Karlsson J, Sjostrom L, Backman L, Bengtsson C, Bouchard C, Dahlgren S, Jonsson E, Larsson B, Lindstedt S, Naslund I, Olbe L, Wedel H: Swedish obese subjects (SOS) – an intervention study of obesity. Baseline evaluation of health and psychosocial functioning in the first 1743 subjects examined. Int J Obes Relat Metab Disord. 1993,17(9):503–512.PubMed Sullivan M, Karlsson J, Sjostrom L, Backman L, Bengtsson C, Bouchard C, Dahlgren S, Jonsson E, Larsson B, Lindstedt S, Naslund I, Olbe L, Wedel H: Swedish obese subjects (SOS) – an intervention study of obesity. Baseline evaluation of health and psychosocial functioning in the first 1743 subjects examined. Int J Obes Relat Metab Disord. 1993,17(9):503–512.PubMed
9.
go back to reference Karlsson J, Sjostrom L, Sullivan M: Swedish obese subjects (SOS) – an intervention study of obesity. Two-year follow-up of health-related quality of life (HRQL) and eating behavior after gastric surgery for severe obesity. Int J Obes Relat Metab Disord 1998,22(2):113–126. 10.1038/sj.ijo.0800553CrossRefPubMed Karlsson J, Sjostrom L, Sullivan M: Swedish obese subjects (SOS) – an intervention study of obesity. Two-year follow-up of health-related quality of life (HRQL) and eating behavior after gastric surgery for severe obesity. Int J Obes Relat Metab Disord 1998,22(2):113–126. 10.1038/sj.ijo.0800553CrossRefPubMed
10.
go back to reference Rabin R, de Charro F: EQ-5D: a measure of health status from the EuroQol Group. Ann Med 2001,33(5):337–343. 10.3109/07853890109002087CrossRefPubMed Rabin R, de Charro F: EQ-5D: a measure of health status from the EuroQol Group. Ann Med 2001,33(5):337–343. 10.3109/07853890109002087CrossRefPubMed
11.
go back to reference Erondu N, Gantz I, Musser B, Suryawanshi S, Mallick M, Addy C, Cote J, Bray G, Fujioka K, Bays H, Hollander P, Sanabria-Bohorquez SM, Eng W, Langstrom B, Hargreaves RJ, Burns HD, Kanatani A, Fukami T, MacNeil DJ, Gottesdiener KM, Amatruda JM, Kaufman KD, Heymsfield SB: Neuropeptide Y5 receptor antagonism does not induce clinically meaningful weight loss in overweight and obese adults. Cell metabolism 2006,4(4):275–282. 10.1016/j.cmet.2006.08.002CrossRefPubMed Erondu N, Gantz I, Musser B, Suryawanshi S, Mallick M, Addy C, Cote J, Bray G, Fujioka K, Bays H, Hollander P, Sanabria-Bohorquez SM, Eng W, Langstrom B, Hargreaves RJ, Burns HD, Kanatani A, Fukami T, MacNeil DJ, Gottesdiener KM, Amatruda JM, Kaufman KD, Heymsfield SB: Neuropeptide Y5 receptor antagonism does not induce clinically meaningful weight loss in overweight and obese adults. Cell metabolism 2006,4(4):275–282. 10.1016/j.cmet.2006.08.002CrossRefPubMed
12.
go back to reference Kolotkin RL, Crosby RD: Psychometric evaluation of the Impact Of Weight On Quality Of Life-Lite Questionnaire (IWQOL-Lite) in a community sample. Qual Life Res 2002,11(2):157–171. 10.1023/A:1015081805439CrossRefPubMed Kolotkin RL, Crosby RD: Psychometric evaluation of the Impact Of Weight On Quality Of Life-Lite Questionnaire (IWQOL-Lite) in a community sample. Qual Life Res 2002,11(2):157–171. 10.1023/A:1015081805439CrossRefPubMed
13.
go back to reference Kolotkin RL, Crosby RD, Williams GR, Hartley GG, Nicol S: The relationship between health-related quality of life and weight loss. Obes Res 2001, 9: 564–571. 10.1038/oby.2001.73CrossRefPubMed Kolotkin RL, Crosby RD, Williams GR, Hartley GG, Nicol S: The relationship between health-related quality of life and weight loss. Obes Res 2001, 9: 564–571. 10.1038/oby.2001.73CrossRefPubMed
14.
go back to reference Engel SG, Crosby RD, Kolotkin RL, Hartley GG, Williams GR, Wonderlich SA, Mitchell JE: The impact of weight loss and regain on obesity-specific quality of life: mirror image or differential effect. Obes Res 2003, 11: 1207–1213. 10.1038/oby.2003.166CrossRefPubMed Engel SG, Crosby RD, Kolotkin RL, Hartley GG, Williams GR, Wonderlich SA, Mitchell JE: The impact of weight loss and regain on obesity-specific quality of life: mirror image or differential effect. Obes Res 2003, 11: 1207–1213. 10.1038/oby.2003.166CrossRefPubMed
15.
go back to reference Kolotkin RL, Crosby RD, Williams GR: Health-related quality of life varies among obese subgroups. Obes Res 2002,10(8):748–756. 10.1038/oby.2002.102CrossRefPubMed Kolotkin RL, Crosby RD, Williams GR: Health-related quality of life varies among obese subgroups. Obes Res 2002,10(8):748–756. 10.1038/oby.2002.102CrossRefPubMed
16.
go back to reference Kolotkin RL, Crosby RD, Pendleton R, Strong M, Gress RE, Adams TD: Health-related quality of life in patients seeking gastric bypass surgery vs. non-treatment-seeking controls. Obes Surg 2003, 13: 371–377. 10.1381/096089203765887688CrossRefPubMed Kolotkin RL, Crosby RD, Pendleton R, Strong M, Gress RE, Adams TD: Health-related quality of life in patients seeking gastric bypass surgery vs. non-treatment-seeking controls. Obes Surg 2003, 13: 371–377. 10.1381/096089203765887688CrossRefPubMed
17.
go back to reference White MA, O'Neil PM, Kolotkin RL, Byrne TK: Gender, race, and obesity-related quality of life at extreme levels of obesity. Obes Res 2004,12(6):949–955. 10.1038/oby.2004.116CrossRefPubMed White MA, O'Neil PM, Kolotkin RL, Byrne TK: Gender, race, and obesity-related quality of life at extreme levels of obesity. Obes Res 2004,12(6):949–955. 10.1038/oby.2004.116CrossRefPubMed
18.
go back to reference Brooks R: EuroQol: the current state of play. Health Policy 1996, 37: 53–72. 10.1016/0168-8510(96)00822-6CrossRefPubMed Brooks R: EuroQol: the current state of play. Health Policy 1996, 37: 53–72. 10.1016/0168-8510(96)00822-6CrossRefPubMed
19.
go back to reference Cohen J: Statistical Power Analysis for the Behavior Sciences. Second Edition. Hillsdale, NJ: Lawrence Erlbaum; 1988. Cohen J: Statistical Power Analysis for the Behavior Sciences. Second Edition. Hillsdale, NJ: Lawrence Erlbaum; 1988.
20.
go back to reference Van Gaal L, De Leeuw I: The beneficial effects of modest weight loss on cardiovascular risk factors. Int J Obes Relat Metab Disord 1997, 21 Suppl 1: S5-S9.PubMed Van Gaal L, De Leeuw I: The beneficial effects of modest weight loss on cardiovascular risk factors. Int J Obes Relat Metab Disord 1997, 21 Suppl 1: S5-S9.PubMed
21.
go back to reference Rejeski WJ, Focht BC, Messier SP, Morgan T, Pahor M, Penninx B: Obese, older adults with knee osteoarthritis: weight loss, exercise, and quality of life. Health Psychol 2002,21(5):419–426. 10.1037/0278-6133.21.5.419CrossRefPubMed Rejeski WJ, Focht BC, Messier SP, Morgan T, Pahor M, Penninx B: Obese, older adults with knee osteoarthritis: weight loss, exercise, and quality of life. Health Psychol 2002,21(5):419–426. 10.1037/0278-6133.21.5.419CrossRefPubMed
22.
go back to reference Fine JT, Colditz GA, Coakley EH, Moseley G, Manson JE, Willett WC, Kawachi I: A prospective study of weight change and health-related quality of life in women. JAMA 1999,282(22):2136–2142. 10.1001/jama.282.22.2136CrossRefPubMed Fine JT, Colditz GA, Coakley EH, Moseley G, Manson JE, Willett WC, Kawachi I: A prospective study of weight change and health-related quality of life in women. JAMA 1999,282(22):2136–2142. 10.1001/jama.282.22.2136CrossRefPubMed
23.
go back to reference Kolotkin RL, Meter K, Williams GR: Quality of life and obesity. Obes Rev 2001, 2: 219–229. 10.1046/j.1467-789X.2001.00040.xCrossRefPubMed Kolotkin RL, Meter K, Williams GR: Quality of life and obesity. Obes Rev 2001, 2: 219–229. 10.1046/j.1467-789X.2001.00040.xCrossRefPubMed
24.
go back to reference Jia H, Lubetkin EI: The impact of obesity on health-related quality-of-life in the general adult US population. J Public Health (Oxf) 2005,27(2):156–164. 10.1093/pubmed/fdi025CrossRef Jia H, Lubetkin EI: The impact of obesity on health-related quality-of-life in the general adult US population. J Public Health (Oxf) 2005,27(2):156–164. 10.1093/pubmed/fdi025CrossRef
25.
go back to reference Sach TH, Barton GR, Doherty M, Muir KR, Jenkinson C, Avery AJ: The relationship between body mass index and health-related quality of life: comparing the EQ-5D, EuroQol VAS and SF-6D. Int J Obes (Lond) 2006, 31: 189–196. 10.1038/sj.ijo.0803365CrossRef Sach TH, Barton GR, Doherty M, Muir KR, Jenkinson C, Avery AJ: The relationship between body mass index and health-related quality of life: comparing the EQ-5D, EuroQol VAS and SF-6D. Int J Obes (Lond) 2006, 31: 189–196. 10.1038/sj.ijo.0803365CrossRef
Metadata
Title
One-year health-related quality of life outcomes in weight loss trial participants: comparison of three measures
Authors
Ronette L Kolotkin
Josephine M Norquist
Ross D Crosby
Shailaja Suryawanshi
Pedro J Teixeira
Steven B Heymsfield
Ngozi Erondu
Allison M Nguyen
Publication date
01-12-2009
Publisher
BioMed Central
Published in
Health and Quality of Life Outcomes / Issue 1/2009
Electronic ISSN: 1477-7525
DOI
https://doi.org/10.1186/1477-7525-7-53

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