Impact Of Weight On Quality Of Life Research Articles

Burden of hyperphagia and obesity in Bardet–Biedl syndrome: a multicountry survey

BackgroundSigns and symptoms of Bardet–Biedl syndrome (BBS) occur during early childhood, progress over time, and place substantial, multifaceted burden on patients and their caregivers. Hyperphagia may be a contributing factor to early-onset obesity in BBS; however, there are limited insights into its impacts on patients and caregivers. We quantified disease burden as it relates to the physical and emotional impacts of hyperphagia in BBS.MethodsThe CAREgiver Burden in BBS (CARE-BBS) study was a multicountry, cross-sectional survey of adult caregivers of patients with BBS who have had hyperphagia and obesity. The survey consisted of questionnaires including Symptoms of Hyperphagia, Impacts of Hyperphagia, Impact of Weight on Quality of Life (IWQOL)-Kids Parent Proxy, and Patient-Reported Outcome Measurement Information System (PROMIS) v1.0-Global Health 7. In addition, clinical characteristics, medical history, and weight management questions were included. Outcomes were scored and summarized descriptively in aggregate and by country, age, and obesity severity according to weight class.ResultsThere were 242 caregivers of patients with BBS who completed the survey. Caregivers observed hyperphagic behaviors throughout the day, with negotiating for food (90%) and waking up and asking or looking for food during the night (88%) being the most frequent. Hyperphagia had at least a moderate negative impact on most patients’ mood/emotions (56%), sleep (54%), school (57%), leisure (62%), and familial relationships (51%). Hyperphagia affected concentration at school (78%), and symptoms of BBS contributed to patients missing ≥ 1 day of school a week (82%). Responses from the IWQOL-Kids Parent Proxy suggested obesity most greatly negatively affected physical comfort (mean [standard deviation (SD)], 41.7 [17.2]), body esteem (41.0 [17.8]), and social life (41.7 [18.0]). On the PROMIS questionnaire, mean (SD) global health score for pediatric patients with BBS and overweight or obesity (36.8 [10.6]) was lower than the general population (mean, 50).ConclusionsEvidence from this study suggests that hyperphagia and obesity may have broad negative impacts on the lives of patients with BBS, including physical health, emotional well-being, school performance, and personal relationships. Therapies that target hyperphagia may alleviate the extensive clinical and nonclinical impacts experienced by patients with BBS and their caregivers.

Impact on Mid-Term Health-Related Quality of Life after Duodenal Switch: a Systematic Review and Meta-Analysis.

Metabolic and bariatric surgery (MBS) could improve health-related quality of life (HrQoL) for selected patients with obesity. Although biliopancreatic diversion with duodenal switch (BPD-DS) is regarded as the most effective MBS technique in achieving weight loss, no consensus has been reached on the impact of BPD-DS on HrQoL. The aim of this meta-analysis is to assess the mid-term HrQoL after BPD-DS in the management of patients with obesity. Cochrane, Embase, APA PsycInfo, PubMed, Scopus, and Web of Science were searched for articles from their inception to August 2022 by two independent reviewers using the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) system. The review was registered prospectively with PROSPERO (CRD42022352073). From 223 studies screened, twelve studies met the eligibility criteria, with a total of 937 patients with obesity undergoing BPD-DS. Minimal clinically important differences (MCID) were reached for the physical component summary score (PCS) of the 36-Item Short-Form Health Survey (SF-36) (MD = 13.4) and impact of weight on quality of life (IWQOL)-Lite total score (MD = 48.7). Similarly, MCIDs were attained in the Laval questionnaire and SF-36 subscales. Our meta-analysis demonstrated an improvement in mid-term HrQoL after BPD-DS. Despite the promising trends demonstrated in this meta-analysis, further studies with large sample sizes are needed to evaluate the impact of HrQoL on patients with obesity after BPD-DS.

Impact of Weight on Quality-of-Life Questionnaire-Lite, Mexican Version. Reliability and Validity Evidence

The short form of the Impact of Weight on Quality of Life (IWQOL) is a 31-item self-report, that assesses the influence of weight on life quality in five areas: physical function, self-esteem, sexual life, public distress, and work. The objective of this study was to assess reliability and validity of the instrument in Mexican adults with weight ranging from normal to obese. Participants were 211 women and 98 men recruited from a public university. During a pre-scheduled appointment their weight and high were measured (average BMI = 26.13). Same participants were e-mailed the IWQOL-Lite, and the collateral measure questionnaires: DASS-21, TFEQ-R18, and a Physical Activity item. Internal consistency of the IWQOL-Lite total scale and subscales ranged from α = .82 to .95. The five-factor structure was confirmed with the number of items reduced to 26 via confirmatory factor analysis. Evidence of the convergent validity was obtained via correlations with the above-mentioned collateral measures. Our findings suggest that IWQOL-Lite (26 items) is a psychometrically valid measure that discriminates between different BMI groups and can be used to evaluate the impact of weight in the population of Mexican adults.

IMPACT OF LOCKDOWN DUE TO CORONAVIRUS DISEASE (COVID-19) ON THE WEIGHT RELATED QUALITY OF LIFE

Background: The current lockdown due to the COVID-19 pandemic has clearly led to changes in the lifestyles of people. This study aimed to determine the effects of this lockdown on the lifestyles of individuals and ultimately the overall changes in weight-based quality of life in the undergraduate students of Pakistan. Methods: This cross-sectional study was conducted on participants of ages 18–25 from different universities around Pakistan. The questionnaires were sent to participants via WhatsApp, posted online using Microsoft forms. A total of 157 responses were received. The questionnaires were adapted using Impact of Weight on Quality of Life (IWQOL). Chi-square test was used for comparison of categorical variables, and p<0.05 was considered statistically significant. Results: Out of 157 responses, 109 were females and 48 males. The mean weight before and after the lockdown was 61.95 Kg and 64.97 Kg respectively. Significant changes in areas of physical function, self-esteem and work were attained with p<0.001, 0.002, and 0.023 respectively. Conclusions: The lifestyle changed and as a result the weight of the undergraduate population of Pakistan generally increased during the lockdown due to the COVID-19 pandemic. Self-esteem decreased among the youth and they faced mental health issues including anxiety and distress due to direct effects of lockdown on lifestyle. Pak J Physiol 2021;17(4):63–6

Changing the quality of life in old age bariatric patients. Cross-sectional study for 79 old age patients

PurposeBariatric surgery is being safely performed in elderly patients. However, current recommendations lack precise indications for bariatric surgery and fail to define an upper age limit for surgical procedure, leaving the field wide open to case by case assessment according to patient's physiological age and benefit-to-risk balance. ObjectivesThe aim of this study is to evaluate the quality of life of obese patients older than 60 years one year after bariatric surgery, and to compare the variation of their nutritional parameters to those of matched younger patients. Methodsand methods. Data were prospectively collected for all patients who underwent bariatric surgery at our institution starting 1998. Seventy-nine patients older than 60 years (Group1) were matched 1:2 with 158 patients younger than 50 years (Group 2) for comparison of nutritional parameters. A modified Impact of Weight on Quality Of Life (IWQOL) questionnaire was filled by all included patients, at the one-year check-up. ResultsThe modified IWQOL questionnaire was filled by 69 patients (87.3%). Of a total of 1860 answers, 11 (0.6%) were marked worsening, 64 (3.4%) were mild worsening, 181 (9.7%) were mild improvement, and 1422 (76.5%) were marked improvement. There were more positive answers than negative ones consistently within the five sections. In both groups, mean serum albumin were lower at the third postoperative month than the preoperative values (39.75 versus 41.72; p < 0.001 and 39.78 versus 41.99; p < 0.001 in Groups 1 and 2, respectively). At 6 and 12 months, in both groups, these values were similar to those of the preoperative period. The serum prealbumin levels reached back the preoperative values at 12 and 6 months, respectively, in Groups 1 and 2. Values were significantly lower in Group1 compared to Group 2 at three and six months (0.18 versus 0.19; p = 0.04 and 0.20 versus 0.21; p = 0.03, respectively) but not at one year. ConclusionsBariatric surgery improves quality of life in elderly obese patients with no compromise on their nutritional status (protein deficiencies). In the lack of precise recommendations, this represents a major argument that may serve to the preoperative assessment of such patients. More complex evaluations in a prospective controlled studies with long-term follow-up are mandatory to validate these findings and precise the estimated advantage in terms of risks of fall and fracture.

PP012 Efficacy And Safety Of The ELIPSE Gastric Balloon For Weight Loss

INTRODUCTION:Conventional gastric balloons for weight loss require endoscopy for placement and removal. The ELIPSETM is a new gastric balloon designed for weight loss that is swallowed and does not require endoscopy or anesthesia. The device is designed to remain in the stomach and be expelled after a predetermined time of 4 months. The objective of this work is to assess the efficacy and safety of the ELIPSETM procedureless gastric balloon for weight loss.METHODS:The ELIPSETM procedureless gastric balloon was identified by the early Awareness and Alert System, “SINTESIS-new technologies,” of The Instituto De Salud Carlos III (AETS-ISCIII). An early assessment of the technology was conducted. The searched databases were: MEDLINE (PubMed), Centre for Reviews and Dissemination, and the Cochrane Library. Clinical studies using the device published in any language until 10 January 2017 were reviewed.RESULTS:A prospective, non-randomized, open label study supported by industry was retrieved. Thirty-four patients were enrolled. Six patients treated with an experimental device were excluded. Twenty-eight patients successfully swallowed the device. No endoscopy or anesthesia was required. All devices were excreted safely. Of the twenty-five patients finally studied, the mean percent total body weight loss was 10 percent (95 percent Confidence Interval, CI 7.3–12.7) and the mean waist circumference was reduced by 8.4cm (95 percent CI 5.7-11.8) at 4 months. Improvements were also seen in metabolic parameters (HbA1c, Low density lipoprotein, triglycerides and blood pressure). All aspects of quality of life measured by the Impact of Weight on Quality of Life (IWQoL) questionnaire demonstrated significant improvements. About safety, there were no serious adverse events or serious adverse device effects, however 64 percent of patients had vomiting, 54 percent experienced nausea, 25 percent had abdominal pain and 2 patients were excluded because of symptoms.CONCLUSIONS:The ELIPSETM gastric balloon for weight loss seems to be an effective therapy with an acceptable safety profile. However it would be necessary to continue further studies to confirm these results, including comparative studies with current treatments.

PSY60 - IMPROVEMENT IN IWQOL-LITE-DERIVED HEALTH UTILITY SCORE WITH LIRAGLUTIDE 3.0 MG VERSUS PLACEBO OVER 3 YEARS IN PREDIABETES

Liraglutide 3.0 mg is a glucagon-like peptide-1 (GLP-1) analog currently licensed for weight management in people with obesity or overweight with comorbidity. This analysis investigated the effects of liraglutide 3.0 mg versus placebo, as an adjunct to diet and exercise, on health utility in people with prediabetes and obesity or overweight with comorbidity, over 3 years. The study was a 3-year, randomized, double-blind, placebo-controlled, parallel-group, multicenter, multinational trial (NCT01272219). Participants were ≥18 years, without type 2 diabetes but with prediabetes and obesity (BMI ≥30 kg/m2) or overweight (BMI ≥27 kg/m2) with hypertension or dyslipidemia. Participants were randomized 2:1 to liraglutide 3.0 mg (n=1505) or placebo (n=749). Health-related quality of life was assessed via the Impact of Weight on Quality Of Life (IWQOL)-Lite questionnaire, completed at baseline and 3 years (Week 160). IWQOL-Lite scores were mapped to the Short-Form-6D (SF-6D) health utility index using a validated algorithm. Health utility scores are constructed so that perfect health is anchored at 1.0 and death is anchored at 0. At Week 160 individuals on liraglutide 3.0 mg had greater weight loss from baseline (-7.1±8.4%) compared with placebo (-2.7±7.2%); estimated treatment difference (ED) -4.3% [95%CI -4.9;-3.7], p<0.0001. Change in IWQOL-Lite total score was significantly higher (better) at Week 160 compared with placebo: ED 3.35 [95%CI 2.04;4.66], p<0.0001. All subscales of the IWQOL-Lite were significantly higher at Week 160 with liraglutide 3.0 mg versus placebo. IWQOL-Lite-derived utility score (mean [SD]) was 0.75 (0.09) and 0.74 (0.09) at baseline, and 0.80 (0.08) and 0.78 (0.09) at Week 160, for liraglutide 3.0 mg and placebo respectively. At Week 160, ED was 0.014 [95%CI 0.008;0.021], p<0.0001. Liraglutide 3.0 mg is associated with improved health utility compared with placebo in weight management of people with prediabetes over 3 years.

Factors Associated with Health-Related Quality of Life Among Overweight and Obese Korean Women

Health-related quality of life (HRQOL) tends to be lower among individuals who are overweight and obese than those of normal weight, and women may be more vulnerable to lower HRQOL associated with obesity than men. Identifying factors associated with HRQOL may be crucial for improving HRQOL for overweight/obese women. We aimed to determine the factors associated with obesity-specific HRQOL among overweight/obese Korean women. A cross-sectional study was conducted with 125 women aged 20–64 years, who comprised a baseline sample in the Community-based Heart and Weight Management Trial. The data were collected from September 2010 to November 2011. The Weight Efficacy Lifestyle, Beck Depression Inventory-II, Interpersonal Social Evaluation List, and Impact of Weight on Quality of Life (IWQOL)–Lite scales were used to measure self-efficacy for weight control, depressive symptoms, social support, and HRQOL, respectively. Increased body mass index, lower self-efficacy for weight control, and higher levels of depressive symptoms were significantly associated with greater impairment in total IWQOL in the regression models. However, social support was not significantly associated with IWQOL. Along with weight loss strategies, other strategies for improving self-efficacy and alleviating depressive symptoms may be essential for improving HRQOL among overweight and obese women.

Journal of Diabetes News

Journal of Diabetes News

Predictors of health‐related quality of life in 500 severely obese patients

To characterize health-related quality of life (HRQL) impairment in severely obese subjects, using several validated instruments. A cross-sectional analysis of 500 severely obese subjects was completed. Short-Form (SF)-12 [Physical (PCS) and Mental (MCS) component summary scores], EuroQol (EQ)-5D [Index and Visual Analog Scale (VAS)], and Impact of Weight on Quality of Life (IWQOL)-Lite were administered. Multivariable linear regression models were performed to identify independent predictors of HRQL. Increasing BMI was associated with lower PCS (-1.33 points per 5 kg/m(2) heavier; P < 0.001), EQ-index (-0.02; P < 0.001), EQ-VAS (-1.71; P = 0.003), and IWQOL-Lite (-3.72; P = 0.002), but not MCS (P = 0.69). The strongest predictors (all P < 0.005) for impairment in each instrument were: fibromyalgia for PCS (-5.84 points), depression for MCS (-7.49 points), stroke for EQ-index (-0.17 points), less than full-time employment for EQ-VAS (-7.06 points), and coronary disease for IWQOL-Lite (-10.86 points). Chronic pain, depression, and sleep apnea were associated with reduced HRQL using all instruments. The clinical impact of BMI on physical and general HRQL was small, and mental health scores were not associated with BMI. Chronic pain, depression, and sleep apnea were consistently associated with lower HRQL.

Exenatide BID Observational Study (ExOS): results for primary and secondary endpoints of a prospective research study to evaluate the clinical effectiveness of exenatide BID use in patients with type 2 diabetes in a real-world setting

Objective:The Exenatide BID Observational Study (ExOS) was designed to evaluate the clinical effectiveness of exenatide BID use in patients with type 2 diabetes (T2D) in a real-world clinical practice setting in the United States.Methods:Patients were enrolled from 74 practice sites from 9/2007 through 1/2009 and followed for 12 months. The primary effectiveness endpoint was achieving or maintaining hemoglobin A1C of ≤7.0%, or an absolute drop of 0.5% from baseline. Secondary measures included absolute and percentage change from baseline for a variety of clinical measures (lipid markers, weight, BMI, etc.), and quality of life (QOL) was assessed using the Impact of Weight on Quality of Life (IWQOL)-Lite.Results:A total of 452 patients were included in the primary study population. At baseline, patients (60% female) had mean (SD) age of 55 (11), T2D duration of 9 (8) years, HbA1c of 8.0 (1.7) %, and body mass index (BMI) of 38.2 (7.4) kg/m2. Family history of T2D was reported in 73.9% of patients. Hypertension was reported in 61.5% of patients, and 47.1% had hyperlipidemia. The HbA1c goal was achieved in 76.3% of the 118 patients with A1C measurements available at 12 months (P < 0.0001). Patients with available clinical measurements achieved significant improvements in HbA1c, weight, BMI, and QOL measurements at 12 months. A mean improvement of 4.56 was seen in the total IWQOL-Lite score at 12 months (P = 0.001). The single-arm design of this study is a limitation; however, the overall objective of the study was to observe patients on exenatide BID therapy over time, comparing their status at endpoint to baseline, rather than to make comparisons among different drug therapies.Conclusions:The Exenatide BID Observational Study supports the clinical effectiveness of exenatide BID observed in previous clinical trials and retrospective database studies.

Examining the Association Between Body Mass Index and Weight Related Quality of Life in Black and White Women.

Obesity not only increases risk for morbidity/mortality, but also impacts the quality of life of obese individuals. In the United States, black women have the highest prevalence of obesity of any other group with approximately 80% of black women over age 20 having a body mass index (BMI) ≥25 kg/m2. We aimed to examine the association between BMI and quality of life in this high risk population compared to this association in white women, using the Impact of Weight on Quality of Life (IWQOL)-Lite questionnaire. Data from 172 black women (mean BMI= 35.7; age=40.5) and 171 white women (mean BMI= 35.5; age=40.4) were collected between 2000 and 2010 analyzed in 2010. The mean IWQOL-Lite total score was 81.6 for black women compared to 66.9 for white women, a statistically significant difference. Hierarchical linear regression models revealed a significant BMI-by-race interaction indicating that the relationship between BMI and IWQOL-Lite score was moderated by race. Our findings suggest notable differences in weight-related quality of life in black and white women. At similar BMIs, black women consistently reported better quality of life than white women on all IWQOL-Lite subscales. The greatest difference in IWQOL-Lite scores between black and white women was seen in the self-esteem subscale. Additional research is needed to understand how to incorporate the weight perspectives of black women into weight management messages and interventions.

Exenatide bid observational study (ExOS): baseline population characteristics of a prospective research study to evaluate the clinical effectiveness of exenatide bid use in patients with type 2 diabetes in a real-world setting

Objectives:To describe the Exenatide Observational Study (ExOS) and patients initiating exenatide therapy in a real-world clinical practice setting.Methods:ExOS is a prospective, single-arm, multicenter, observational study to assess the effectiveness of up to 24 months of exenatide therapy in patients with type 2 diabetes (T2D). Patients with T2D ≥18 years of age, who initiated exenatide therapy, were eligible. The primary effectiveness endpoint is achieving or maintaining hemoglobin A1C of ≤7.0%, or an absolute drop of 0.5% from baseline. Secondary objective measures evaluate the absolute and percentage changes from baseline for a variety of clinical measures (lipid markers, weight, BMI, etc.) and quality of life (QOL) is assessed using the Impact of Weight on Quality of Life (IWQOL)-LiteResults:On average, the baseline population (n = 531) was aged 55 years, predominantly female (62%), white (79%), educated, obese (mean BMI 39 kg/m2), with mean HbA1c, blood pressure, total cholesterol, and triglyceride values of 8.0%, 129/76 mmHg, 174 mg/dL, and 197 mg/dL, respectively. A total of 28% entered the study with HbA1c ≤7.0% and 67% were being treated with oral antihyperglycemic drug(s) (OAD) only [1 (28.4%), 2 (28.4%), >2 (10.2%)], or some form of insulin ±OADs (19%), and ≥50% were on a cholesterol-lowering drug(s) ± antihypertensive medication(s). The single-arm design of this study is a limitation; however, the overall objective of the ongoing study is to observe patients on exenatide therapy over time, comparing their status at endpoint to baseline, rather than to make comparisons among different drug therapies.Conclusions:Patients treated with exenatide tended to be obese, middle-aged women on various combinations of OADs and/or insulin who often had hypertension and/or dyslipidemia. Further planned analyses will provide the largest sample of prospective data on outcomes of exenatide therapy for up to 24 months in this usual-care population.

Night eating syndrome in class II–III obesity: metabolic and psychopathological features

To investigate the relationship of metabolic disorders and psychological features with the night eating syndrome (NES) in individuals with moderate-to-severe obesity. Cross-sectional observation. A total of 266 consecutive participants with class II-III obesity, entering an inpatient weight loss program. Participants who reported consuming either a large amount of their caloric intake after the evening meal (roughly self-assessed as > or =25% of daily calories) or the presence of nocturnal feeding at the Night Eating Questionnaire (NEQ) (N=49) were interviewed by the Night Eating Syndrome History and Inventory (NESHI). Assessment also included the clinical/biochemical parameters of the metabolic syndrome and several questionnaires of psychopathology. NES was diagnosed by NESHI criteria (evening hyperphagia (> or =25% of daily food intake after the evening meal) and/or waking at night to eat at least three times a week) in the last 3 months. Twenty-seven participants (10.1%) met NESHI criteria. Differences were not observed between participants with and without NES as to age, body mass index (BMI), prevalence of metabolic syndrome, Binge Eating Scale and Body Shape Questionnaire. NES participants had significantly higher scores of Beck Depression Inventory (BDI) and Impact of Weight on Quality of Life (IWQOL). Among NES cases, the BDI score was indicative of moderate depression in 18.5% of cases and of severe depression in 44.4%. Logistic regression analysis, adjusted for confounders, identified the BDI score as the only variable significantly associated with the diagnosis of NES. Diagnosing NES does not help identify obese individuals with specific medical complications, but indicates more severe psychological distress and depression.

Physical training combined with dietary measures in the treatment of adult obesity. A comparison of two protocols

Objective Our objective was to study the effects of physical training combined with dietary measures in obese adults. In a second step, we sought to compare two training protocols and establish the additional contribution of strength training. Methods We performed a randomized, prospective survey from July 2004 to November 2007. Included patients were randomized into three groups: a control group (G1), a group (G2) performing dietary measures and a programme of treadmill training at 60% of each individual's maximum heart rate (HR max) and a group (G3) who followed the G2 programme supplemented with strength training. All patients underwent an initial and final assessment of anthropometric & cardiovascular parameters, muscle strength, dyspnoea during activities of daily living, metabolic disorders, psychological status and quality of life. Results The greatest weight loss (7.24%) was observed in G3. Reduction in waistline measurement (WL) of 4.3% and 10.26% were noted in G2 and G3, respectively ( p < 0.001). The percentage fat body mass fell by 10.4% in G3 ( p < 0.001) and 8.6% in G2 ( p = 0.03). We particularly noted an improvement in physical condition in groups 2 and 3, with lower HR and blood pressure values at rest and at maximum effort. The overall improvement in both arm and leg muscle strength was greater for G3 than for G2. Likewise, we noted an improvement in the metabolic parameters and depression & anxiety scores for the trained groups (G2, G3), relative to the control group (G1). We also noted improvements in the total impact of weight on quality of life (IWQOL) lite score of 15.2% in G2 and 18% in G3. Conclusion Our survey demonstrated the beneficial effect of combining dietary measures and physical training in obese patients. In addition to weight loss, the programme enabled a reduction in the patients’ body fat mass and abdominal obesity, a correction of metabolic disorders and an improvement in aerobic capacity. The improvement in all these parameters also enhanced the patients’ psychological status and quality of life. The addition of strength training produced notable improvements in weight loss, arm muscle strength and abdominal obesity.

Assessing Weight‐Related Quality of Life in Adolescents

The development of a new weight-related measure to assess quality of life in adolescents [Impact of Weight on Quality of Life (IWQOL)-Kids] is described. Using a literature search, clinical experience, and consultation with pediatric clinicians, 73 items were developed, pilot tested, and administered to 642 participants, 11 to 19 years old, recruited from weight loss programs/studies and community samples (mean z-BMI, 1.5; range, -1.2 to 3.4; mean age, 14.0; 60% female; 56% white). Participants completed the 73 items and the Pediatric Quality of Life Inventory and were weighed and measured. Four factors (27 items) were identified (physical comfort, body esteem, social life, and family relations), accounting for 71% of the variance. The IWQOL-Kids demonstrated excellent psychometric properties. Internal consistency coefficients ranged from 0.88 to 0.95 for scales and equaled 0.96 for total score. Convergent validity was demonstrated with strong correlations between IWQOL-Kids total score and the Pediatric Quality of Life Inventory (r = 0.76, p < 0.0001). Significant differences were found across BMI groups and between clinical and community samples, supporting the sensitivity of this measure. Participants in a weight loss camp demonstrated improved IWQOL-Kids scores, suggesting responsiveness of the IWQOL-Kids to weight loss/social support intervention. The present study provides preliminary evidence regarding the psychometric properties of the IWQOL-Kids, a weight-related quality of life measure for adolescents. Given the rise of obesity in youth, the development of a reliable and valid weight-related measure of quality of life is timely.

Psychometric evaluation of the impact of weight on quality of life-lite questionnaire (IWQOL-lite) in a community sample.

The short form of impact of weight on quality of life (IWQOL)-Lite is a 31-item, self-report, obesity-specific measure of health-related quality of life (HRQOL) that consists of a total score and scores on each of five scales--physical function, self-esteem, sexual life, public distress, and work--and that exhibits strong psychometric properties. This study was undertaken in order to assess test-retest reliability and discriminant validity in a heterogeneous sample of individuals not in treatment. Individuals were recruited from the community to complete questionnaires that included the IWQOL-Lite, SF-36, Rosenberg self-esteem (RSE) scale, Marlowe-Crowne social desirability scale, global ratings of quality of life, and sexual functioning and public distress ratings. Persons currently enrolled in weight loss programs or with a body mass index (BMI) of less than 18.5 were dropped from the analyses, leaving 341 females and 153 males for analysis, with an average BMI of 27.4. For test-retest reliability, 112 participants completed the IWQOL-Lite again. ANOVA revealed significant main effects for BMI for all IWQOL-Lite scales and total score. Females showed greater impairment than males on all scales except public distress. Internal consistency ranged from 0.816 to 0.944 for IWQOL-Lite scales and was 0.958 for total score. Test-retest reliability ranged from 0.814 to 0.877 for scales and was 0.937 for total score. Internal consistency and test-retest results for overweight/obese subjects were similar to those obtained for the total sample. There was strong evidence for convergent and discriminant validity of the IWQOL-Lite in overweight/obese subjects. As in previous studies conducted on treatment-seeking obese persons, the IWQOL-Lite appears to be a reliable and valid measure of obesity-specific quality of life in overweight/obese persons not seeking treatment.

The relationship between health-related quality of life and weight loss.

This is a report of health-related quality of life (HRQOL) changes in obese patients completing at least 1 year of outpatient treatment in a weight reduction program combining phentermine-fenfluramine and dietary counseling. Participants were 141 women (87.6%) and 20 men (12.4%) who had an average body mass index at intake of 41.1 kg/m(2) (SD = 7.0, range = 29.5 to 67.0 kg/m(2)) and an average age of 44.9 years (SD = 9.3, range = 23 to 65 years). HRQOL was assessed at intake and at 1-year follow-up using the Impact of Weight on Quality of Life (IWQOL)-Lite questionnaire. The relationship between HRQOL changes and weight loss was examined using Pearson correlations. Clinically meaningful change in HRQOL was defined as a 1.96 SEM reduction in IWQOL-Lite total score. On average, participants lost 20.2 kg or 17.6% of their weight over the 1-year period. Of the participants, 15.5% lost <10% of their weight, 24.2% lost 10% to 14.9%, 23.6% lost 15% to 19.9%, and 36.6% lost 20% or more. All five IWQOL-Lite scales and total score showed statistically significant improvement over the 1-year period. Changes in IWQOL-Lite scores from intake to 1 year showed statistically significant correlations with percentage of weight loss for all subscales and total score. Subscale correlations with weight loss ranged from 0.166 (Public Distress) to 0.396 (Physical Function) and was 0.370 for the total score. Forty-four percent of participants losing <10% met the criterion of clinically meaningful change, compared with 51.3% losing 10% to 14.9%, 55.3% losing 15% to 19.95%, and 76.3% losing >20%. For total score and for three of the five IWQOL-Lite scales (Physical Function, Self-Esteem, and Sexual Life), the relationship between weight loss and clinically meaningful change was linear and was significant at p < 0.05. Physical Function and Self-Esteem were most strongly affected by weight loss. HRQOL changes, as measured by an obesity-specific instrument (IWQOL-Lite), are strongly related to weight reduction.

Assessing Impact of Weight on Quality of Life

This paper is a preliminary report on the development of a new instrument, the Impact of Weight on Quality of Life (IWQOL) questionnaire, that assesses the effects of weight on various areas of life. We conducted two studies utilizing subjects in treatment for obesity at Duke University Diet and Fitness Center. The first study describes item development, assesses reliability, and compares pre- and post-treatment scores on the IWQOL. In the second study we examined the effects of body mass index (BMI), gender, and age on subjects' perceptions of impact of weight on quality of life. Results indicate adequate psychometric properties with test-retest reliabilities averaging .75 for single items, and .89 for scales. Scale internal consistency averaged .87. Post-treatment scores differed significantly from pre-treatment scores on all scales, indicating that treatment produced positive changes in impact of weight on quality of life. The results of the second study indicate that the impact of weight generally worsened as the patients' size increased. However for women there was no association between BMI and impact of weight on Self-Esteem and Sexual Life. Even at the lowest BMI tertile studied, women reported that weight had a substantial impact in these areas. There were also significant gender differences, with women showing greater impact of weight on Self-Esteem and Sexual Life compared with men. The impact of age was a bit surprising, with some areas showing positive changes and others showing no change.