A prospective study of weight change and health-related quality of life inwomen

Context The mean body weight of US adults increased by 3.6 kg (7.6 lb) duri ng the past 15 years, but few studies exist that examine the impact of such weight change on functional health status. Objective To investigate, prospectively, the association between weight cha nge and health-related quality of life in women. Design and Setting Nurses' Health Study, a 4-year prospective observational study from 1992 to 1996, using the Medical Outcomes Study Short-Form 36 He alth Status Survey (a self-administered 36-item questionnaire) to measure q uality of life. Participants A cohort of 40 098 women (from 46-71 years old in 1992) groupe d according to 3 patterns of weight change over the 4-year period: women wh ose weight remained within 2.25 kg (5 lb) of their baseline weight, women w ho lost 2.25 kg (5 lb) or more, and women who gained 2.25 kg (5 lb) or more . Main Outcome Measures Change in scores on 7 health-related quality-of-life dimensions: physical functioning, vitality, bodily pain, limitations in rol e functioning due to emotional or physical problems, social functioning, an d mental health, measured by the Short-Form 36 Health Status Survey, Results A total of 15 602 women (39%) maintained their weight, 15 160 (38%) gained between 2.25 and 9.0 kg (5-20 lb), and 6667 (17%) lost between 2.25 and 9.0 kg (5-20 Ib), Weight gain was associated with decreased physical f unction and vitality, and increased bodily pain regardless of baseline weig ht. For example, the odds ratio for developing role limitations due to phys ical problems was 2.05 (95% confidence interval, 1.69-2.49) for the leanest women who gained 9.0 kg (20 lb) or more. Weight loss in overweight women w as associated with improved physical function and vitality as well as decre ased bodily pain. Weight change was more strongly associated with physical rather than mental health. The impact of weight change, especially weight g ain, was just as strong in women 65 years and older as in women younger tha n 65 years. Conclusions These longitudinal data support current US guidelines for women of all body mass index levels to avoid weight gain. Weight maintenance and , in cases of overweight, weight loss are desirable and likely to be benefi cial for physical function, vitality, and bodily pain.