Obesity and quality of life: Mediating effects of pain and comorbidities

Moonseong Heo, David B. Allison, Myles S. Faith, Shankuan Zhu, Kevin R. Fontaine

Research output: Contribution to journalArticlepeer-review

162 Scopus citations


Objective: To estimate the association between body mass index (BMI) and health-related quality of life (HRQL) and examine whether joint pain and obesity-related comorbidities mediate the BMI-HRQL association. Research Methods and Procedures: Population-based survey data from the 1999 Behavioral Risk Factor Surveillance Survey. Adults (N = 155,989) were classified according to BMI as underweight (2), desirable weight (18.5 to 24.9 kg/m2), overweight (25 to 29.9 kg/m2), obese class I (30 to 34.9 kg/m2), obese class II (35 to 39.9 kg/m2), and obese class III (≥40 kg/m2). Data including general health status, unhealthy days in the past 30 caused by physical problems and mental problems, and total unhealthy days in the past 30 were collected. Results: After adjusting for age, sex, race, smoking, education, and income, we observed J-shaped associations between BMI and HRQL. Compared with desirable weight adults, underweight, overweight, and obesity classes I, II, and III adults [odds ratio (OR) = 1.57, 1.19, 1.95, 2.72, and 4.36, respectively] were significantly (p <0.001) more likely to report fair/poor general health status. For unhealthy days caused by physical problems, the corresponding ORs were 1.51, 1.15, 1.66, 2.27, and 3.61 (p <0.001). For unhealthy days caused by mental problems, the ORs were 1.35, 1.14 1.43, 1.57, and 2.25 (p <0.001). For total unhealthy days, the corresponding ORs were 1.27, 1.09, 1.37, 1.73, and 2.46 (p <0.01). Adding joint pain and obesity-related comorbidities into models attenuated BMI-HRQL associations. Discussion: Associations between BMI and HRQL indices were J-shaped. Joint pain and comorbidities may mediate BMI-HRQL associations.

Original languageEnglish (US)
Pages (from-to)209-216
Number of pages8
JournalObesity Research
Issue number2
StatePublished - 2003


  • Comorbidities
  • Health-related quality of life
  • Joint pain
  • Mediators

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Public Health, Environmental and Occupational Health
  • Endocrinology
  • Food Science
  • Endocrinology, Diabetes and Metabolism


Dive into the research topics of 'Obesity and quality of life: Mediating effects of pain and comorbidities'. Together they form a unique fingerprint.

Cite this