Association of body weight with condition-specific quality of life in male veterans

PURPOSE: We hypothesized that obese adults with coronary heart disease, obstructive lung disease, or depression would report greater impairments in health-related quality of life owing to their angina, dyspnea, or depressive symptoms as compared with persons with normal body weight. METHODS: We analyzed cross-sectional data from the Ambulatory Care Quality Improvement Project, a multicenter study of veterans enrolled in general internal medicine clinics. Health-related quality of life was assessed using the Medical Outcomes Study Short Form-36, the Seattle Angina Questionnaire, the Seattle Obstructive Lung Disease Questionnaire, and the Hopkins Symptom Checklist for Depression. RESULTS: Compared with patients of normal weight (body mass index: 18.5 to 24.9 kg/m2), underweight patients (body mass index <18.5 kg/m2) reported health-related quality-of-life scores that were at least 5% lower (worse) in all 15 quality-of-life domains examined. Patients with class III obesity (body mass index > or =40 kg/m2) reported quality-of-life scores that were at least 5% lower than those of normal weight patients in eight domains. Scores of overweight patients (body mass index: 25 to 29.9 kg/m2) were higher (better) than those of normal weight patients in 11 domains. CONCLUSION: Body mass index was strongly associated with generic- and condition-specific health-related quality of life. Our results suggest that, when considering health-related quality-of-life outcomes among veterans, the optimal body mass index may be above the "normal" range. Further research should test the validity of the 1998 National Institutes of Health body mass index categories as predictors of health outcomes among veterans.