Quality of life among obese patients seeking weight loss surgery: the importance of obesity-related social stigma and functional status
Open accessAbstract
Background Obesity is a stigmatizing condition associated with adverse psychosocial consequences. The relative importance of weight stigma in reducing health utility or the value a person places on their current health state is unknown.Methods We conducted a telephone survey of patients with obesity. All were seeking weight loss surgery at two bariatric centers (70 % response rate). We assessed patients' health utility (preference-based quality life measure) via a series of standard gamble scenarios assessing patients' willingness to risk death to lose various amounts of weight or achieve perfect health (range 0 to 1; 0 = death and 1 = most valued health/weight state). Multivariable models assessed associations among quality of life domains from the Short-form 36 (SF-36) and Impact of Weight on Quality of Life-lite (IWQOL-lite) and patients' health utility.Results Our study sample (n = 574) had a mean body mass index of 46.5 kg/m(2) and a mean health utility of 0.87, reflecting the group's average willingness to accept a 13 % risk of death to achieve their most desired health/weight state; utilities were highly variable, however, with 10 % reporting a utility of 1.00 and 27 % reporting a utility lower than 0.90. Among the IWQOL-lite subscales, Public Distress and Work Life were the only two subscales significantly associated with patients' utility after adjustment for sociodemographic factors. Among the SF-36 subscales, Role Physical, Physical Functioning, and Role Emotional were significantly associated with patients' utility. When the leading subscales on both IWQOL-lite and SF-36 were considered together, Role Physical, Public Distress, and to a lesser degree Role Emotional remained independently associated with patients' health utility.Conclusion Patients seeking weight loss surgery report health utilities similar to those reported for people living with diabetes or with laryngeal cancer; however, utility values varied widely with more than a quarter of patients willing to accept more than a 10 % risk of death to achieve their most valued health/weight state. Interference with role functioning due to physical limitations and obesity-related social stigma were strong determinants of reduced health utility.
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Mindfulness-based approaches offer a systematic method of stress reduction and may be especially suitable for bariatric patients who face high levels of obesity-related stigma, discrimination, and social bias.
“Mindfulness-based approaches, in contrast, provide a systematic method of stress reduction that may be particularly well suited for bariatric patients who face unusually high levels of obesity-related stigma, discrimination, and social bias.5,6”
From A Mindfulness-Based Intervention to Control Weight After Bariatric Surgery: Preliminary Results From a Randomized Controlled Pilot Trial (2016) · cites this paper as [6]
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- Authors
- Wee, C. C., Davis, R. B., Huskey, K. W., Jones, D. B., & Hamel, M. B.
- Affiliations
- Beth Israel Deaconess Medical Center (US)
- Corresponding author
- Wee, Christina C.
- Venue
- Journal of General Internal Medicine
- Published
- 2012-09-07
- Volume
- 28
- Issue
- 2
- Pages
- 231-238
- ISSN
- 0884-8734 (ISSN-L)
- 1525-1497
- PMC
- PMC3614124
- OpenAlex
- W2064808311
- Cited by
- 71
- References
- 33
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 3 · 2023: 3 · 2022: 5 · 2021: 6 · 2020: 4 · 2019: 6 · 2018: 6 · 2017: 4 · 2016: 5 · 2015: 8 · 2014: 11 · 2013: 5 · 2012: 1
- FWCI
- 18.65
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Journal of General Internal Medicine (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute of Diabetes and Digestive and Kidney Diseases (K24DK087932, R01DK073302)
- Topics
- Health Sciences › Health Professions › Pharmacy › Obesity and Health Practices
- Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Keywords
- obesity, bariatric surgery, health utility, quality of life, weight stigma, social stigma, functional status, role functioning, willingness to accept, standard gamble
- MeSH terms
- Adolescent, Adult, Aged, Attitude to Health, Female, Humans, Male, Middle Aged, Obesity, Psychometrics, Waiting Lists, Comorbidity, Body Mass Index, Bariatric Surgery, Young Adult, Social Stigma
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