How Does Weight Loss Affect Your Quality Of Life?Monday, November 10, 2014
One of the most profound impacts of weight loss in people with severe obesity is on quality of life. But just how much weight loss is required for a clinically important effect?
We now examined this issue in a paper by Lindsey Warkentin and colleagues published in BMC Medicine and selected among the top 10 posters at Obesity Week (congratulations Lindsey!).
We determined the amount of weight loss required to attain established minimal clinically important differences (MCIDs) in health-related quality of life (HRQL), using three validated instruments (Short-Form (SF)-12 physical (PCS) and mental (MCS) component summary score, EQ-5D Index and Visual Analog Scale (VAS), Impact of Weight on Quality of Life (IWQOL)-Lite) over 24 months in 150 wait-listed, 200 medically managed and 150 surgically treated patients from the Alberta Population-based Prospective Evaluation of Quality of Life Outcomes and Economic Impact of Bariatric Surgery (APPLES) study.
In the overall cohort of 500 participants with a mean age of 44, 88% women, 92% white, and a mean initial BMI of 47.9, the percent weight loss required to achieve MCDs ranged between 9% and 25%, depending on the instrument used: 23% for PCS, 25% for MCS, 9% for EQ-Index, 23% for EQ-VAS, and 17% for IWQOL-Lite.
Thus, it appears that the percent weight loss to achieve MCIDs for most HRQL instruments are markedly higher than the conventional threshold of 5% to 10% often seen in the literature – i.e. well beyond what can generally be achieved with diet and exercise (or even pharmacotherapy) at 24 months.
Currently, surgery appears to be the only treatment for obesity that consistently delivers this amount of weight loss (compared to other interventions).
Given that surgery is not a realistic option for the millions of people living with severe obesity, we simply need to find better medical treatments that can deliver sustainable weight loss of this magnitude.
Warkentin LM, Majumdar SR, Johnson JA, Agborsangaya CB, Rueda-Clausen CF, Sharma AM, Klarenbach SW, Karmali S, Birch DW, & Padwal RS (2014). Weight loss required by the severely obese to achieve clinically important differences in health-related quality of life: two-year prospective cohort study. BMC medicine, 12 (1) PMID: 25315502