The impact of living with morbid obesity on psychological need frustration: A study with bariatric patients

Guided by self‐determination theory, the purpose of this study was to gain an understanding of the previous experiences of living with morbid obesity of 10 postbariatric patients enrolled in a physical activity programme. Qualitative data were collected through interviews and diarized observations. A thematic analysis revealed that participants suffered from health and mobility troubles in their daily life and experienced stigmatization and discrimination in most areas of their social functioning. Participants described how these experiences resulted in the thwarting of their basic psychological needs for autonomy, competence and relatedness. In turn, psychological need frustration contributed to negative consequences such as body image concerns, low self‐esteem, anxiety and depression; controlled regulation of their eating behaviour and extrinsic goals; rigid behaviours such as avoiding social situations; and compensatory and self‐defeating behaviours such as giving up diet and physical activity regimens and binge eating (i.e., oppositional defiance). This study highlights how living with morbid obesity can impair optimal functioning and well‐being via experiences of psychological need frustration

Obesity and health-related quality of life: Does social support moderate existing associations?

OBJECTIVES: Obesity has been shown to be negatively related to physical health-related quality of life (HQOL) much more strongly than mental HQOL. This is remarkable given findings on obesity-related social stigmata and associations with depression. Considering obesity as a stressor, this study tests for a moderating role of social support for obesity/HQOL associations among women and men. DESIGN: Data come from N=2,732 participants aged 35-74 years in a 2004-2005 general population survey in the Augsburg region, Germany. METHODS: Body weight and height were assessed by anthropometric measurements (classified by body mass index using WHO standards), social support by the Social Support Questionnaire 14-item Short-Form (F-SozU-K14) and HQOL by the 12-item Short-Form Health Survey (SF-12). In multiple regression and general linear models, age, education, family status, health insurance, and place of residence were adjusted for. RESULTS: Among both genders, obesity was associated with reduced physical but not mental HQOL. Among men reporting strong social support, physical HQOL was impaired neither in the moderately nor the severely obese group (compared with normal weight), while it was given less social support. Among women, poor physical HQOL was associated with obesity regardless of social support. CONCLUSIONS: In this adult population sample, no association was found for obesity with mental HQOL. In contrast, a negative association with physical HQOL exists for all subgroups except men with strong social support, indicating that social support buffers obesity-related impairments in physical HQOL in men but not in women. This suggests that obese women and men with strong social support represent distinct populations, with possible implications for obesity care

Associations between body mass index and health-related quality of life among Australian adults

Objectives To assess the relationship between body mass index (BMI) and health-related quality of life (HQoL), as measured by the Short Form Health Survey (SF-36) within a sample with broad population coverage. Subjects and methods Survey data incorporating the SF-36 questionnaire, height and weight were obtained from a nationally representative sample of 9,771 Australians aged 21 or older (4,649 men and 5,122 women). Linear multiple regression methods were employed to estimate the magnitude of association between BMI classes and HQoL variables, adjusting for disability and other covariates. Results Less than 1% of men and just 3.5% of women were classified as underweight while 52.2% of women and 65.9% of men were classified as overweight or obese. For all SF-36 health dimensions, people with BMI scores in the healthy range reported, on average, higher health-related HQoL scores than underweight and obese people, and HQoL scores decreased with the degree of obesity. Although overweight and obesity were associated with decreasing levels of both physical and emotional wellbeing, the deterioration in health status was significantly more evident in the physical than in the mental, social or emotional dimensions Conclusions Low and high BMIs were associated with decreasing levels of both physical and emotional wellbeing, but the deterioration in health status was more consistent in the physical than in other dimensions

Chapter 42

Obesity is associated with reductions in quality of life, with women often experiencing greater impairment than men. General health problems, mobility/functional disability, depression and low self-esteem are commonly reported. Weight-related stigmatisation and societal pressure on women to be thin causes gender disparity in body image dissatisfaction. This can contribute to discomfort about health care encounters both generally and during childbearing, where the perceived attitudes of health professionals, physical examinations and discussions of weight status all have potential to cause distress. In pregnancy, exclusion from decision-making and medicalisation reduces obese women's opportunities to experience a more normal pregnancy and birth