Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Paper
  • Published:

The health status of obese individuals in Canada

Abstract

OBJECTIVE: To determine whether there is a clinically relevant difference in the health state utilities of obese and non-obese individuals as measured by the Health Utility Index Mark III.

METHODS: Secondary analysis of the population-based, cross-sectional, interviewer-administered National Population Health Survey (NPHS), 1996–1997. A probability sample of house-dwelling Canadians, excluding populations on First Nations Reserves, Canadian Armed Forces Bases, the Yukon and Northwest Territories, and long-term residents of hospitals or residential care facilities. The sub-sample used in this analysis consisted of 38 151 respondents (52.4% male) between the ages of 20 and 64 y, excluding pregnant women. Health Utilities Index-Mark III (HUI3) scores were used to define normal weight (body mass index (BMI) 19–24.9 kg/m2), overweight (BMI 25–29.9 kg/m2), obese (BMI 30–34.9 kg/m2), and morbidly obese (BMI≥35 kg/m2) individuals. HUI3 scores were age- and gender-standardized.

RESULTS: The overall prevalence of obesity (BMI≥30 kg/m2) in this Canadian population was 13.3%. The average difference in HUI3 scores between normal weight and morbidly obese respondents was 0.04 (P<0.001). Statistically significant (P<0.05) differences across BMI categories were found in each of the eight component attributes of the HUI3. The attributes with the most substantial difference between normal and obese patients were cognition, mobility and pain. All demonstrated a ≥2-fold increase in the proportion of individuals in poorer classifications of health when normal weight respondents were compared with the morbidly obese. The magnitude of the decrement in utility ratings associated with obesity was comparable with other chronic non-cardiovascular conditions such as migraine or colitis.

CONCLUSION: The results indicate that changes in self-rated health status appear to be due to significant changes across several relevant domain attributes. Obesity has a significant impact on both quality of life and health.

This is a preview of subscription content, access via your institution

Access options

Rent or buy this article

Prices vary by article type

from$1.95

to$39.95

Prices may be subject to local taxes which are calculated during checkout

Similar content being viewed by others

References

  1. Statistics Canada . National Population Health Survey: public use microdata files. Report no. 82F0001XDB Government of Canada: Ottawa; 1994–1995

  2. Trakas K, Lawrence K, Shear N . Utilization of health care resources by obese Canadians CMAJ 1999 160: 1457–1462.

    CAS  PubMed  PubMed Central  Google Scholar 

  3. WHO MONICA Project . Risk factors Int J Epidemiol 1989 18 (Suppl 1): S46–55.

    Article  Google Scholar 

  4. Must A, Spadano J, Coakley E, Field A, Colditz G, Dietz W . The disease burden associated with overweight and obesity JAMA 1999 282: 1523–1529.

    Article  CAS  Google Scholar 

  5. Pi-Sunyer F . Medical hazards of obesity Ann Intern Med 1993 119: 655–660.

    Article  CAS  Google Scholar 

  6. Felber J, Acheson K, Tapp L . From obesity to diabetes Wiley: Chichester 1993.

  7. Manson JE, Colditz GA, Stampfer MJ, Willett WC, Rosner B, Monson RR, Speizer FE, Hennekens CH . A prospective study of obesity and risk of coronary heart disease in women New Engl J Med 1990 322: 882–889.

    Article  CAS  Google Scholar 

  8. Hart D, Spector T . The relationship of obesity, fat distribution, and osteoarthritis in women in the general population: the Chingford Study J Rheumatol 1993 20: 331–335.

    CAS  PubMed  Google Scholar 

  9. Hartz AJ, Fischer ME, Bril G, Kelber S, Rupley D Jr, Oken B, Rimm AA . The association of obesity with joint pain and osteoarthritis in the Hanes data J Chronic Dis 1986 39: 311–319.

    Article  CAS  Google Scholar 

  10. Maclure K, Hayes K, Colditz G, Stampfer M, Speizer F, Willett W . Weight, diet, and the risk, of symptomatic gallstones, in middle-aged women New Engl J Med 1989 321: 563–569.

    Article  CAS  Google Scholar 

  11. Kissebah A, Freedman D, Peiris A . Health risks of obesity Med Clin N Am 1989 73: 111–119.

    Article  CAS  Google Scholar 

  12. Garfinkel L . Overweight and cancer Ann Intern Med 1985 103: 1034–1036.

    Article  CAS  Google Scholar 

  13. Allison DB, Fontaine KR, Manson JE, Stevens J, Vanltallie TB . Annual deaths attributable to obesity in the United States JAMA 1999 282: 1530–1538.

    Article  CAS  Google Scholar 

  14. McGinnis J, Foege W . Actual causes of death in the United States JAMA 1993 270: 2207–2212.

    Article  CAS  Google Scholar 

  15. Stewart AL, Brook RH . Effects of being overweight Am J Public Health 1983 73: 171–178.

    Article  CAS  Google Scholar 

  16. Launer LJ, Harris T, Rumpel C, Madans J . Body mass index, weight change, and risk of mobility disability in middle-aged and older women. The epidemiologic follow-up study of NHANES I JAMA 1994 271: 1093–1098.

    Article  CAS  Google Scholar 

  17. Sullivan M, Sullivan L, Kral J . Quality of life assessment in obesity: physical, psycological, and social function Gastroenterol Clin N Am 1987 16: 433–442.

    CAS  Google Scholar 

  18. Fontaine K, Cheskin L, Barofsky I . Health-related quality of life in obese persons seeking treatment J Family Pract 1996 43: 265–270.

    CAS  Google Scholar 

  19. Fontaine KR, Barofsky I, Cheskin LJ . Predictors of quality of life for obese persons J Nerv Mental Dis 1997 185: 120–122.

    Article  CAS  Google Scholar 

  20. Drummond M, O'Brien B, Stoddart G, Torrance G . Cost-utility analysis In: Methods for the economic evaluation of health care programmes, 2nd edn Oxford University Press: Oxford 1997 139–199.

  21. Boyle M, Furlong W, Feeny D, Torrance G, Hatcher J . Reliability of the Health Utilities Index-Mark III used in the 1991 cycle 6 Canadian General Survey Health Questionnaire Qual Life 1995 4: 249–257.

    Article  CAS  Google Scholar 

  22. Statistics Canada . National Population Health Survey: public use microdata files. Report no. 82M0009XCB Government of Canada: Ottawa 1996–1997.

  23. WHO . Physical status: the use and interpretation of anthropometry. Report of a WHO Expert Committee. Technical Report Series, no. 854 WHO: Geneva 1995.

  24. Micozzi M, Albanes D, Jones V, Chumlea W . Correlation of body mass indicies with weight, stature, and body composition in men and women in NHANES I and NHANES II Am J Clin Nutr 1986 44: 725–731.

    Article  CAS  Google Scholar 

  25. Fryback DG, Dasbach EJ, Klein R, Klein BE, Dorn N, Peterson K, Martin PA . The Beaver Dam Health Outcomes Study: initial catalog of health-state quality factors Med Decis Making 1993 13: 89–102.

    Article  CAS  Google Scholar 

  26. Macdonald S, Reeder B, Chen Y, Desprese J . Obesity in Canada: a descriptive analysis CMAJ 1997 157 (Suppl 1): 53–59.

    Google Scholar 

  27. Fine JT, Colditz GA, Coakley EH, Moseley G, Manson JE, Willett WC, Kawachi I . A prospective study of weight change and health-related quality of life in women JAMA 1999 282: 2136–2142.

    Article  CAS  Google Scholar 

  28. Kolotkin R, Head S, Hamilton M, Tse C . Assessing impact of weight on quality of life Obes Res 1995 3: 49–56.

    Article  CAS  Google Scholar 

  29. Han TS, Tijhuis MA, Lean ME, Seidell JC . Quality of life in relation to overweight and body fat distribution Am J Public Health 1998 88: 1814–1820.

    Article  CAS  Google Scholar 

  30. Beck A, Rush A, BF S, Emery G . Cognitive therapy of depression Guilford Press: New York 1979.

  31. Seligman M . Helplessness: on depression, development, and death Freeman: New York 1975.

  32. Kretsch MJ, Green MW, Fong AK, Elliman NA, Johnson HL . Cognitive effects of a long-term weight reducing diet Int J Obes Relat Metab Disord 1997 21: 14–21.

    Article  CAS  Google Scholar 

  33. Friedman MA, Brownell KD . Psychological correlates of obesity: moving to the next research generation Psychol Bull 1995 117: 3–20.

    Article  CAS  Google Scholar 

  34. Bromberger J, Costello E . Epidemiology of depression for clinicians Social Work 1992 37: 120–125.

    CAS  PubMed  Google Scholar 

  35. Sarlio-Lahteenkorva S, Stunkard A, Rissanen A . Psychosocial factors and quality of life in obesity Int J Obes Relat Metab Disord 1995 19 (Suppl 6): S1–5.

    PubMed  Google Scholar 

Download references

Acknowledgements

The authors would like to acknowledge financial support in the form of a Medical Research Council of Canada/Canadian Drug Manufacture's Association/Centre for Evaluation of Medicine Studentship as well as a United States Pharmacopeial Convention Fellowship. The authors would also like to thank Statistics Canada for access to the National Population Health Survey (1996–1997). The opinions expressed in the manuscript do not necessarily reflect those of Statistics Canada.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to K Trakas.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Trakas, K., Oh, P., Singh, S. et al. The health status of obese individuals in Canada. Int J Obes 25, 662–668 (2001). https://doi.org/10.1038/sj.ijo.0801591

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.ijo.0801591

Keywords

This article is cited by

Search

Quick links