The Impact of Long-Term Body Mass Index Patterns on Health-Related Quality: The Doetinchem Cohort Study

Overweight is associated with a reduced health-related quality of life (QOL), but less is known about the impact of long-term body mass index (BMI, calculated as weight (kg)/height (m)2) patterns on QOL in adults. In the Dutch Doetinchem Cohort Study (1989–2009) that included 1,677 men and 1,731 women aged 20–66 years, 6 BMI patterns were defined by using 4 measurements over a 15-year period: 1) persistent healthy weight (18.5–24.9, reference pattern); 2) persistent overweight (25.0–29.9); 3) persistent obesity (=30.0); 4) developing overweight; 5) developing obesity; and 6) switching between BMI categories. For each BMI pattern, adjusted QOL (measured on a 0–100 scale) was estimated at the end of this period. The lowest QOL was observed for persistent obesity of all BMI patterns. It was 5.0 points (P = 0.02) lower for 1 mental dimension in men and 6.2–11.6 points (P <0.05) lower for 5 (mainly physical) dimensions in women. Developing overweight or obesity scored 1.8–6.3 points (P <0.05) lower on 2–5 (mainly physical) dimensions. Persistent overweight hardly differed from a persistent healthy weight. In women, switching between BMI categories resulted in a lower QOL on the mental dimensions. Studying long-term BMI patterns over a 15-year period showed that persistent obesity, developing overweight, and developing obesity resulted in a lower QOL—particularly on the physical dimensions—compared with a persistent healthy weight