Use of the Health and Activities Limitation Index as a Measure of Quality of Life in Obesity

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Abstract
Obesity reduces the quality of life (QOL); however, quantification of obesity's impact on QOL is cumbersome. Utility indices reduce QOL measurements to a single numerical value that can be used in the calculation of Quality-Adjusted Life-Years and the cost effectiveness for obesity treatment. The purpose of this investigation is to assess the sensitivity of the Health and Activities Limitation Index (HALex) utility index to obesity. The answers to five questions regarding an individual's self-perception of his or her health status and information about limitation in daily and work activities were collected from 32,440 adults in the 1998 National Health Information Survey. Answers to the questions were scored and converted to a utility index score ranging from 0 (near-death state) to 1 (perfect health) with no limitations. Average values for indices corresponding to differing body mass indices were obtained and significance determined by ANOVA. The utility index for normal weight males and females was 0.86 +/- 0.19 and fell to 0.68 +/- 0.27 for superobese males and 0.60 +/- 0.28 in superobese females. Utility indices fell linearly with increasing body mass index and were lower for respondents having obesity-related comorbid conditions known to reduce the quality of life. There is a statistically significant decrease in the QOL with increasing obesity, slightly worse for women compared with men. The Health and Activities Limitation Index can quantitate the effect obesity and its complications have on quality of life.