Associations among Co-morbid Conditions, Health-Related Quality of Life and Self-Efficacy in Adults Seeking Weight Loss Treatment

Monday, 18 November 2013: 10:40 AM

Lora E. Burke, PhD, MPH, RN, FAAN1
Mindi A. Styn, PhD1
Lei Ye, BMed2
Yaguang Zheng, BSN1
Meghan Mattos, BSN1
Susan M. Sereika, PhD1
(1)School of Nursing, University of Pittsburgh, Pittsburgh, PA
(2)School of Nursing; Biostatistics, University of Pittsburgh, Pittsburgh, PA

Overweight/obesity, a chronic condition affecting nearly 70% of U.S. adults, is associated with co-morbid conditions (e.g. osteoarthritis, hypertension) and may affect health-related quality of life (HR-QOL). We examined the effect of co-morbid conditions on self-efficacy for weight loss among treatment-seeking adults and the possible mediating effects of HR-QOL, depression and prescribed medications using baseline data from a clinical trial (SELF Trial) of standard behavioral treatment for weight loss. Measures included sociodemographic and medical history questionnaires, SF-36, Beck Depression Inventory (BDI) and Weight Efficacy Lifestyle (WEL), a measure of self-efficacy for weight loss.

The sample (N=130) was predominantly White (71.5%), female (83.1%), middle-aged (53.0±9.6 years) with a BMI of 33.5±3.9 kg/m2. The average number of self-reported co-morbid conditions was 2.88±2.17, range 0-10. The self-reported conditions were: hypercholesterolemia (52.3%), hypertension (33.1%), hypertriglyceridemia and digestive disorders (29.2%), and anxiety 21.6%, while over 10% reported heart problems, osteoarthritis and sleep-disordered breathing. On average, participants had 0.92 ±1.36 prescribed medications, range 0-7. Mean±SD scores were:  BDI 7.25±7.26, WEL 99.52± 33.50; SF-36 Physical Component Score (PCS) 51.23±7.19 and Mental Component Score (MCS) 49.23±10.39. The number of co-morbid conditions was significantly negatively related to the PCS, r= -0.52, p<.01; however, there was no association with the MCS.  The number of prescribed medications was negatively associated with the PCS (r= -0.39, p<.01) and weakly related to the MCS (r= 0.18, p=.04).  The BDI was associated with PCS (r= -0 .23) and MCS (r= -0.69), ps≤.01. Self-efficacy (WEL) was associated with the BDI, r= -.24, p<.01. Co-morbid conditions did not affect self-efficacy for weight loss and there were no mediating effects of HR-QOL, depressive symptomatology and the number of prescribed medications.

Our findings confirm that overweight/obese individuals suffer from co-morbidities that affect their physical HR-QOL; however, these do not have a significant impact on their mental HR-QOL.