The humanistic and economic burden associated with increasing body mass index in the EU5

Objectives: This study evaluated the association of body mass index (BMI) with health-related quality of life (HRQoL), health utilities, health care resource utilization, productivity, activity impairment, and the associated costs. Methods: Results were from the 2013 EU5 (France, Germany, Italy, Spain, UK) National Health and Wellness Survey, a nationally representative, online survey of respondents aged >= 18 years. Analyses focused on normal weight (BMI >= 18.5 kg/m(2) and BMI,25 kg/m(2)), overweight (BMI >= 25 kg/m(2) and BMI,30 kg/m(2)), Obese Class (OC) I (BMI >= 30 kg/m(2) and BMI,35 kg/m(2)), OC II (BMI >= 35 kg/m(2) and BMI,40 kg/m(2)), and OC III (BMI >= 40 kg/m(2)) respondents. Outcomes included HRQoL (Short Form [SF]-36v2), health utilities (SF-six dimension [6D]), productivity loss (Work Productivity and Activity Impairment questionnaire), and resource utilization (provider visits, emergency room visits, and hospitalizations) in the past 6 months. Direct and indirect costs were estimated from the literature. Generalized linear regression models predicted outcomes as a function of BMI, adjusting for covariates (age, sex, comorbidities). Results: Among 58,364 respondents, 46.9% were normal weight, 34.5% were overweight, 12.5% were OC I, 4.0% were OC II, and 2.1% were OC III. Metabolic comorbidities increased as BMI increased. After adjustments, all three OC respondents exhibited significantly lower HRQoL than normal weight respondents. Health utilities (normal weight: 0.720; overweight: 0.718; OC I: 0.703; OC II: 0.683; OC III: 0.662) declined with an increase in BMI (all P, 0.05 vs normal). Among employed respondents (57.7%), overall work impairment increased as BMI increased. Normal (vs all OCs) had lower activity impairment and fewer provider visits, lower indirect costs (normal weight: (sic)7,974; overweight: (sic)7,825; OC I: (sic)8,465; OC II: (sic)9,394; OC III: (sic)10,437), and lower total direct costs (normal weight: (sic)516; overweight: (sic)553; OC I: (sic)583; OC II: (sic)605; OC III: (sic)717), all P, 0.05. Conclusion: Increased BMI was associated with worse HRQoL, greater comorbidities, higher direct and indirect costs, and worse health utilities. Weight management may improve patient outcomes.