Self-reported body mass index and health-related quality of life: Findings from the behavioral risk factor surveillance system

Objective: To examine the relationship between self-reported body mass index (BMI) and health-related quality of life in the general adult population in the United States. Research Methods and Procedures: Using data from 109,076 respondents in the 1996 Behavioral Risk Factor Surveillance System, we examined how self-reported BMI is associated with five health-related quality of life measures developed by the Centers for Disease Control and Prevention for population health surveillance. Results: After adjusting for age, gender, race or ethnicity, educational attainment, employment status, smoking status, and physical activity status, participants with a self-reported BMI of < 18.5 kg/m(2) and participants with a self-reported BMI of greater than or equal to 30 kg/m(2) reported impaired quality of life. Compared with persons with a self-reported BMI of 18.5 to < 25 kg/m(2), odds ratios (ORs) of poor or fair self-rated health increased among persons with self-reported BMIs of < 18.5 (1.57, 95% confidence interval [CI]: 1.31 to 1.89), 25 to < 30 kg/m(2) (1.12, 95% CI: 1.04 to 1.20), 30 to < 35 kg/m(2) (1.65, 95% CI: 1.50 to 1.81), 35 to < 40 kg/m(2) (2.58, 95% CI: 2.21 to 3.00), and greater than or equal to 40 kg/m(2) (3.23, 95% CI: 2.63 to 3.95); ORs for reporting greater than or equal to 14 days of poor physical health during the previous 30 days were 1.44 (95% CI: 1.21 to 1.72), 1.04 (95% CI: 0.96 to 1.14), 1.32 (95% CI: 1.19 to 1.47), 1.80 (95% CI: 1.52 to 2.13), and 2.37 (95% CI: 1.90 to 2.94), respectively; ORs for having greater than or equal to 14 days of poor mental health during the previous 30 days were 1.18 (95% CI: 0.97 to 1.42), 1.02 (95% CI: 0.95 to 1.11), 1.22 (95% CI: 1.10 to 1.36), 1.68 (95% CI: 1.42 to 1.98), and 1.66 (95% CI: 1.32 to 2.09), respectively. Discussion: In the largest study to date, low and increased self-reported BMI significantly impaired health-related quality of life. Particularly, deviations from normal BMI affected physical functioning more strongly than mental functioning.