Lifestyle and Work-Related Factors Associated with Work Ability and Work Participation for People with Obesity: A Prospective Observational Study After Vocational Rehabilitation

Purpose: We aimed to investigate which changes in the explanatory factors that were associated with positive change in the work ability score (WAS) and degree of work participation (DWP) for participants in a new 1-year vocational rehabilitation (VR) program for people on or at risk of sick leave due to obesity or obesity-related problems. Patients and Methods: This prospective observational study included 95 participants with a body mass index (BMI) above 30 kg/m(2). The 1-year multidisciplinary VR program with an integrated work and lifestyle intervention included 4 weeks of inpatient stay followed-up by five meetings. Differences between baseline and 12-month follow-up data were analyzed for the change in explanatory variables WAS, DWP, health-related quality of life (HRQoL), BMI, and return-to-work self-efficacy (RTWSE). The primary outcome was measured by multiple linear regression for predicting WAS and DWP. Results: We found significant changes in WAS (1.51, 95% CI: 0.83 to 2.20, p<0.001), DWP (18.69, 95% CI: 8.35 to 29.02, p<0.001), HRQoL (2.57, 95% CI: 1.35 to 3.79, p<0.001), BMI (-2.33, 95% CI: -3.10 to -1.56, p<0.001), and in RTWSE (15.89, 95% CI: 4.07 to 27.71, p = 0.009). Regression analysis yielded a strong association between WAS at 12-month follow-up with an increase in HRQoL (beta=0.27, 95% CI: 0.16 to 0.38, p<0.001) and WAS baseline (beta=0.49, 95% CI: 0.28 to 0.71, p<0.001). Further, regression analysis demon-strated a strong association between DWP at 12-month follow-up with return-to-work expectancy (RTWEXP) (beta=-10.62, 95% CI: -15.25 to -6.03, p<0.001). Conclusion: The results indicate positive changes in WAS, DWP, HRQoL, BMI, and RTWSE from baseline to 12-month follow-up. For people with BMI above 30 kg/m(2), changes in HRQoL are important for an increase in WAS, and a high RTWEXP is essential to achieve work participation. Future studies examining VR programs with lifestyle inter-ventions for people with obesity are recommended.

Automated summary

This study investigated the positive changes in work ability score and degree of work participation for participants in a new 1-year vocational rehabilitation program for individuals with obesity or obesity-related problems. The results showed significant improvements in work ability score, work participation, health-related quality of life, BMI, and return-to-work self-efficacy over the course of the program. Changes in health-related quality of life were found to be important for improving work ability score, while having high return-to-work expectancy was essential for achieving work participation. Future studies on vocational rehabilitation programs with lifestyle interventions for individuals with obesity are recommended.