Health-related Quality of Life in obesity: The ignored outcome in Arab population Marwan El Ghoch, MD

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1 Health-related Quality of Life in obesity: The ignored outcome in Arab population Marwan El Ghoch, MD

2 NAME: Professor Marwan El Ghoch AFFILIATION: CONFLICT OF INTEREST DISCLOSURE Department of Nutrition and Dietetics, Faculty of Health Sciences, Beirut Arab University, Lebanon Nutrition & Dietetics Program, CTR Centre of Rehabilitation Therapy, Reggio Emilia, Italy x I have no potential conflict of interest to report O I have the following potential conflict(s) of Interest to report

3 Obesity Is an excessive accumulation of fat in adipose tissue, associated with an increased risk of: Diseases Disability Mortality American Medical Association House of Delegates. Resolution 420 (A-13)

4 Obesity Only five years ago the American Medical Association (AMA) recognized obesity as a disease that requires a wide range of interventions American Medical Association House of Delegates. Resolution 420 (A-13)

5 Definition (1) Body Mass Index (BMI) = Weight (kg)/height 2 (m) BMI 30 kg/m 2 WHO (1997). Obesity. Preventing and Managing the Global Epidemic, Geneva.

6 Waist Circumference (WC) Males >102 cm Females >88 cm Definition (2) WHO (1997). Obesity. Preventing and Managing the Global Epidemic, Geneva.

7 Body Fat percentage (%BF) Males 25% Females 32% Definition (3) Das SK. Curr Opin Clin Nutr Metab Care Nov;8(6):602-6.

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9 Obesity and psychosocial complications El Ghoch M. et al Nutrients 2016, 8, 402.

10 BMI and mortality All-cause mortality was minimal at normal weight and increased significantly from overweight and throughout obesity ranges Global BMI Mortality. Lancet Jul 13. S (16)

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12 Quality of life (QoL) is a multidimensional concept of well being encompassing Physical and occupational function Psychological state Social interaction Somatic sensation

13 Since the early 80s, there has been growing interest in a new dimension of QoL, termed Health-Related Quality of Life (HRQoL) It is defined as an assessment of how the individual s wellbeing may be affected over time by a disease, disability or disorder

14 Several studies have shown extensively that HRQoL is impaired in adolescent and adult males and females with obesity, however data derived prevalently from Western populations

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16 Few studies have been conducted on HRQoL and obesity in Arab-speaking countries, in fact very little is known on regard The few available studies relied on non-specific weight-related HRQoL questionnaires known for their non ability to assess the impact of obesity on quality of life

17 In a sample of Arab (Lebanese) adults with obesity: Investigate the impact of obesity of HRQoL Assess the association between BMI and HRQoL

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19 ORWELL 97 Specific for obesity-related quality of life Measures both physical and psychosocial distress

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21 129 treatment-seeking individuals with obesity referred to the Nutritional and Weight Management Outpatient Clinic at the Department of Nutrition and Dietetics of BAU in Lebanon 129 normal-weight participants of similar age and gender

22 Patients with obesity, regardless of gender, displayed higher total ORWELL 97 scores when compared with normal-weight controls This indicated that obesity is associated with impaired HRQoL

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24 Linear regression analysis showed that a higher body mass index (BMI) is associated with an increase in ORWELL 97 scores, but only among female, participants with obesity β = 2.89, 95% CI = , p < 0.001

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26 Logistic regression analysis showed that a one unit increase in BMI increases the odds of an ORWELL 97 score considered indicative of a clinically significant impairment of HRQoL by nearly 23%

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28 HRQoL in the clinical sample is lower that normal weight controls of similar age and gender Significant association between BMI and HRQoL in females but not in males

29 Sample included only patients seeking outpatient management, thus finding are not generalizable to individuals with obesity seeking other treatment forms Cross sectional study design Small sample size necessitate that the study be replicated in a larger sample size

30 Our findings should prompt clinicians operating in Arab countries to encourage patients with obesity to initiate and persevere in weight-loss programs at the earliest opportunity

31 Department of Nutrition & Dietetics Beirut Arab University Dr Nada El Darra, PhD, Assistente professor Leila Itani, Lecturer, PhD candidate Dima Kreidieh, Lecturer, PhD candidate Hana Tannir, Lecturer, Master degree holder Dana El Masri, Lab Maneger, Master degree stududent

32 Thank you for attention Questions and feedback are highly appreciated