Weight Loss Enriches Diabetics’ Quality of Life

LOS ANGELES — Losing weight improves patients with type 2 diabetes self-esteem, as well as their overall quality of life, researchers found. In a survey, patients who reported weight loss had significantly greater improvements in several markers of quality of life, especially self-esteem and physical health, than those who gained weight (P<0.001), Kathleen Fox, PhD, of Strategic Healthcare Solutions in Monkton, Md., and colleagues reported at the World Congress on Insulin Resistance, diabetes, and Cardiovascular Disease meeting.

”For every single quality-of-life domain alone, those who lost weight had greater improvements,” Fox told MedPage Today. ”So there are a lot of benefits to weight loss” other than just the physiological ones.

In type 2 diabetics, weight loss has been shown to reduce insulin resistance and improve glycemic control, and may also lead to improvements in well-being, the researchers hypothesized.

So to look at the association between self-reported weight change and quality of life among patients with type 2 diabetes, they assessed data from the U.S. Study to Help Improve Early evaluation and management of risk factors Leading to diabetes (SHIELD) study, a five-year population-based survey looking at the development of diabetes as well as disease burden.

They looked specifically at data from 2008, which captured information on 14,921 patients; 2,969 of whom had type 2 diabetes.

Patients reported whether they lost or gained weight during the course of the previous year. They also completed the SF-12 questionnaire, assessing physical and mental health, and the SHIELD WQ-9 questionnaire, indicating how their weight change affected nine aspects of their daily lives:

Physical health
Interactions with family
Work performance
Interactions with co-workers and friends
Social activities
Daily activities
Self-esteem
Emotional health
Overall quality of life
Fox and colleagues excluded those who reported no weight change. A total of 16% of the sample reported weight gain and 30% reported weight loss.

Those who reported weight loss were older and weighed less at the time of the survey than those who reported weight gain (P<0.05).

Also, a greater proportion of those who said they gained weight were obese, compared with those who said they shed pounds (P<0.001).

Fox and colleagues found that for all nine parameters of the SHIELD study questionnaire, a significantly greater proportion of those who reported losing weight had improvements in well-being compared with those who said they gained weight (ranging from 12% to 44% versus 3% to 5%, P<0.0001 for each).

Among those who lost weight compared with those who gained weight, the greatest improvement was seen for physical health (44% versus 3.1%), followed by self esteem (39.4% versus 4.9%), and overall quality of life (34.2% versus 4.9%).

Fox added that in data not yet reported, there appears to be a strong correlation between well-being scores and the amount of weight patients reported losing.

She and colleagues also found that mental health scores on the SF-12 were significantly higher among those who reported weight loss than weight gain (P<0.001).

And while physical component scores on that scale were numerically higher for those who lost pounds, the difference wasn’t significant.

The study was limited because the diagnosis of diabetes, weight, height, and weight change were self-reported and couldn’t be validated with lab tests, medical records, or administrative data. The researchers noted, however, that the bias was similar between groups.

Also, the survey tended to underrepresent very wealthy and very poor segments of the population, and didn’t include military or institutionalized individuals, so the findings may be limited in generalizability.

Still, Fox and colleagues concluded that weight loss was associated with improved quality of life in patients with type 2 diabetes, which treating clinicians should potentially take into account.

Primary source: World Congress on Insulin Resistance, diabetes, and Cardiovascular Disease
Source reference:
Grandy S, et al. ”Impact of self-reported weight change on quality of life among individuals with type 2 diabetes mellitus” WCIR 2011.

From ADA/MedPage

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