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What are the Psychological Consequences and Impact of Weight on Quality of Life?

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What are the Psychological Consequences and Impact of Weight on Quality of Life?

— By Karol Clark, MSN, RN

Psychological consequences can affect quality of life for adults with obesity.

For adults with obesity, the psychological consequences associated with excess weight are an important consideration for their health care team. It’s estimated that between 20 to 60 percent of adults with obesity experience psychological consequences.1 Psychological consequences associated with obesity include depression, stress, low self-esteem, and impaired body image,2 each of which is related to quality of life.

life is conceptualized as one’s assessment of their well-being in the context of physical and mental health, social relationships, and economic factors.3 The impact of weight on quality of life is becoming increasingly popular topic for health care professionals to explore because efficacious patient care considers the patient as a whole and consider the bio-psychosocial impact of weight on well-being.

The Impact of Weight on Quality of Life

The relationship between obesity and depression is complex. Research has shown that excess weight can lead to depression while other research has shown that depression and antidepressant use can lead to unwanted weight gain.4 Gendered differences have also been observed, with depression being observed more often in women with obesity.5 And to further complicate matters, as summarized in a recent meta-analysis, other research has found positive, negative, or no relationship at all between depression and obesity.6 A systematic review of 17 cross-sectional studies found that adults with obesity were more likely to experience depression compared to healthy-weight counterparts.6 It should be noted that the reviewed studies assessed reports of mood and weight at a single time point.

In another meta-analysis7, 58,000 participants were followed for 28 years. Results suggest that participants who were overweight at the start of the study had a 55 percent increased risk of experiencing depression while participants who were depressed at the beginning of the study had a 58 percent of experiencing unwanted weight gain.7 Low self-esteem has also been associated with a higher BMI.2

Assessing Well-Being and Quality of Life

Health-related quality of life measures such as the Impact of Weight on Quality of Life and Impact of Weight on Quality of Life-Lite (IWQOL and IWQOL-Lite), validated by the USDA,8 are used to assess quality of life across physical land psychosocial domains. Items on the physical subscale include trouble bending over, becoming tired or winded, and being unable to walk far/quickly; items on the psychosocial subscale include feeling down or depressed about weight, avoiding social gatherings, and experiencing less confidence.9

Because there is a relationship between depression, self-esteem, and quality of life, it is important to attend patients’ psychosocial health to mitigate the negative psychological consequences associated with excess weight. For adults with obesity, withdrawing from social interactions and social activities because of low confidence or low self-esteem can lead to isolation and loneliness, which in turn can lead to depression and other negative psychological consequences. Clinicians should consider working with patients to assess how their quality of life is affecting their psychological health to ensure they are treating the whole patient and not just the physiological or metabolic effects of excess weight.

It is important to consider referrals to mental health professionals as part of as patient’s treatment protocol. Working with patients to develop sustainable, healthy eating plans can help patients lose weight and become more active, which in turn can lead to improvements in quality of life. To ensure patient nutritional needs are maintained, pre-packaged, nutritionally formulated meal replacements offer convenience and satisfy daily recommendations for vitamins and minerals. A Low Calorie Diet (LCD) or Very Low Calorie Diet (VLCD) should also be considered as part of an overall healthy eating plan.


1 The psychosocial burden of obesity

2 An update on obesity: Mental consequences and psychological interventions

3 A systematic review of reviews: exploring the relationship between obesity, weight loss and health‐related quality of life

4 Depression and anxiety among US adults: associations with body mass index

5 Depression and obesity in the U.S. Adult household population, 2005–2010

6 Depression and obesity: A meta-analysis of community-based studies

7 Overweight, obesity, and depression: a systematic review and meta-analysis of longitudinal studies

8 Validation of a new measure of quality of life in obesity trials: Impact of Weight on Quality of Life-Lite clinical trials version

9 Confirmatory psychometric evaluations of the Impact on Weight on Quality of Life-Lite clinical trials version (IWQOL-Lite-CT)

About the Author: Dr. Dawn M. Sweet has over 20 years of experience in the field of communication. Dr. Sweet has given several invited talks to and workshops for academic and private sector audiences on the role of nonverbal and verbal communication in achieving positive outcomes and mitigating bias. Her research has been published in several top ranked peer-review journals, and it has been featured on NPR’s River to River / All Things Considered, Buzzfeed, and Science Daily. Her research has also been used to inform expert testimony.

About Robard: For 45 years, Robard Corporation’s medical obesity treatment programs and nutrition products have been utilized by physicians, surgeons and hospitals across the United States to successfully treat patients living with obesity. To learn more about us and how we can help your practice and patients, visit us online at, email us at, or call (800) 222-9201.

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