Article

Obesity Utilization and Health-Related Quality of Life in Medicare Enrollees.

and RAND Corporation, Santa Monica, California (Dr Elliott).
The Journal of ambulatory care management 01/2013; 36(1):61-71. DOI: 10.1097/JAC.0b013e31826746bf
Source: PubMed

ABSTRACT The obese, with disproportionate chronic disease incidence, consume a large share of health care resources and drive up per capita Medicare spending. This study examined the prevalence of obesity and its association with health status, health-related quality of life (HRQOL), function, and outpatient utilization among Medicare Advantage seniors. Results indicate that obese beneficiaries, much more than overweight beneficiaries, have poorer health, functions, and HRQOL than normal weight beneficiaries and have substantially higher outpatient utilization. While weight loss is beneficial to both the overweight and obese, the markedly worse health status and high utilization of obese beneficiaries may merit particular attention.

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    • "Obesity is a major public health problem in the United States [1] which may result in a significant increase in morbidity and mortality and a decreased quality of life [2] [3] [4]. Bariatric surgery, and most commonly Roux-en-Y Gastric Bypass (RYGB) surgery [5], has been a major advance in the long-term treatment of medically complicated obesity. "
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    ABSTRACT: Objective To describe the clinical phenotype of alcohol use disorder (AUD) treatment-seeking patients with Roux-en-Y Gastric Bypass Surgery (RYGB) history; and to compare it to AUD obese non-RYGB controls. Methods Retrospective study of electronic medical records for all patients 30-60 years treated at the Mayo Clinic Addiction Treatment Program, between June, 2004 and July, 2012. Comparisons were performed with consumption patterns pre-RYGB and at time of treatment; excluding patients with AUD treatments pre-RYGB. Results Forty-one out of 823 patients had a RYGB history (4.9%); 122 controls were selected. Compared to controls, the RYGB group had significantly more females [n = 29 (70.7%) vs. n = 35 (28.7%) p < 0.0001]; and met AUD criteria at a significantly earlier age (19.1 ± 0.4 vs. 25.0 ± 1 years old, p = 0.002). On average, RYGB patients reported resuming alcohol consumption 1.4 ± 0.2 years post-surgery, meeting criteria for AUD at 3.1 ± 0.5 years and seeking treatment at 5.4 ± 0.3 years postoperatively. Pre-surgical drinks per day were significantly fewer compared to post-surgical consumption [2.5 ± 0.4 vs. 8.1 ± 1.3, p = 0.009]. Prior to admission, RYGB patients reported fewer drinking days per week vs. controls (4.7 ± 0.3 vs. 5.5 ± 1.8 days, p = 0.02). Neither RYGB, gender, age nor BMI were associated with differential drinking patterns. Conclusion The results of this study suggest that some patients develop progressive AUD several years following RYGB. This observation has important clinical implications, calling for AUD-preventive measures following RYGB. Further large-scale longitudinal studies are needed to clarify the association between RYGB and AUD onset.
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    • "Health conditions associated with obesity include high rates of diabetes mellitus, coronary heart disease , heart failure, and stroke (Allison et al., 2008; Go et al., 2013). Many non-cardiovascular health conditions such as asthma, cancer, chronic renal failure, back pain, and degenerative joint disease are also known to be related to obesity (Allison et al., 2008; Go et al., 2013; Malik et al., 2013; Malinoff et al., 2013). Health-related quality of life (HRQoL) may be diminished in obese individuals due to symptoms associated with obesity-related diseases and medical illnesses. "
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    ABSTRACT: Obesity is a chronic, progressive, multifactorial medical condition. It is known that obesity is associated with cardiovascular disease, metabolic disorders, degenerative joint disorders, and decreased health-related quality of life (HRQoL). In addition, there are socio-economic, gender, age, and racial differences in the population distribution of obesity. The extent to which HRQoL is impaired by obesity independent of associated chronic disease and known demographic risk factors is less well understood by nurses. A secondary analysis of the National Health Measurement Study (NHMS) was conducted to illustrate this relationship. Regression analyses were used to assess the association between body mass index (BMI) and HRQol. BMI was categorized as normal, overweight, obese, and morbidly obese. HRQoL was measured using the EQ-5D and EQ-VAS. After adjusting for chronic health conditions and demographic factors, lower HRQoL was observed as BMI category increased for both the EQ-5D, F = 40.49, 15 df, p < .001, and EQ-VAS, F = 35.5, 15 df, p < .001.
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