title: Excess weight and physical health-related quality of life in postmenopausal women of diverse racial/ethnic backgrounds.
abstract: BACKGROUND
  Studies of weight and health-related quality of life (HRQOL) generally focus on white populations. This analysis examines the association between clinical weight categories and physical HRQOL in five racial/ethnic groups of older women and determines the extent to which emotional/psychological (social support, caregiver burden) and physical health (diabetes, osteoarthritis) factors modify this relationship.
  
  
  METHODS
  The cross-sectional analysis, completed in 2007, used baseline data from postmenopausal women enrolled in the Women's Health Initiative (WHI) during the 5-year recruitment period (1993-1998).
  
  
  RESULTS
  Of 161,393 women, 83% were non-Hispanic white, 9% were African American, 4% were Hispanic/Latina, 3% were Asian/Pacific Islander, and <1% were American Indian/Alaska Native. Obesity (body mass index [BMI] > or =30 kg/m(2)) was most common in non-Asian minority groups. Regression modeling showed higher odds of poor physical HRQOL with increasing weight category in all groups. In the total sample, these odds were at least 6 times as high in women with class 3 obesity as in women of normal weight and were only mildly attenuated after the analysis adjusted for emotional/psychological factors. Further adjustment for physical health factors made odds ratio (OR) estimates drop from 2.36 to 1.59 for class 1 obesity and from 6.96 to 3.71 for class 3 obesity. This pattern generally persisted within each racial/ethnic group.
  
  
  CONCLUSIONS
  Heavier weight negatively affects physical HRQOL in postmenopausal women across diverse racial/ethnic backgrounds. Weight-relevant physical health factors have a greater impact on this weight-HRQOL association than do emotional/psychological factors.
authors.affiliation: Ralph H. Johnson V.A. Medical Center and Department of Medicine, Medical University of South Carolina, Charleston, South Carolina 29425, USA. lynchcp@musc.edu
authors.forename: Cheryl P
authors.initials: CP
authors.lastname: Lynch
authors.forename: Kathleen M
authors.initials: KM
authors.lastname: McTigue
authors.forename: James E
authors.initials: JE
authors.lastname: Bost
authors.forename: Lesley F
authors.initials: LF
authors.lastname: Tinker
authors.forename: Mara
authors.initials: M
authors.lastname: Vitolins
authors.forename: Lucile
authors.initials: L
authors.lastname: Adams-Campbell
authors.forename: Gloria E
authors.initials: GE
authors.lastname: Sarto
authors.forename: Jennifer
authors.initials: J
authors.lastname: Hays-Grudo
authors.forename: Joann E
authors.initials: JE
authors.lastname: Manson
authors.forename: Lewis H
authors.initials: LH
authors.lastname: Kuller
mesh_terms: D000368:Aged; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D005006:Ethnicity / Q000523:psychology / Q000706:statistics & numerical data; D005260:Female; D006304:Health Status; D006801:Humans; D008875:Middle Aged; D009765:Obesity / Q000208:ethnology / Q000523:psychology; D016017:Odds Ratio; D050177:Overweight / Q000208:ethnology / Q000523:psychology; D017698:Postmenopause / Q000208:ethnology; D011788:Quality of Life; D012044:Regression Analysis; D014481:United States; D015430:Weight Gain / Q000208:ethnology