Usefulness of standard BMI cut-offs for quality of life and psychological well-being in women.

OBJECTIVE We examined BMI-based obesity categories and risk for poor health-related quality of life (HRQOL) and psychological well-being (PWB). METHODS Participants were 1,795 women aged 35.3 ± 10.2 years with a mean BMI of 26.6 kg/m(2), not seeking treatment (55%) or upon entry into a weight control program. Assessments included general HRQOL, weight-related HRQOL, self-esteem, and body image. RESULTS All variables, except general HRQOL, were different (p < 0.001) between normal-weight and overweight/obese women. For weight-related HRQOL and body image, worse psychosocial scores were observed linearly with higher obesity levels. Self-esteem was lower in overweight and obese women in comparison with normal-weight women, with no difference between class I and class II obesity. Participants entering a clinical program reported higher physical HRQOL, but lower self-esteem and poorer body image than community-dwelling women of equal weight. CONCLUSIONS BMI categories are useful for identifying increased impairment in PWB and HRQOL in overweight and obese (class I or II) women. Women with a BMI under 25 kg/m(2) reported improved well-being and HRQOL in comparison to overweight or obese women. However, this relation may not be linear across all psychosocial outcomes, with unique patterns emerging for the association of obesity level with specific dimensions of PWB and HRQOL.