Relationship Between Body Weight and Quality of Life in Older Adults with Medicare Supplement Insurance

Research Objective: To estimate the relative impact that each body mass index (BMI) category has on health-related quality of life. Study Design: The Medicare Health Outcomes Survey instrument was used, but renamed the Health Update Survey. Population Studies: A mail survey was sent to 60,000 adults with an AARP®-branded Medicare Supplement Insurance (i.e. Medigap) plan provided by UnitedHealthcare Insurance Company (for New York residents, UnitedHealthcare Insurance Company of New York) in 10 states. Principle Findings: Casemix-adjusted comparisons were made between each BMI category versus those with normal BMI. 22,827 (38%) eligible sample members responded to the survey. Of those, 2.2% were underweight, 37.0% were overweight, 18.5% were obese, 1.9% were morbidly obese, 38.5% had a normal BMI. Factors associated with being underweight or overweight were generally consistent with past reports. Quality of life was assessed using the average physical component scores (PCS) and mental component scores (MCS) obtained from the VR-12 health status tool. Respondents' PCS values were 5.01, 0.16, 3.60 and 9.50 points lower on average, respectively, for the underweight, overweight, obese and morbidly obese BMI categories, compared to the normal BMI group. Respondents' MCS values were 3.28, +0.52, 0.32 and 1.39 points lower on average, respectively for the underweight, overweight, obese and morbidly obese BMI categories, compared to the normal weight group. Conclusions: The greatest impact on quality of life was on those in the underweight and morbidly obese categories, with the greater negative impacts were on the physical rather than mental aspects of quality of life.