Impact of Obesity on Work Productivity and Role Disability in Individuals with and at Risk for Diabetes Mellitus

Abstract

Purpose. Evaluate work absence, work productivity, and disruption of work, social, and family life among individuals of varying body mass index (BMI) with or at risk for diabetes mellitus. Design. Cross-sectional analysis of survey data. Setting. Community-based U.S. population. Subjects. Respondents (n = 15,132; n = 7338 working adults) participating in the U.S. Study to Help Improve Early evaluation and management of risk factors Leading to Diabetes (SHIELD) study were stratified by combinations of BMI (i.e., ≥ 30 kg/m2 [obese], 25 to 29.9 kg/m2 [overweight], and < 25 kg/m2 [normal weight]) and diabetes (i.e., type 2 diabetes mellitus [T2DM], type 1 diabetes mellitus [T1DM], and high risk [HR] or low risk [LR] of T2DM). Measures. Work impairment was measured using the Work Productivity and Activity Impairment Questionnaire: General Health. Disruption in life was measured using the Sheehan Disability Scale. HR was defined as 3 to 5 of the following factors: abdominal obesity, BMI ≥ 28 kg/m2, reported diagnosis of “cholesterol problems,” reported diagnosis of “hypertension,” or history of coronary heart disease or stroke. LR was defined as ≤ 2 of these factors. Results. Percentage of work impairment and proportion with severe disruption of work, family, and social life increased systematically from normal weight to obese (p < .001). Obese individuals had the greatest impairment at work (11%-15% of work time), greatest impairment of daily activities (20%-34% of time), and greatest overall impairment (11%-15% of time) in the LR, HR, and T2DM groups. Obesity and T2DM were independent predictors of overall work impairment and life disruption (p < .001). Between 5% and 7% of total variance was explained in the regression models with BMI category, diabetes/risk group, age, gender, race, income, and household size as variables. Conclusion. Greatest impairment of work and daily activities was evident among obese individuals for all groups.