Physical impairment and body weight history in postmenopausal women: the Women’s Health Initiative

Abstract

Objective: To examine whether weight history and weight transitions over adult lifespan contribute to physical impairment among postmenopausal women. Design: BMI categories were calculated among postmenopausal women who reported their weight and height at age 18 years. Multiple-variable logistic regression was used to determine the association between BMI at age 18 years and BMI transitions over adulthood on severe physical impairment (SPI), defined as scoring <60 on the Physical Functioning subscale of the Rand thirty-six-item Short-Form Health Survey. Setting: Participants were part of the Women's Health Initiative Observational Study (WHI OS), where participants' health was followed over time via questionnaires and clinical assessments. Subjects: Postmenopausal women (n 76 016; mean age 635 (sd 73) years). Results: Women with overweight (BMI=250-299 kg/m(2)) or obesity (BMI = 300 kg/m(2)) at 18 years had greater odds (OR (95 % CI)) of SPI (151 (135, 169) and 214 (172, 265), respectively) than normal-weight (BMI=185-249 kg/m(2)) counterparts. Transitions from normal weight to overweight/obese or to underweight (BMI<185 kg/m(2)) were associated with greater odds of SPI (197 (184, 211) and 135 (106, 171), respectively) compared with weight stability. Shifting from underweight to overweight/obese also had increased odds of SPI (152 (111, 209)). Overweight/obese to normal BMI transitions resulted in a reduced SPI odds (052 (039, 071)). Conclusions: Higher weight history and transitions into higher weight classes were associated with higher likelihood of SPI, while transitioning into lower weight classes for those with overweight/obesity was protective among postmenopausal women.