Open Access Highly Accessed Research article

Body mass index and health-related quality of life among young Swiss men

Michelle Dey1*, Gerhard Gmel2 and Meichun Mohler-Kuo1

Author Affiliations

1 Institute of Social and Preventive Medicine, University of Zurich, Hirschengraben 84, Zurich 8001, Switzerland

2 Alcohol Treatment Centre, Lausanne University Hospital CHUV, Av. Beaumont 21 bis, Pavillon 2, Lausanne 1011, Switzerland

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BMC Public Health 2013, 13:1028  doi:10.1186/1471-2458-13-1028

Published: 30 October 2013



Studies about the association between body mass index (BMI) and health-related quality of life (HRQOL) are often limited, because they 1) did not include a broad range of health-risk behaviors as covariates; 2) relied on clinical samples, which might lead to biased results; and 3) did not incorporate underweight individuals. Hence, this study aims to examine associations between BMI (from being underweight through obesity) and HRQOL in a population-based sample, while considering multiple health-risk behaviors (low physical activity, risky alcohol consumption, daily cigarette smoking, frequent cannabis use) as well as socio-demographic characteristics.


A total of 5 387 young Swiss men (mean age = 19.99; standard deviation = 1.24) of a cross-sectional population-based study were included. BMI was calculated (kg/m2) based on self-reported height and weight and divided into ‘underweight’ (<18.5), ‘normal weight’ (18.5-24.9), ‘overweight’ (25.0-29.9) and ‘obese’ (≥30.0). Mental and physical HRQOL was assessed via the SF-12v2. Self-reported information on physical activity, substance use (alcohol, cigarettes, and cannabis) and socio-demographic characteristics also was collected. Logistic regression analyses were conducted to study the associations between BMI categories and below average mental or physical HRQOL. Substance use variables and socio-demographic variables were used as covariates.


Altogether, 76.3% were normal weight, whereas 3.3% were underweight, 16.5% overweight and 3.9% obese. Being overweight or obese was associated with reduced physical HRQOL (adjusted OR [95% CI] = 1.58 [1.18-2.13] and 2.45 [1.57-3.83], respectively), whereas being underweight predicted reduced mental HRQOL (adjusted OR [95% CI] = 1.49 [1.08-2.05]). Surprisingly, obesity decreased the likelihood of experiencing below average mental HRQOL (adjusted OR [95% CI] = 0.66 [0.46-0.94]). Besides BMI, expressed as a categorical variable, all health-risk behaviors and socio-demographic variables were associated with reduced physical and/or mental HRQOL.


Deviations from normal weight are, even after controlling for important health-risk behaviors and socio-demographic characteristics, associated with compromised physical or mental HRQOL among young men. Hence, preventive programs should aim to preserve or re-establish normal weight. The self-appraised positive mental well-being of obese men noted here, which possibly reflects a response shift, might complicate such efforts.

Health-related quality of life; Body mass index; Physical activity; Alcohol; Cigarettes; Cannabis