Effects of Physical Exercise on the Quality of Life of Individuals with Diabetes and Obesity

  • Simona Moscatiello
  • Rita Manini
  • Rebecca Marzocchi
  • Giulio Marchesini


Health-related quality of life (HRQL) corresponds to a multidimensional concept, summarized as the satisfaction of the individuals with their life, specifically related to the individual’s perception of his/her health status (somatic as well as mental) and the limitations to functioning related to health, independent of socioeconomic conditions. All aspects are considered as reported by patients. In metabolic diseases, as any chronic condition, HRQL has become a relevant target of interventions, and there is evidence that in diabetes and obesity the participation in programs of physical activity is significantly associated with better health status and HRQL, not limited to physical domains, but extending to mental health. All actors of the therapeutic process need to reconsider the importance of physical activity. It is a very demanding challenge for the coming years.


Physical Activity Leisure Time Physical Activity Weight Loss Maintenance Weight Cycling Psychiatric Distress 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Sullivan MB, Sullivan LG, Kral JG (1987) Quality of life assessment in obesity: Physical, psychological, and social function. Gastroenterol Clin North Am 16:433–442PubMedGoogle Scholar
  2. 2.
    Fitzpatrick R, Davey C, Buxton MJ, Jones DR (1998) Evaluating patient-based outcome measures for use in clinical trials. Health Technol Assess 2:i-iv, 1–74PubMedGoogle Scholar
  3. 3.
    Apolone G, De Carli G, Brunetti M, Garattini S (2001) Health-related quality of life (HR-QOL) and regulatory issues. An assessment of the European Agency for the Evaluation of Medicinal Products (EMEA) recommendations on the use of HR-QOL measures in drug approval. Pharmacoeconomics 19:187–195PubMedCrossRefGoogle Scholar
  4. 4.
    McHorney CA, Ware JE, Jr, Raczek AE (1993) The MOS 36-Item Short-Form Health Survey (SF-36): II. Psychometric and clinical tests of validity in measuring physical and mental health constructs. Med Care 31:247–263PubMedCrossRefGoogle Scholar
  5. 5.
    Dupuy HJ (1984) The psychological general well-being (PGWB) inventory. In: Wenger NK (ed) Assessment of quality of life in clinical trials of cardiovascular therapies. Le Jacq Publications, New York, pp. 170–183Google Scholar
  6. 6.
    Pate RR, Pratt M, Blair SN et al (1995) Physical activity and public health. A recommendation from the Centers for Disease Control and Prevention and the American College of Sports Medicine. JAMA 273:402–407PubMedCrossRefGoogle Scholar
  7. 7.
    Fox KR (1999) The influence of physical activity on mental well-being. Public Health Nutr 2:411–418PubMedGoogle Scholar
  8. 8.
    Scully D, Kremer J, Meade MM et al (1998) Physical exercise and psychological well-being: A critical review. Br J Sports Med 32:111–120PubMedCrossRefGoogle Scholar
  9. 9.
    Penedo FJ, Dahn JR (2005) Exercise and well-being: A review of mental and physical health benefits associated with physical activity. Curr Opin Psychiatry 18:189–193PubMedCrossRefGoogle Scholar
  10. 10.
    Laforge RG, Rossi JS, Prochaska JO et al (1999) Stage of regular exercise and health-related quality of life. Prev Med 28:349–360PubMedCrossRefGoogle Scholar
  11. 11.
    Steptoe A, Butler N (1996) Sports participation and emotional wellbeing in adolescents. Lancet 347:1789–1792PubMedCrossRefGoogle Scholar
  12. 12.
    Brown DW, Balluz LS, Heath GW et al (2003) Associations between recommended levels of physical activity and health-related quality of life. Findings from the 2001 Behavioral Risk Factor Surveillance System (BRFSS) survey. Prev Med 37:520–528PubMedCrossRefGoogle Scholar
  13. 13.
    Brown DW, Brown DR, Heath GW et al (2004) Associations between physical activity dose and health-related quality of life. Med Sci Sports Exerc 36:890–896PubMedCrossRefGoogle Scholar
  14. 14.
    Astrup A (2001) Healthy lifestyles in Europe: Prevention of obesity and type II diabetes by diet and physical activity. Public Health Nutr 4:499–515PubMedGoogle Scholar
  15. 15.
    Wendel-Vos GC, Schuit AJ, Tijhuis MA, Kromhout D (2004) Leisure time physical activity and health-related quality of life: Cross-sectional and longitudinal associations. Qual Life Res 13:667–677PubMedCrossRefGoogle Scholar
  16. 16.
    Dong C, Sanchez LE, Price RA (2004) Relationship of obesity to depression: A family-based study. Int J Obes Relat Metab Disord 28:790–795PubMedCrossRefGoogle Scholar
  17. 17.
    Peyrot M, Rubin RR (1999) Persistence of depressive symptoms in diabetic adults. Diabetes Care 22:448–452PubMedCrossRefGoogle Scholar
  18. 18.
    Peyrot M, Rubin RR (1997) Levels and risks of depression and anxiety symptomatology among diabetic adults. Diabetes Care 20:585–590PubMedCrossRefGoogle Scholar
  19. 19.
    Kull M (2002) The relationships between physical activity, health status and psychological well-being of fertility-aged women. Scand J Med Sci Sports 12:241–247PubMedCrossRefGoogle Scholar
  20. 20.
    Hassmen P, Koivula N, Uutela A (2000) Physical exercise and psychological wellbeing: A population study in Finland. Prev Med 30:17–25PubMedCrossRefGoogle Scholar
  21. 21.
    Fontaine KR, Bartlett SJ, Barofsky I (2000) Health-related quality of life among obese persons seeking and not currently seeking treatment. Int J Eat Disord 27:101–105PubMedCrossRefGoogle Scholar
  22. 22.
    Marchesini G, Solaroli E, Baraldi L et al (2000) Health-related quality of life in obesity: The role of eating behaviour. Diabetes Nutr Metab 13:156–164PubMedGoogle Scholar
  23. 23.
    Marchesini G, Bellini M, Natale S et al (2003) Psychiatric distress and healthrelated quality of life in obesity. Diab Nutr Metab 16:145–154Google Scholar
  24. 24.
    Katz DA, McHorney CA, Atkinson RL (2000) Impact of obesity on health-related quality of life in patients with chronic illness. J Gen Intern Med 15:789–796PubMedCrossRefGoogle Scholar
  25. 25.
    Marchesini G, Natale S, Chierici S et al (2002) Effects of cognitive-behavioural therapy on health-related quality of life in obese subjects with and without binge eating disorder. Int J Obes Relat Metab Disord 26:1261–1267PubMedCrossRefGoogle Scholar
  26. 26.
    Walker LL, Gately PJ, Bewick BM, Hill AJ (2003) Children’s weight-loss camps: Psychological benefit or jeopardy? Int J Obes Relat Metab Disord 27:748–754PubMedCrossRefGoogle Scholar
  27. 27.
    Mellin LM, Slinkard LA, Irwin CE Jr (1987) Adolescent obesity intervention: Validation of the SHAPEDOWN program. J Am Diet Assoc 87:333–338PubMedGoogle Scholar
  28. 28.
    Hulens M, Vansant G, Claessens AL et al (2002) Health-related quality of life in physically active and sedentary obese women. Am J Hum Biol 14:777–785PubMedCrossRefGoogle Scholar
  29. 29.
    Marchesini G, Pontiroli A, Salvioli G et al (2004) Snoring, hypertension and type 2 diabetes in obesity. Protection by physical activity. J Endocrinol Invest 27:150–157PubMedGoogle Scholar
  30. 30.
    Marchesini G, Melchionda N, Apolone G wt al. (2004) The metabolic syndrome in treatment-seeking obese persons. Metabolism 53:435–440PubMedCrossRefGoogle Scholar
  31. 31.
    Grossi E, Mosconi P, Groth N et al (2002) Il Questionario Psychological General Well-Being. Versione Italiana. Milano: Edizioni “Mario Negri”Google Scholar
  32. 32.
    Apolone G, Mosconi P (1998) The Italian SF-36 Health Survey: Translation, validation and norming. J Clin Epidemiol 51:1025–1036PubMedCrossRefGoogle Scholar
  33. 33.
    Elfhag K, Rossner S (2005) Who succeeds in maintaining weight loss? A conceptual review of factors associated with weight loss maintenance and weight regain. Obes Rev 6:67–85PubMedCrossRefGoogle Scholar
  34. 34.
    Villanova N, Pasqui F, Burzacchini S et al (2006) A physical activity program to reinforce weight maintenance following a behavior program in overweight/obese subjects. Int J Obes (Lond) 30:697–703CrossRefGoogle Scholar
  35. 35.
    Brownell KD, Rodin J (1994) Medical, metabolic, and psychological effects of weight cycling. Arch Intern Med 154:1325–1330PubMedCrossRefGoogle Scholar
  36. 36.
    Melchionda N, Marchesini G, Apolone G et al (2003) The QUOVADIS study. Features of obese Italian patients seeking treatment at specialist centers. Diabetes NutrMetab 16:115–124Google Scholar
  37. 37.
    Stewart AL, Hays RD, Wells KB et al (1994) Long-term functioning and wellbeing outcomes associated with physical activity and exercise in patients with chronic conditions in the Medical Outcomes Study. J Clin Epidemiol 47:719–730PubMedCrossRefGoogle Scholar
  38. 38.
    Sigal RJ, Kenny GP, Wasserman DH et al (2006) Physical activity/exercise and type 2 diabetes: A consensus statement from the American Diabetes Association. Diabetes Care 29:1433–1438PubMedCrossRefGoogle Scholar
  39. 39.
    Jacobson AM, de Groot M, Samson JA (1994) The evaluation of two measures of quality of life in patients with type I and type II diabetes. Diabetes Care 17:267–274PubMedCrossRefGoogle Scholar
  40. 40.
    Jacobson AM (1997) Quality of life in patients with diabetes mellitus. Semin Clin Neuropsychiatry 2:82–93PubMedGoogle Scholar
  41. 41.
    Glasgow RE, Ruggiero L, Eakin EG et al (1997) Quality of life and associated characteristics in a large national sample of adults with diabetes. Diabetes Care 20:562–567PubMedCrossRefGoogle Scholar
  42. 42.
    Chyun DA, Melkus GD, Katten DM et al (2006) The association of psychological factors, physical activity, neuropathy, and quality of life in type 2 diabetes. Biol Res Nurs 7:279–288PubMedCrossRefGoogle Scholar
  43. 43.
    Derogatis LR, Rickels K, Rock AF (1976) The SCL-90 and the MMPI: A step in the validation of a new self-report scale. Br J Psychiatry 128:280–289PubMedCrossRefGoogle Scholar
  44. 44.
    DCCT Research Group (1996) Influence of intensive diabetes treatment on quality-of-life outcomes in the diabetes control and complications trial. Diabetes Care 19:195–203CrossRefGoogle Scholar
  45. 45.
    Forlani G, Zannoni C, Tarrini G et al (2006) An empowerment-based educational program improves psychological well-being and health-related quality of life in Type 1 diabetes. J Endocrinol Invest 29:405–412PubMedGoogle Scholar
  46. 46.
    Mannucci E, Ricca V, Bardini G, Rotella CM (1996) Well-being enquiry for diabetics: A new measure of diabetes-related quality of life. Diab Nutr Metab 9:89–102Google Scholar
  47. 47.
    Brekke HK, Jansson PA, Lenner RA (2005) Long-term (1-and 2-year) effects of lifestyle intervention in type 2 diabetes relatives. Diabetes Res Clin Pract 70:225–234PubMedCrossRefGoogle Scholar
  48. 48.
    Di Loreto C, Fanelli C, Lucidi P et al (2005) Make your diabetic patients walk: Long-term impact of different amounts of physical activity on type 2 diabetes. Diabetes Care 28:1295–1302PubMedCrossRefGoogle Scholar
  49. 49.
    Wylie-Rosett J, Herman WH, Goldberg RB (2006) Lifestyle intervention to prevent diabetes: Intensive AND cost effective. Curr Opin Lipidol 17:37–44PubMedCrossRefGoogle Scholar
  50. 50.
    Schulze MB, Hu FB (2005) Primary prevention of diabetes: What can be done and how much can be prevented? Annu Rev Public Health 26:445–467PubMedCrossRefGoogle Scholar
  51. 51.
    Delahanty LM, Meigs JB, Hayden D et al (2002) Psychological and behavioral correlates of baseline BMI in the diabetes prevention program (DPP). Diabetes Care 25:1992–1998PubMedCrossRefGoogle Scholar
  52. 52.
    Melchionda N, Forlani G, La Rovere L et al (2006) Disease management of the metabolic syndrome in a community. Study design and process analysis on baseline data. Metab Synd & Rel Dis 4:7–16CrossRefGoogle Scholar

Copyright information

© Springer 2007

Authors and Affiliations

  • Simona Moscatiello
    • 1
  • Rita Manini
    • 1
  • Rebecca Marzocchi
    • 1
  • Giulio Marchesini
    • 1
  1. 1.Department of Internal Medicine and Gastroenterology “Alma Mater Studiorum”University of BolognaBolognaItaly

Personalised recommendations