Special Issue "The Burden of Obesity in Health Care"


A special issue of Healthcare (ISSN 2227-9032).

Deadline for manuscript submissions: closed (15 February 2014)

Special Issue Editors

Guest Editor
Prof. Dr. Clare Collins
Priority Research Centre in Physical Activity and Nutrition, Faculty of Health, School of Health Sciences, University of Newcastle, ATC 310, Atc Building, Callaghan, New South Wales 2308, Australia
Website: http://www.newcastle.edu.au/profile/clare-collins
E-Mail: Clare.Collins@newcastle.edu.au
Phone: +61 2 4921 5646
Fax: +61 2 4921 7053
Interests: nutrition; dietary intake; caloric restriction; dietary patterns; diet quality

Guest Editor
Dr. Linda J. Cobiac
School of Population Health, The University of Queensland, Herston, Queensland, QLD 4006, Australia
Website: http://www.uq.edu.au/uqresearchers/researcher/cobiaclj.html
E-Mail: l.cobiac@uq.edu.au
Phone: +64 4 918 6251
Interests: cost-effectiveness; prevention; non-communicable disease

Special Issue Information

Dear Colleagues,

Obesity is prevalent internationally and at all ages and lifestages. While the relationship between obesity, poor dietary patterns and sub-optimal leveal of physical activity with the risk of morbidity and mortality due to chronic conditions has been examined extensively, the relationship with healthcare usage and costs is less studied. This special issue of Healthcare “The burden of obesity in health care” welcomes submission of previously unpublished manuscripts from original work on all the above aspects.

Prof. Dr. Clare E. Collins
Dr. Linda J. Cobiac
Guest Editors


Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. Papers will be published continuously (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are refereed through a peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Healthcare is an international peer-reviewed Open Access quarterly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. For the first couple of issues the Article Processing Charge (APC) will be waived for well-prepared manuscripts. English correction and/or formatting fees of 250 CHF (Swiss Francs) will be charged in certain cases for those articles accepted for publication that require extensive additional formatting and/or English corrections.


  • obesity
  • healthcare cost
  • healthcare use
  • health economics
  • diet
  • physical activity

Published Papers (3 papers)

Healthcare 2014, 2(2), 166-182; doi:10.3390/healthcare2020166
Received: 12 February 2014; in revised form: 14 March 2014 / Accepted: 17 March 2014 / Published: 1 April 2014
Show/Hide Abstract | Download PDF Full-text (132 KB) | Download XML Full-text

Healthcare 2014, 2(2), 150-165; doi:10.3390/healthcare2020150
Received: 26 November 2013; in revised form: 25 February 2014 / Accepted: 5 March 2014 / Published: 27 March 2014
Show/Hide Abstract | Download PDF Full-text (125 KB) | Download XML Full-text

Healthcare 2014, 2(1), 47-59; doi:10.3390/healthcare2010047
Received: 13 November 2013; in revised form: 31 December 2013 / Accepted: 6 January 2014 / Published: 13 January 2014
Show/Hide Abstract | Download PDF Full-text (194 KB) | View HTML Full-text | Download XML Full-text

Planned Papers

The below list represents only planned manuscripts. Some of these manuscripts have not been received by the Editorial Office yet. Papers submitted to MDPI journals are subject to peer-review.

Type of Paper: Article
Title: Obesity and Serious Mental Illness: A Critical Review of the Literature
Authors: Tim Bradshaw and Hilary Mairs
Affiliation: Jean McFarlane Building, University of Manchester, Oxford Road, Manchester, M13 9PL, UK; E-Mails: t.bradshaw@manchester.ac.uk; hilary.mairs@manchester.ac.uk
Abstract: Individuals who experience psychosis are more likely to be overweight or obese than others in the general population. Reasons for this include lifestyle factors such as diet and exercise and the prescription of antipsychotic medication which can result in up to 1 kg in weight-gain each week for up to 8 weeks post onset of treatment. Consequences of this include poor physical health and a reduced life expectancy of up to 25 years. In this manuscript we review the prevalence of obesity in this group, discuss the potential causes of weight-gain and highlight the implications for the Professionals involved in their care.

Type of Paper: Article
Living with a gastric band. A qualitative study.
M. Pfeil 1, A Pulford 2, Y. Ferguson 3, D. Mahon 3, M. Lewis 2
1 School of Nursing Sciences, University of East Anglia, Norwich Research Park, Norwich NR4 7TJ, England. E-Mail: m.pfeil@uea.ac.uk; 2 Department of General Surgery, Norfolk and Norwich University HospitalNHS Foundation Trust, Colney, Norwich NR4 7UY, England; 3 Department of Upper Gastrointeastinal and Bariatric Surgery, Musgrove Park Hospital, taunton and Somerset NHS Foundation Trust, Taunton, TA1 5DA, England
Gastric banding is an established and effective form of weightloss surgery. Semi-structured interviews explored the experiences of gastric banding of twenty purposively recruited patients one year after surgery. Data was analysed using thematic analysis.
Three themes emerged.

•      Exercising choiceParadoxically, restricting choice by banding provided patients with new life choices.

•      Rediscovering lifeImproved health, physical ability and energy enabled the patients to re-discover life.

•      Goals achieved with no regretsPatients had [nearly] achieved their self-set goals.

Beyond achieving weightloss and improved health the participants had improved the quality of life as defined by patients.  Knowledge about this active process informs the care of these patients.

Type of Paper: Article
Multilevel and Geospatial Analysis of the Burden of Obesity: Prevalence, Hospitalization, Mortality, and Healthcare Cost in the United States
Longjian Liu, MD, PhD, MSc
Department of Epidemiology and Biostatistics, Drexel University School of Public Health, Philadelphia, PA, 19102, USA; E-Mail: LL85@Drexel.edu
The prevalence of overweight and obesity has been increasing significantly over the last three decades in the United States. Little research has addressed the heterogeneity and the determinants of obesity-related outcomes on the basis of differences in physical environment and healthcare system. The present study aims to examine the patterns of the prevalence of overweight and obesity in 50 states in the nation, and to examine hospitalization, mortality and healthcare cost attributable to obesity. Data from three nationally representative large-scale surveys will be used, including the National Health and Nutrition Examination Survey's Mortality Follow-up data (1988-2006), 2010 Behavior Risk Factor Surveillance System, and 2010 Nationwide Hospital Sample. The burden of obesity and its associations with multiple comorbidity, hospitalization, mortality and healthcare cost will be tested cross-sectionally and prospectively using multiple logistic regression and Cox proportional hazard regression models. Findings from the study will add new evidence of the burden of obesity to the literature of research, and may offer new insights into the prevention and control of obesity at individual, regional and national levels.

Type of Paper: Article
A changing body image: the experiences of massive weight loss patients following reconstructive surgery
Jo Gilmartin, Andrew Long and Mark Soldin
School of Healthcare, University of Leeds, Baines Wing, Leeds LS2 9UT, UK; E-Mail: J.Gilmartin@leeds.ac.uk
Background: In contemporary global healthcare, an increasing number of morbidly obese patients are seeking surgical solutions such as bariatric surgery. Dramatic weight loss can leave patients with a huge excess of overstretched skin triggering discomfort and significant appearance related distress. There is a scarcity of research in regard to the needs of patients and this is hugely important for global healthcare practice. Aim: To gain an in-depth understanding of body image matters and psychosocial health amongst patients following dramatic weight loss and reconstructive surgery. Methods: In this qualitative study, we recruited 20 adult patients who had undergone reconstructive surgery procedures and conducted in-depth interviews. The interviews were transcribed and thematically analysed using NVIVO software and a content analysis framework. Results: The core theme of changing body image and three interrelated sub themes emerged. The changing body image theme shed light on the impact of ‘early scarring’ and ‘late scarring’ on the adjustment process following reconstructive surgery. The three subthemes including social acceptance, undoing depression and sexual vitality highlight both transformation processes and the challenges encountered throughout recovery from reconstructive surgery. Conclusions: The findings provide evidence for nurses to empower clients to achieve body image enhancement and to employ body image acceptance programmes and cognitive behavioural therapy to facilitate positive adjustment.
changing body image, massive weight loss, reconstructive surgery, adjusting to the changing body, improved well-being

Type of paper: Article
How well does a Type 2 Diabetes Prevention Index Score (T2DPIS), predict incidence of the disease in the UK Women’s Cohort Study?
Lee Ashton 1,*, Janet Cade 2, Victoria Burley 2
1 Clinical Trials Research Unit, University of Leeds, Leeds, UK, E-Mail: L.Ashton@leeds.ac.uk; 2 Foods Science, University of Leeds, Leeds, UK
Abstract: Aims:
This study aims to create a Type 2 Diabetes Prevention Index Score (T2DPIS) and assess the association of dietary patterns identified in relation to incidence of Type 2 diabetes (T2DM). Method: A T2DPIS was created based on information from a 217-item Food Frequency Questionnaire completed by 35,000 participants of the U.K Women’s Cohort Study (UKWCS) between 1995 and 1998. Ascertainment of T2DM was established 5 years subsequent to baseline measurements with around 14,000 respondents. Odds ratios (OR) for T2DM were calculated using logistic regression and adjusted for known diabetic risk factors. Results: A total of 114 incident cases of T2DM developed during 5 years of follow up. Women adhering to a healthy dietary pattern (quartile 5) were at decreased odds of T2DM when compared to quartile 1. The OR for the age adjusted model were 0.48 (95% CI; 0.27, 0.86, ptrend =0.01). Further adjustment for a range of covariates did not modify this association: 0.49 (95% CI 0.24, 0.98 ptrend =0.02 ). Results for the multivariate model plus body mass index and energy intake was not significant with OR; 0.51 (95% CI; 0.25, 1.07 ptrend =0.03). However quartile 4 shows a significant reduction in OR of T2DM; 0.47 (95% CI; 0.23, 0.96 ptrend =0.03). Conclusion: Consuming a healthy dietary pattern as characterized by the T2DPIS is associated with decreased odds of T2DM. Consequently the T2DPIS has potential for use in public health settings as a guide to preventing T2DM.

Last update: 15 November 2013

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