Self-reported disability in performing daily life activities was assessed in adults with severe obesity (BMI ≥？35？kg/m2) using the Health Assessment Questionnaire (HAQ). 262 participants were recruited into three BMI groups: Group I: 35–39.99？kg/m2; Group II: 40–44.99？kg/m2; Group III: ≥45.0？kg/m2. Progressively increasing HAQ scores were documented with higher BMI; Group I HAQ score: 0.125 (median) (range: 0–1.75); Group II HAQ score: 0.375 (0–2.5); Group III HAQ score: 0.75 (0–2.65) (Group III versus II ; Group III versus I ; Group II versus I ). HAQ score strongly correlated with BMI and age. Nearly three-fourths of the study participants reported some degree of disability (HAQ score > 0). The prevalence of this degree of disability increased with increasing BMI and age. It also correlated to type 2 diabetes, metabolic syndrome, and clinical depression, but not to gender. Our data suggest that severe obesity is associated with self-reported disability in performing common daily life activities, with increasing degree of disability as BMI increases over 35？kg/m2. Functional assessment is crucial in obesity management, and establishing the disability profiles of obese patients is integral to both meet the specific healthcare needs of individuals and develop evidence-based public health programs, interventions, and priorities. 1. Introduction Obesity is the most frequent metabolic disease worldwide and can progressively lead to a spectrum of comorbidities, including type 2 diabetes, hypertension, dyslipidaemia, cardiovascular disease, liver dysfunction, and osteoarthritis [1–3]. Preventing obesity-related co-morbidity relies on effective weight loss interventions; however, it is becoming evident that there is also a further need to focus on the daily living and well-being of obese patients. Obesity is still associated with high early mortality, but advances in the treatment of cardiovascular risk factors and acute coronary syndromes are now offering better cardioprotection options and prolong life expectancy . Current data support the notion that in developed societies an increasing number of obese patients are expected to live more than previously estimated, despite failing to reduce their body weight [4, 5]. Furthermore, demographic and epidemiological projections predict growing and progressively ageing obese populations in the Western world [6–8]. These populations are expected to exhibit an escalating burden of obesity-related disease, particularly regarding complications which were previously underestimated or underexpressed due to earlier
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