Purpose. Evaluate work absence, work productivity, and disruption of work, social, and family life among individuals of varying body mass index (BMI) with or at risk for diabetes mellitus. Design. Cross-sectional analysis of survey data. Setting. Community-based U.S. population. Subjects. Respondents (n = 15, 132; n = 7338 working adults) participating in the U.S. Study to Help Improve Early evaluation and management of risk factors Leading to Diabetes (SHIELD) study were stratified by combinations of BMI (i.e., >= 30 kg/m(2) [obese], 25 to 29.9 kg/m(2) [overweight], and <25 kg/m(2) [normal weight]) and diabetes (i.e., type 2 diabetes mellitus [T2DM], type 1 diabetes mellitus [T1DM], and high risk [HR] or low risk [LR] of T2DM). Measures. Work impairment was measured using the Work Productivity and Activity Impairment Questionnaire: General Health. Disruption in life was measured using the Sheehan Disability Scale. HR was defined as 3 to 5 of the following factors: abdominal obesity, BMI >= 28 Kg/m(2), reported diagnosis of "cholesterol problems," reported diagnosis of "hypertension," or history of coronary heart disease or stroke. LR was defined as <= 2 of these factors. Results. Percentage of work impairment and proportion with severe disruption of work, family, and social life increased systematically from normal weight to obese (p < .001). Obese individuals had the greatest impairment at work (11%-15% of work time), greatest impairment of daily activities (20%-34% of time), and greatest overall impairement (11%-15% of time) in the LR, Hr, and T2DM groups. Obesity and T2DM were independent predictors of overall work impairment and life disruption (p < .001). Between 5% and 7% of total variance was explained in the regression models with BMI category, diabetes/risk group, age, gender, race, income, and household size as variables. Conclusion. Greatest impairment of work and daily activities was evident among obese individuals for all groups. (Am J Health Promot 2009;23[5]:353-360.)
