本研究目的為探討台灣老年族群自我評估的健康狀況與肥胖狀況之間的關係，特別聚焦於研究BMI超過24kg/m2過重及肥胖之老年族群幸福感與肥胖風險之間的關聯。使用體育署之國民體適能檢測的資料庫進行橫斷面研究，該調查是對台灣人口的全國代表性調查。2015年10月至2016年10月期間為數據收集之階段，共有20,295名65歲及以上的老年人最終被納入研究。根據研究結果，在老年男性族群中可以看出幸福感與過重風險呈正相關，而在其他族群中未發現幸福感與肥胖風險呈顯著相關。此研究指出在評估BMI超過24 kg/m2老年男性的肥胖風險時，考慮幸福感為一個非常重要的因素，且突顯身體組成與心理健康對此關係的潛在影響。未來，應進一步探討台灣老年人自我評估之健康狀況及肥胖狀態間的因果關係，透過長期研究來調查可能會對此種關係的調節因素產生影響，以獲得更深入的了解。

For this study, it was the purpose to explore the correlation between self-reported health status and obesity status in Taiwanese elderly , with strong emphasis on the relationship between happiness and obesity risk in elderly with a BMI over 24 kg/m2. There was a cross-sectional study using a secondary dataset based on the National Physical Fitness Survey, a nationally representative survey among Taiwan's residents. For the period October 2015 to October 2016, altogether, 20,295 elderly people who were aged 65 and older eventually participated as part of the study. A positive association was shown between happiness and overweight in the males, while no significant relationship was found between happiness and obesity risk in the remaining groups. These observations demonstrate the critical value of accounting for happiness as a factor in assessing obesity risk among elderly men with a BMI in the overweight range, and highlight the potential influence of body composition and mental health on this relationship. Future research should further explore the relationship between self-reported health status and obesity status in Taiwanese elderly. In order to get a deeper understanding of this relationship, longitudinal studies could be conducted to investigate potential moderating factors that may influence it.

National Development Council. Population estimates of the Republic of China (2020 to 2070). Accessed August, 2020. https://www.ndc.gov.tw/Content_List.aspx?n=3CF120A42CD31054
World Health Organization. Decade of Healthy Ageing: Plan of Action. Accessed December 14, 2020. Available online: https://www.who.int/publications/m/item/decade-of-healthy-ageing-plan-of-action
Health Promotion Administration, Ministry of Health and Welfare. National Nutrition and Health Status Change Survey (2013-2016).Health Promotion Statistical Report. Available online: https://www.hpa.gov.tw/Pages/Detail.aspx?nodeid=3999&pid=11145 (accessed on 12 July 2019).
Health Promotion Administration, Ministry of Health and Welfare. National Nutrition and Health Status Change Survey (2017-2020).Health Promotion Statistical Report. Available online: https://www.hpa.gov.tw/Pages/Detail.aspx?nodeid=3999&pid=15562 (accessed on 09 May 2022).
Piché, M. E., Poirier, P., Lemieux, I., & Després, J. P. (2018). Overview of epidemiology and contribution of obesity and body fat distribution to cardiovascular disease: an update. Progress in cardiovascular diseases, 61(2), 103-113.
Sahakyan, K. R., Somers, V. K., Rodriguez-Escudero, J. P., Hodge, D. O., Carter, R. E., Sochor, O., ... & Lopez-Jimenez, F. (2015). Normal-weight central obesity: implications for total and cardiovascular mortality. Annals of internal medicine, 163(11), 827-835.
Stiegler, P., & Cunliffe, A. (2006). The role of diet and exercise for the maintenance of fat-free mass and resting metabolic rate during weight loss. Sports medicine, 36, 239-262.
Panel, O. E. (2013). Managing overweight and obesity in adults: Systematic evidence review. Bethesda, MD: National Heart, Lung and Blood Institute, NIH, US DHHS.
Schaller, A., Dejonghe, L., Haastert, B., & Froboese, I. (2015). Physical activity and health-related quality of life in chronic low back pain patients: a cross-sectional study. BMC musculoskeletal disorders, 16(1), 1-8.
Bhaskaran, K., dos-Santos-Silva, I., Leon, D. A., Douglas, I. J., & Smeeth, L. (2018). Association of BMI with overall and cause-specific mortality: a population-based cohort study of 3• 6 million adults in the UK. The lancet Diabetes & endocrinology, 6(12), 944-953.
Dai, H., Alsalhe, T. A., Chalghaf, N., Riccò, M., Bragazzi, N. L., & Wu, J. (2020). The global burden of disease attributable to high body mass index in 195 countries and territories, 1990–2017: An analysis of the Global Burden of Disease Study. PLoS medicine, 17(7), e1003198.
Vigo, D., Thornicroft, G., & Atun, R. (2016). Estimating the true global burden of mental illness. The Lancet Psychiatry, 3(2), 171-178.
Wang, H., Naghavi, M., Allen, C., Barber, R. M., Bhutta, Z. A., Carter, A., ... & Bell, M. L. (2016). Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980–2015: a systematic analysis for the Global Burden of Disease Study 2015. The lancet, 388(10053), 1459-1544.
Mathers, C. (2008). The global burden of disease: 2004 update. World Health Organization.
Mathers, C. D., & Loncar, D. (2006). Projections of global mortality and burden of disease from 2002 to 2030. PLoS medicine, 3(11), e442.
Dolan, P. (2014). Happiness by design: Finding pleasure and purpose in everyday life. Penguin UK.
Graham, C., & Felton, A. (2009). Does inequality matter to individual welfare? An initial exploration based on happiness surveys from Latin America. In Happiness, Economics and Politics. Edward Elgar Publishing.
Layard, R. (2011). Happiness 2/e: Lessons From A New Science. Penguin UK.
Linna, M. S., Kaprio, J., Raevuori, A., Sihvola, E., Keski-Rahkonen, A., & Rissanen, A. (2013). Body mass index and subjective well-being in young adults: a twin population study. BMC public health, 13(1), 1-10.
Dierk, J. M., Conradt, M., Rauh, E., Schlumberger, P., Hebebrand, J., & Rief, W. (2006). What determines well-being in obesity? Associations with BMI, social skills, and social support. Journal of psychosomatic research, 60(3), 219-227.
United Nations, Department of Economic and Social Affairs, Population Division (2019). Our world is growing older. Retrieved from https://www.un.org/development/desa/en/news/population/our-world-is-growing-older.html
Ng, M., Fleming, T., Robinson, M., Thomson, B., Graetz, N., Margono, C., ... & Gakidou, E. (2014). Global, regional, and national prevalence of overweight and obesity in children and adults during 1980–2013: a systematic analysis for the Global Burden of Disease Study 2013. The lancet, 384(9945), 766-781.
Swinburn, B. A., Kraak, V. I., Allender, S., Atkins, V. J., Baker, P. I., Bogard, J. R., ... & Dietz, W. H. (2019). The global syndemic of obesity, undernutrition, and climate change: the Lancet Commission report. The lancet, 393(10173), 791-846.
Chooi, Y. C., Ding, C., & Magkos, F. (2019). The epidemiology of obesity. Metabolism, 92, 6-10.
World Health Organization. Obesity and Overweight. Accessed June 09, 2021. Available online: https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight
Hazzard, W. R. (1985). The practice of geriatric medicine. In Principles of geriatric medicine (pp. 3-5). McGraw-Hill, New York.
Flegal, K. M., Kruszon-Moran, D., Carroll, M. D., Fryar, C. D., & Ogden, C. L. (2016). Trends in obesity among adults in the United States, 2005 to 2014. Jama, 315(21), 2284-2291.
Johnson, N. B., Hayes, L. D., Brown, K., Hoo, E. C., & Ethier, K. A. (2014). CDC National Health Report: leading causes of morbidity and mortality and associated behavioral risk and protective factors—United States, 2005–2013.
Hales, C. M., Carroll, M. D., Fryar, C. D., & Ogden, C. L. (2020). Prevalence of obesity and severe obesity among adults: United States, 2017–2018. NCHS Data Brief, no 360. National Center for Health Statistics, (360).
De Groot, C. P., Perdigao, A. L., & Deurenberg, P. (1996). Longitudinal changes in anthropometric characteristics of elderly Europeans. SENECA Investigators. European Journal of Clinical Nutrition, 50, S9-15.
Powell-Wiley, T. M., Poirier, P., Burke, L. E., Després, J. P., Gordon-Larsen, P., Lavie, C. J., ... & American Heart Association Council on Lifestyle and Cardiometabolic Health; Council on Cardiovascular and Stroke Nursing; Council on Clinical Cardiology; Council on Epidemiology and Prevention; and Stroke Council. (2021). Obesity and cardiovascular disease: a scientific statement from the American Heart Association. Circulation, 143(21), e984-e1010.
Couillard, C., Ruel, G., Archer, W. R., Pomerleau, S., Bergeron, J., Couture, P., ... & Bergeron, N. (2005). Circulating levels of oxidative stress markers and endothelial adhesion molecules in men with abdominal obesity. The Journal of Clinical Endocrinology & Metabolism, 90(12), 6454-6459.
De Graaf, J. H. L. M., Hak-Lemmers, H. L., Hectors, M. P., Demacker, P. N., Hendriks, J. C., & Stalenhoef, A. F. (1991). Enhanced susceptibility to in vitro oxidation of the dense low density lipoprotein subfraction in healthy subjects. Arteriosclerosis and thrombosis: a journal of vascular biology, 11(2), 298-306.
Medvedev, O. N., & Landhuis, C. E. (2018). Exploring constructs of well-being, happiness and quality of life. PeerJ, 6, e4903.
Diener, E., & Biswas-Diener, R. (2011). Happiness: Unlocking the mysteries of psychological wealth. John Wiley & Sons.
Vaillant, G. (2011). The happiness effect. Bull World Health Organ, 89, 246-247.
Graham, C. (2012). Happiness around the world: The paradox of happy peasants and miserable millionaires. Oxford University Press.
Silverio, S. A. (2021). Women’s mental health as a public health priority: a call for action. Journal of Public Mental Health, 20(1), 60-68.
Thaithatkul, P., Chalermpong, S., Laosinwattana, W., & Kato, H. (2022). Mobility, activities, and happiness in old age: case of the elderly in Bangkok. Case studies on transport policy, 10(2), 1462-1471.
Mishra, R., & Sekher, T. V. (2022). Social capital and subjective well-being contribute happiness among the elderly? A study in India. In Handbook of Health and Well-Being: Challenges, Strategies and Future Trends (pp. 419-436). Singapore: Springer Nature Singapore.
Shah, S. A., Safian, N., Ahmad, S., Wan Ibadullah, W. A. H., Mohammad, Z. B., Nurumal, S. R., ... & Shobugawa, Y. (2021). Factors associated with happiness among Malaysian elderly. International journal of environmental research and public health, 18(7), 3831.
Suriyanrattakorn, S., & Chang, C. L. (2021). Long-term care (LTC) policy in Thailand on the homebound and bedridden elderly happiness. Health Policy Open, 2, 100026.
Lee, M. R. (2020). The relationship between interpersonal relationships and subjective experience of happiness among active elderly in Korea. Asia-pacific Journal of Convergent Research Interchange, 6(11), 131-147.
Xu, W., Sun, H., Zhu, B., Bai, W., Yu, X., Duan, R., ... & Li, W. (2019). Analysis of factors affecting the high subjective well-being of Chinese residents based on the 2014 China family panel study. International journal of environmental research and public health, 16(14), 2566.
Assari, S. (2020). Income and mental well-being of middle-aged and older Americans: Immigrants’ diminished returns. International Journal of Travel Medicine and Global Health, 8(1), 37-43.
Mínguez, A. M., & Vírseda, J. A. V. (2019). Well-being and living arrangement of elderly people from European comparative perspective. The Social Science Journal, 56(2), 228-242.
Guh, D.P.; Zhang, W.; Bansback, N.; Amarsi, Z.; Birmingham, C.L.; Anis, A.H. The incidence of co-morbidities related to obesity 301 and overweight: a systematic review and meta-analysis. BMC public health 2009, 9(1), 1-20.
McElroy, S. L., Kotwal, R., Malhotra, S., Nelson, E. B., Keck, P. E., & Nemeroff, C. B. (2004). Are mood disorders and obesity related? A review for the mental health professional. J Clin Psychiatry, 65(5), 634-651.
Needham, B. L., & Crosnoe, R. (2005). Overweight status and depressive symptoms during adolescence. Journal of Adolescent Health, 36(1), 48-55.
REED, D. B. (1985). The relationship between obesity and psychological general well-being in United States women (Doctoral dissertation, The University of Texas School of Public Health).
Horner Jr, T. N., & Utermohlen, V. (1993). A multivariate analysis of psychological factors related to body mass index and eating preoccupation in female college students. Journal of the American College of Nutrition, 12(4), 459-465.
Robertson, S., Davies, M., & Winefield, H. (2015). Why weight for happiness? Correlates of BMI and SWB in Australia. Obesity research & clinical practice, 9(6), 609-612.
Headey, B., Muffels, R., & Wagner, G. G. (2013). Choices which change life satisfaction: Similar results for Australia, Britain and Germany. Social Indicators Research, 112(3), 725-748.
Crisp, A. H., & McGuiness, B. (1976). Jolly fat: relation between obesity and psychoneurosis in general population. Br Med J, 1(6000), 7-9.
Crisp, A. H., Queenan, M., Sittampaln, Y., & Harris, G. (1980). ‘Jolly fat’revisited. Journal of psychosomatic research, 24(5), 233-241.
Kittel, F., Rustin, R. M., Dramaix, M., De Backer, G., & Kornitzer, M. (1978). Psycho-socio-biological correlates of moderate overweight in an industrial population. Journal of Psychosomatic Research, 22(3), 145-158.
Faubel, M. (1989). Body image and depression in women with early and late onset obesity. The Journal of psychology, 123(4), 385-395.
Hällström, T., & Noppa, H. (1981). Obesity in women in relation to mental illness, social factors and personality traits. Journal of Psychosomatic Research, 25(2), 75-82.
Pinhey, T. K., Rubinstein, D. H., & Colfax, R. S. (1997). Overweight and happiness: The reflected self-appraisal hypothesis reconsidered. Social Science Quarterly, 747-755.
Godoy-Izquierdo, D., González-Hernández, J., Rodríguez-Tadeo, A., Lara, R., Ogallar, A., Navarrón, E., ... & Arbinaga, F. (2020). Body satisfaction, weight stigma, positivity, and happiness among Spanish adults with overweight and obesity. International Journal of Environmental Research and Public Health, 17(12), 4186.
Kasman, S., & Kasman, A. (2023). The impact of obesity and income on happiness: Evidence from EU countries. Panoeconomicus, 70(2), 303-319.
Sato, K. (2021). Unhappy and happy obesity: a comparative study on the United States and China. Journal of Happiness Studies, 22(3), 1259-1285.
Liu, Y., Xu, L., & Hagedorn, A. (2022). How is obesity associated with happiness? Evidence from China. Journal of Health Psychology, 27(3), 568-580.
Fang, J., Wen, Z., Ouyang, J., Huang, G., & Liu, X. (2022). The reciprocal longitudinal relationship between body mass index and subjective well-being in China. Social Science & Medicine, 297, 114829.
Department of Household Registration, Ministry of the Interior. Taiwan Demographics Data in December 2020. Available online: https://www.ris.gov.tw/app/portal/346 (accessed on 12 December 2021).
Health Promotion Administration Ministry of Health and Welfare. Statistics of Health Promotion 2018. Available online: https://www.hpa.gov.tw/Pages/List.aspx?nodeid=1757 (accessed on 12 July 2021).
Goldberg, D. P., Gater, R., Sartorius, N., Ustun, T. B., Piccinelli, M., Gureje, O., & Rutter, C. (1997). The validity of two versions of the GHQ in the WHO study of mental illness in general health care. Psychological medicine, 27(1), 191-197.
Kye, S. Y., & Park, K. (2014). Health-related determinants of happiness in Korean adults. International journal of public health, 59, 731-738.
Kainulainen, S., Saari, J., & Veenhoven, R. (2018). Life-satisfaction is more a matter of feeling well than having what you want. Tests of Veenhoven's theory. International Journal of happiness and Development, 4(3), 209-235.
Won, K. H. (2003). A comparative study of the degree satisfaction of body image and sex-role identity between primary school boys and girls. Journal of the Korean Society of School Health, 16(1), 135-148.
Niu, J., Seo, D. C., & Lohrmann, D. K. (2014). Weight perception and dietary intake among Chinese youth, 2004–2009. International journal of behavioral medicine, 21, 691-699.
Gaylis, J. B., Levy, S. S., & Hong, M. Y. (2020). Relationships between body weight perception, body mass index, physical activity, and food choices in Southern California male and female adolescents. International Journal of Adolescence and Youth, 25(1), 264-275.
Solmi, F., Sharpe, H., Gage, S. H., Maddock, J., Lewis, G., & Patalay, P. (2021). Changes in the prevalence and correlates of weight-control behaviors and weight perception in adolescents in the UK, 1986-2015. JAMA pediatrics, 175(3), 267-275.
Chang, V. W., & Christakis, N. A. (2003). Self-perception of weight appropriateness in the United States. American journal of preventive medicine, 24(4), 332-339.
Oh, D. N., Kim, E. M., & Kim, S. (2013). Weight control behaviors and correlates in Korean adolescents. The Journal of the Korea Contents Association, 13(3), 218-228.
Nam, S., & Park, J. (2013). Adolescents' satisfaction of body and self-esteem according to obesity and subjective perception of body: Verification of moderating effect of sex. The Korean Journal of Obesity, 22(4), 251-253.
Homan, K., McHugh, E., Wells, D., Watson, C., & King, C. (2012). The effect of viewing ultra-fit images on college women's body dissatisfaction. Body image, 9(1), 50-56.
Tiggemann, M., Polivy, J., & Hargreaves, D. (2009). The processing of thin ideals in fashion magazines: A source of social comparison or fantasy?. Journal of Social and Clinical Psychology, 28(1), 73-93.
Harrison, K., & Hefner, V. (2006). Media exposure, current and future body ideals, and disordered eating among preadolescent girls: A longitudinal panel study. Journal of Youth and Adolescence, 35, 146-156.
Grabe, S., Ward, L. M., & Hyde, J. S. (2008). The role of the media in body image concerns among women: a meta-analysis of experimental and correlational studies. Psychological bulletin, 134(3), 460.
Knobloch-Westerwick, S., & Crane, J. (2012). A losing battle: Effects of prolonged exposure to thin-ideal images on dieting and body satisfaction. Communication research, 39(1), 79-102.
Jorm, A. F., Korten, A. E., Christensen, H., Jacomb, P. A., Rodgers, B., & Parslow, R. A. (2003). Association of obesity with anxiety, depression and emotional well‐being: a community survey. Australian and New Zealand journal of public health, 27(4), 434-440.
Han, S. S., Kim, K. W., Kim, K. I., Na, K. Y., Chae, D. W., Kim, S., & Chin, H. J. (2010). Lean mass index: a better predictor of mortality than body mass index in elderly Asians. Journal of the American Geriatrics Society, 58(2), 312-317.
Janssen, I., Katzmarzyk, P. T., & Ross, R. (2005). Body mass index is inversely related to mortality in older people after adjustment for waist circumference. Journal of the American Geriatrics Society, 53(12), 2112-2118.
Wannamethee, S. G., Shaper, A. G., Lennon, L., & Whincup, P. H. (2007). Decreased muscle mass and increased central adiposity are independently related to mortality in older men. The American journal of clinical nutrition, 86(5), 1339-1346.
Auyeung, T. W., Lee, J. S., Leung, J., Kwok, T., Leung, P. C., & Woo, J. (2010). Survival in older men may benefit from being slightly overweight and centrally obese—a 5-year follow-up study in 4,000 older adults using DXA. Journals of Gerontology Series A: Biomedical Sciences and Medical Sciences, 65(1), 99-104.
Chapman, I. M. (2010). Obesity paradox during aging. Body composition and aging, 37, 20-36.
Visscher, T. L. S., Seidell, J. C., Molarius, A., van der Kuip, D., Hofman, A., & Witteman, J. C. M. (2001). A comparison of body mass index, waist–hip ratio and waist circumference as predictors of all-cause mortality among the elderly: the Rotterdam study. International journal of obesity, 25(11), 1730-1735.
Price, G. M., Uauy, R., Breeze, E., Bulpitt, C. J., & Fletcher, A. E. (2006). Weight, shape, and mortality risk in older persons: elevated waist-hip ratio, not high body mass index, is associated with a greater risk of death–. The American journal of clinical nutrition, 84(2), 449-460.
Dolan, C. M., Kraemer, H., Browner, W., Ensrud, K., & Kelsey, J. L. (2007). Associations between body composition, anthropometry, and mortality in women aged 65 years and older. American journal of public health, 97(5), 913-918.
Reis, J. P., Macera, C. A., Araneta, M. R., Lindsay, S. P., Marshall, S. J., & Wingard, D. L. (2009). Comparison of overall obesity and body fat distribution in predicting risk of mortality. Obesity, 17(6), 1232-1239.
Testa, G., Cacciatore, F., Galizia, G., Della‐Morte, D., Mazzella, F., Langellotto, A., ... & Abete, P. (2010). Waist circumference but not body mass index predicts long‐term mortality in elderly subjects with chronic heart failure. Journal of the American Geriatrics Society, 58(8), 1433-1440.
Heiat, A., Vaccarino, V., & Krumholz, H. M. (2001). An evidence-based assessment of federal guidelines for overweight and obesity as they apply to elderly persons. Archives of internal medicine, 161(9), 1194-1203.
Chang, S. H., Beason, T. S., Hunleth, J. M., & Colditz, G. A. (2012). A systematic review of body fat distribution and mortality in older people. Maturitas, 72(3), 175-191.
Gambert, S. R., & Pinkstaff, S. (2006). Emerging epidemic: diabetes in older adults: demography, economic impact, and pathophysiology. Diabetes Spectrum, 19(4), 221-228.