Abstract
Obesity is a psychosomatic condition characterized by a complex interaction of biological and psychological factors and a large body of research has aimed to identify variables limiting efficacy and determining high attrition rates in weight loss programs. In this study, we used the Diagnostic Criteria for Psychosomatic Research (DCPR), designed to broaden the clinician’s perspective on patients’ problems by providing additional clinical information not found in the more traditional psychiatric classification, to predict psychosomatic variables that may limit efficacy and determine attrition in clinical interventions with people with obesity. We evaluated 82 consecutive participants with obesity at baseline for psychopathology, psychosomatic correlates, psychological distress, and eating-related symptoms before entering a weight loss program. Regression models were used to assess attrition and outcome at a 6-month follow-up and per-protocol and intention-to-treat analyses were performed. DPCR alexithymia significantly predicted attrition (OR = 6.9), and unsuccessful weight-loss (OR = 11.3). These findings suggest that the identification of psychosomatic factors, in addition to psychological and psychopathological factors, may predict adherence to weight-loss programs.
Highlights
Obesity is a multifactorial condition, characterized by complex interactions between biological and psychological factors, that results in the accumulation of adipose tissue due to increased caloric intake and/or decreased expenditure of calories (Karasu, 2012)
The Diagnostic Criteria for Psychosomatic Research (DCPR) diagnoses present in the sample included Alexithymia, Irritable Mood, Demoralization, Illness Denial, and Type A Behavior
We aimed to extend results by Venditti et al (2013) that demonstrated the importance of DCPR diagnoses in characterizing the functioning and psychological response to medical illness in people with obesity
Summary
Obesity is a multifactorial condition, characterized by complex interactions between biological and psychological factors, that results in the accumulation of adipose (fat) tissue due to increased caloric intake and/or decreased expenditure of calories (Karasu, 2012). Obesity has become a major health concern in developing countries and is considered a risk factor for many non-communicable diseases including type 2 diabetes, cardiovascular disease (Ortega et al, 2016), musculoskeletal problems and many cancers (Stone et al, 2018). Obesity affects self-esteem and is often associated with anxiety (Gariepy et al, 2010), social isolation and mood problems (Naper et al, 2017). Behavior modification is the first recommended step in obesity management. Key features include self-monitoring, goal setting, nutrition, exercise, stimulus control, problem solving, Alexithymia Predicts Obesity Treatment Outcomes cognitive restructuring, and relapse prevention (Poston and Foreyt, 2000; Reed, 2014). Lifestyle modifications, including dieting and exercise, are essential for any treatment of obesity. Behavioral modification programs generally show attrition rates that range from 10 to 80% within a few days of initiating treatment (Farley et al, 2003), only small changes in targeted behaviors (van Sluijs et al, 2004; Lakerveld et al, 2013) and relatively little weight loss is maintained across time (Wing and Hill, 2001)
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