Effect of a Six-Month Weight Loss Program on The Scores of The Edmonton Obesity Staging System

Abstract

The effect of multidisciplinary obesity treatments on mental health and functional status in addition to medical aspects and weight loss is not known. We analyzed the effect of a multidisciplinary treatment for obesity on the score of the Edmonton Obesity System (EOSS) in mexican subjects. Scores of the EOSS were obtained from patients who attended the Obesity and Eating Disorders Clinic at the Instituto Nacional de Ciencias Médicas y Nutrición in Mexico city. Mental health was assessed with the Hospital Anxiety and Depression Scale and through a structured interview by a psychologist. Functional status was determined by a quality of life questionnaire. EOSS Scores at first and last visits were compared and separate comparisons were made between medical aspects, mental health and functional status with weight loss. 365 subjects (76% women, median age 41 years, median BMI 42.05) were included. On visit 1, 76% had an EOSS score of 2 and 24% had a score of 3. On mental health, 33% were categorized on stage 0, 28% on stage 1, 24% on stage 2, and 12% on stage 3. Functional status was equally distributed through the four stages. On visit 7, with 49% of subjects achieving 5% of weight loss, 0.2% were categorized on EOSS stage 0, 3% were categorized on stage 1, 85% were categorized on stage 2, and 11% on stage 3 (p<0.001). Median of weight loss was not associated with improvement in the EOSS stage (p=0.38). EOSS improvement was positively associated with having type 2 diabetes on visit 1 (p=0.02) and with better functional status (p=0.002), and negatively associated with mental health stage 3 (p<0.001). With moderate weight loss, global health was improved in a multidisciplinary obesity treatment. Functional and mental factors need to be adressed additionally to medical treatments.