Abstract
This study aimed to evaluate the risk of eating disorders, psychological distress, and health-related quality of life (HRQoL) in people with class 3 obesity (body mass index (BMI) ≥ 40 kg/m2), and the effect of multidisciplinary weight management over 12 months. This retrospective cohort study included all adults with class 3 obesity who enrolled in a weight management program from March 2018 to December 2019. Questionnaires included the Eating Disorder Examination Questionnaire Short (EDE-QS), Kessler Psychological Distress Scale (K10), and 36-Item Short Form Survey (SF-36) for HRQoL. Physical and Mental Component Summary scores (PCS and MCS) were derived from the SF-36. Of 169 participants who completed 12 months in the program, 65.7% (n = 111) completed questionnaires at baseline and 12 months, with 6.0 ± 6.8% weight loss over this period. Compared to baseline, there was significant improvement at 12 months in EDE-QS (15.7 ± 6.6 vs. 13.6 ± 6.2, p = 0.002), K10 (25.7 ± 9.7 vs. 21.2 ± 9.4, p < 0.001), PCS (29.4 ± 10.1 vs. 36.1 ± 10.9, p < 0.001), and MCS scores (40.2 ± 12.4 vs. 44.0 ± 13.4, p = 0.001). All, apart from EDE-QS scores, remained significant after adjusting for weight change. This study highlights the importance of multidisciplinary management in people with class 3 obesity to help reduce eating disorder risk and psychological distress, and improve HRQoL, in addition to weight loss.
Highlights
The increasing global prevalence of class 3 obesity (body mass index (BMI) ≥ 40 kg/m2 )is a major public health problem [1–3]
The evidence for physical comorbidities to be associated with obesity, such as type 2 diabetes mellitus (T2DM), non-alcoholic fatty liver disease (NAFLD), cardiovascular disease (CVD), and obstructive sleep apnoea (OSA), is well established [6–8], and weight loss has been linked to improved outcomes in people with these physical comorbidities [9–12]
The baseline BMI of study participants was 51.2 ± 9.0 kg/m2, and they had a high risk of eating disorders (EDE-QS score: 16.2 ± 6.7), high levels of psychological distress (K10 score: 26.0 ± 9.6), and a poor quality of life
Summary
The increasing global prevalence of class 3 obesity (body mass index (BMI) ≥ 40 kg/m2 )is a major public health problem [1–3]. The evidence for physical comorbidities to be associated with obesity, such as type 2 diabetes mellitus (T2DM), non-alcoholic fatty liver disease (NAFLD), cardiovascular disease (CVD), and obstructive sleep apnoea (OSA), is well established [6–8], and weight loss has been linked to improved outcomes in people with these physical comorbidities [9–12]. This has led to an increasing number of patients opting to undergo bariatric surgery to aid weight loss, with over 630,000 procedures performed annually worldwide [13], and over 20,000 per year in Australia alone [14]. While the improvements in physical comorbidities following bariatric surgery have been demonstrated in the short- as well as long-term [23–25], the mental health outcomes, eating disorder status, and quality of life following bariatric surgery or weight loss are less clear [18]
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