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Psychological Distress in Morbid Obesity in Relation to Weight History

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Background

Very few data are available on psychological distress in morbidly obese subjects in relation to the history of their weight. In subjects with childhood obesity, psychological distress might be better than in adult-onset obesity, because of progressive adaptation to the social stigma.

Methods

Psychological distress was tested in relation to BMI at age 20 years (BMI-20), weight history and somatic co-morbidities in 632 treatment-seeking, morbidly obese participants from the QUOVADIS cohort (130 men, 502 women; mean age 45.5 years). The number of dieting attempts/year, BMI increase and cumulative BMI loss since age 20 were calculated as weight cycling parameters.The Symptom Check List-90 (SCL-90), the Psychological General Well-Being (PGWB), the Binge-Eating Scale, and the ORWELL-97 questionnaire were used to score psychometry and health-related quality of life (HRQL). Complications were quantitatively assessed by a modified Charlson’s score.

Results

BMI-20 was normal in 35% of cases and >35 kg/m2 in only 14%. Psychometric scores were not different in relation to BMI-20, when corrected for age, with the exception of the General Health scale of PGWB, showing a greater distress in subjects with normal BMI-20. In most cases, the prevalence of pathological results of questionnaires showed a Jshaped curve, with participants with normal BMI-20 or those with Class II–III obesity in early adulthood having the highest prevalence of psychological/psychiatric distress and poor HRQL.Weight cycling was a risk factor for binge–eating, depression and interpersonal sensitivity in SCL–90, whereas somatic co–morbidities adversely affected most SCL–90 and all PGWB scales.

Conclusion

Weight cycling and somatic co–morbidities, but not age of onset of obesity, are the main factors negatively influencing psychological health in treatment–seeking, morbidly obese subjects.

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Authors and Affiliations

  1. Nutrition Rehabilitation Unit, IRCCS Istituto Auxologico Italiano, Piancavallo (Verbania), Italy

    Maria Letizia Petroni MD

  2. Department of Internal Medicine and Gastroenterology, “Alma Mater Studiorum” University of Bologna, 9, via Massarenti, 40138, Bologna, Italy

    Nicola Villanova MD & Giulio Marchesini MD

  3. Division of Dietetics and Clinical Nutrition, S. Giovanni Battista Hospital, Turin, Italy

    Sebastiano Avagnina MD

  4. Division of Dietetics and Clinical Nutrition, San Camillo-Forlanini Hospital, Rome, Italy

    Maria Antonia Fusco MD

  5. Division of Dietetics and Diabetology, Santa Maria Hospital, Terni, Italy

    Giuseppe Fatati MD

  6. Clinical Psychology Laboratory, IRCCS Istituto Auxologico Italiano, Piancavallo (Verbania), Italy

    Angelo Compare PhD, PsyD

Authors
  1. Maria Letizia Petroni MD
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  2. Nicola Villanova MD
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  3. Sebastiano Avagnina MD
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  4. Maria Antonia Fusco MD
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  5. Giuseppe Fatati MD
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  6. Angelo Compare PhD, PsyD
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  7. Giulio Marchesini MD
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Consortia

the QUOVADIS Study Group

Corresponding author

Correspondence to Giulio Marchesini MD.

Additional information

A complete list of participants in the QUOVADIS study has been previously published in Diabetes Nutr Metab 2003; 16: 115–24

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Petroni, M.L., Villanova, N., Avagnina, S. et al. Psychological Distress in Morbid Obesity in Relation to Weight History. OBES SURG 17, 391–399 (2007). https://doi.org/10.1007/s11695-007-9069-3

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  • DOI: https://doi.org/10.1007/s11695-007-9069-3

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