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. 2024 Apr 5;16(7):1068.
doi: 10.3390/nu16071068.

Predictors of Mental Health Outcomes in a Multidisciplinary Weight Management Program for Class 3 Obesity

Ashley Lam  1 , Milan K Piya  2   3 , Nasim Foroughi  2 , Mohammed Mohsin  4   5 , Ritesh Chimoriya  2 , Nic Kormas  3 , Janet Conti  1   2 , Phillipa Hay  2   3   4
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Predictors of Mental Health Outcomes in a Multidisciplinary Weight Management Program for Class 3 Obesity

Ashley Lam et al. Nutrients. .

Abstract

This study aimed to examine the potential predictors of improvement in mental health outcomes following participation in an intensive non-surgical outpatient weight management program (WMP) in an Australian public hospital. This was a retrospective cohort study of all adults with Class 3 obesity (BMI ≥ 40 kg/m2) who enrolled in the WMP from March 2018 to June 2021. The participants completed the Eating Disorder Examination Questionnaire Short Version (EDE-QS), Kessler-10 Psychological Distress Scale, and 36-Item Short-Form Survey (SF-36) at baseline and 12-month follow-up. A total of 115 patients completed 12 months in the WMP and were included in the study, with 76.5% being female, a mean ± SD age at baseline of 51.3 ± 13.8 years, a weight of 146 ± 26 kg, and a BMI of 51.1 ± 8.6 kg/m2. The participants lost an average of 8.6 ± 0.2 kg over 12 months, and greater weight loss at follow-up was significantly associated with improved global EDE-QS scores, psychological distress, and improved mental health quality of life. However, improvements in most mental health outcomes were not predicted by weight loss alone. Notably, a lower eating disorder risk at baseline was associated with less psychological distress at follow-up and greater weight loss at follow-up. Our results also found an association between reduced psychological distress and reduced binge eating frequency. These findings support the inclusion components of obesity interventions that target the psychological correlates of obesity to support improved outcomes in people with Class 3 obesity. Future studies should aim to identify which aspects of the WMP helped improve people's psychological outcomes.

Keywords: class 3 obesity; eating disorders; mental health; obesity; psychological distress; quality of life; weight management.

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Conflict of interest statement

M.K.P. has received travel and consulting fees for educational activities from Takeda Pharmaceuticals, Novo Nordisk, Eli Lilly, Ethicon, and iNova Pharmaceuticals and was on the guideline development committee for the National Eating Disorder Collaboration ‘Management of eating disorders for people with higher weight: clinical practice guideline (2022)’. P.H. receives sessional fees and lecture fees from the Australian Medical Council, Therapeutic Guidelines publication, and New South Wales Health Education and Training Institute and royalties from Hogrefe and Huber, McGraw Hill Education, and Blackwell Scientific Publications, and she has received research grants from the NHMRC and ARC. She is the Chair of the National Eating Disorders Collaboration Steering Committee in Australia (2019–current) and was Member of the ICD-11 Working Group for Eating Disorders (2012–2018) and was the Chair of the Clinical Practice Guidelines Project Working Group (Eating Disorders) of RANZCP (2012–2015). She has prepared a report under contract for Shire Pharmaceuticals (July 2017) and received travel and consulting fees for educational activities from Takeda (formerly Shire). All the views in this paper are her own. All the other authors declare no conflict of interest.

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