Improvement in quality of life, psychological distress and eating disorder risk in people with class 3 obesity in an Australian multidisciplinary weight management program

![CDATA[Background: Class 3 obesity (BMI>40kg/m2) can have a substantial effect on physical and mental well-being. This study aimed to understand quality of life, psychological distress and risk of eating disorders in people with class 3 obesity, and the effect of a multidisciplinary weight management program. Methods: This retrospective cohort study investigated all adults with class 3 obesity who enrolled in a Sydney-based multidisciplinary weight management program from March 2018-March 2019. Questionnaires were completed at baseline, 6 and 12 months to assess quality of life (SF-36), psychological distress (Kessler Scale, K10), and risk of eating disorders (Eating Disorder Examination Questionnaire Short, EDE-QS). Physical and mental component scores (PCS and MCS) were derived from the SF-36. Results: The 178 patients who joined the program were aged 50.8±14.10 (mean±SD) years, weighed 142.9±31.4kg, had a BMI of 51.3±9.1kg/m2, and 70.8% were females. Their PCS (32.7±8.9) and MCS (34.0±7.7) were significantly lower than the Australian average, 45% were in the K10’s moderate-severe category, and 48.3% were above the EDE-QS cut-off score of 15. Baseline, 6- and 12-month questionnaire and weight data were available for 33.7% (n=60) patients, with no baseline differences between those with and without follow-up data. Compared to baseline, there was significant weight loss at 6 (132.6±25.1kg,p<0.001) and 12 months (129.9±25.6kg,p<0.001). There was no change in PCS, but there was significant improvement at 6 and 12 months in MCS (baseline:34.4±8.4; 6-month:45.8±12.8,p<0.001; 12-month:47.2±13.1,p<0.001), K10 (baseline:25.6±10.0; 6-month:20.0±9.2,p<0.001; 12-month:20.3±9.8,p<0.001) and EDE-QS scores (baseline:15.0±6.6; 6-month:13.3±5.8,p=0.02; 12-month:12.6±5.7,p<0.001). These remained significant after correcting for weight loss. Conclusion: This study highlights the high prevalence of poor quality of life, psychological distress and eating disorder risk in people with class 3 obesity. The significant improvements in their mental health and psychological well-being, independent of weight loss, highlights the importance of multidisciplinary management in this population.]]