Prevalence of anxiety, depression and chronic stress in adults with Class 3 Obesity attending a multidisciplinary weight management program in South West Sydney

INTRODUCTION: There is a higher reported prevalence of mental health disorders with obesity. This study aimed to evaluate symptoms of anxiety, depression and chronic stress in adults with class 3 obesity (BMI ≥ 40 kg/m2), and assess the effect of a multidisciplinary weight management program over 12 months. MATERIALS AND METHODS: This retrospective cohort study included adults with class 3 obesity enrolled in a publicly funded multidisciplinary weight management program in Sydney between March-2018 and January-2022. The Depression Anxiety and Stress Score 21 (DASS21) was completed at baseline. A subset of participants completed follow-up DASS21 at 12 months. RESULTS: The studied population (n = 178) had a mean age of 49.6 ± 13.0 years, mostly Caucasian ethnicity (68.5%) with female predominance (68.5%). At baseline, mean BMI was 51.7 ± 10.2 kg/m2. Common metabolic complications included hypertension (51.9%), dyslipidaemia (44.2%), and Type 2 diabetes (T2DM) (38.8%), while 70% reported joint pain, 46.4% gastroesophageal reflux disease and 45.4% obstructive sleep apnoea. Based on the DASS21 scores, at baseline, 53.9% (n = 96) had moderate to extremely severe symptoms of depression, while 39.3% (n = 70) had moderate to extremely severe symptoms of chronic stress. Moderate to extremely severe anxiety symptoms were reported in 51.1% (n = 91), with 30.3% (n = 54) experiencing extremely severe anxiety symptoms at baseline. DASS21 scores were not affected by baseline BMI or presence of T2DM. For the subset who had completed the DASS21 at 12 months (n = 49) there was mean total weight loss of 9.5% (134.3 ± 21.1 kg vs 127.0 ± 19.8, p < 0.001), regardless of the presence of T2DM. Most participants achieved at least 5% weight loss (57.1%) or 10% weight loss (20.4%). A negative correlation was found between weight loss and baseline DASS21 Stress score (r = −0.314, p = 0.028) and DASS21 total score (r = −0.286, p = 0.046). No statistically significant improvement in symptoms of depression, anxiety or stress was found. CONCLUSION: This study demonstrates a very high prevalence of symptoms of depression, anxiety and chronic stress in adults with class 3 obesity. More than 1 in 2 studied participants were experiencing moderate to extremely severe symptoms of depression and anxiety, and almost 1 in 3 reported levels of anxiety in the extremely severe range. Although high baseline symptoms of depression, anxiety and chronic stress predicted less weight loss, significant weight loss was still achieved by most participants in a multidisciplinary weight management program.