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2015 ; 10
(12
): e0145273
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Who is the Treatment-Seeking Young Adult with Severe Obesity: A Comprehensive
Characterization with Emphasis on Mental Health
#MMPMID26694031
Dreber H
; Reynisdottir S
; Angelin B
; Hemmingsson E
PLoS One
2015[]; 10
(12
): e0145273
PMID26694031
show ga
OBJECTIVE: To characterize treatment-seeking young adults (16-25 years) with
severe obesity, particularly mental health problems. STUDY DESIGN AND
PARTICIPANTS: Cross-sectional study of 165 participants (132 women, 33 men) with
BMI ?35 kg/m2 or ?30 kg/m2 with comorbidities, enrolling in a multidisciplinary
obesity treatment program. METHOD: Data collection at admission of present and
life-time health issues including symptomatology of anxiety, depression (Hospital
Anxiety and Depression Scale) and attention-deficit/hyperactivity disorder (Adult
ADHD Self-Report scale); self-esteem (Rosenberg Self-Esteem Scale), suicide
attempts, health-related quality of life (Short Form-36 Health Survey),
psychosocial functioning related to obesity (Obesity-related Problems Scale),
cardiorespiratory fitness (Astrand's bicycle ergometer test), somatic and
psychiatric co-morbidities, cardiometabolic risk factors, and micronutritional
status. We used multiple regression analysis to identify variables independently
associated with present anxiety and depressive symptomatology. RESULTS: Mean body
mass index was 39.2 kg/m2 (SD = 5.2). We found evidence of poor mental health,
including present psychiatric diagnoses (29%), symptomatology of anxiety (47%),
depression (27%) and attention-deficit/hyperactivity disorder (37%); low
self-esteem (42%), attempted suicide (12%), and low quality of life (physical
component score = 46, SD = 11.2; mental component score = 36, SD = 13.9, P<0.001
for difference). Variables independently associated with present anxiety
symptomatology (R2 = 0.33, P<0.001) included low self-esteem (P<0.001) and pain
(P = 0.003), whereas present depressive symptomatology (R2 = 0.38, P<0.001) was
independently associated with low self-esteem (P<0.001), low cardiorespiratory
fitness (P = 0.009) and obesity-related problems (P = 0.018). The prevalence of
type 2 diabetes was 3%, and hypertension 2%. Insulin resistance was present in
82%, lipid abnormality in 62%, and poor cardiorespiratory fitness in 92%.
Forty-eight percent had at least one micronutritional deficiency, vitamin D being
the most common (35%). CONCLUSION: A wide range of health issues, including quite
severe mental health problems, was prevalent in treatment-seeking young adults
with severe obesity. These are likely to constitute a major treatment challenge,
including options relating to bariatric surgery.