Psychological profile and quality of life of morbid obese patients attending a cognitive behavioural program

Objective: Obesity treatment is finalized to increase physical and psychological health, by reducing body weight, but management of therapy should consider the baseline conditions. We tested the psychological profile of morbid obese patients seeking medical treatment, as a basis for developing more specific therapeutic protocols. Patients and methods: 135 consecutive patients with a BMI > 40 mg/kg2 admitted to an outpatient program of cognitive-behavioral treatment (CBT) were investigated. At enrolment, the patients filled in a series of self-administered questionnaires on binge eating (Binge Eating Scale, BES), depression symptoms (Beck Depression Inventory, BDI), obesity-specific quality of life (Obesity-Related Well Being-97, Orwell-97), and generic health-related quality of life (HRQL) (Psychological General, Well-Being, PGWB), where psychological distress is clustered in six domains related to mood states. Results: 27% of cases had a BES score ≥ 17, indicative of possible binge eating, and 13% had a BES ≥ 27, largely indicative of binge eating, with a higher prevalence in females. The BDI score was above normal in 30% of males and 45% of females, and 13% of females were in the range of moderate-severe depression. BES and BDI were significantly correlated with each other (r= 0.722; P < 0.001). Orwell-97 was much higher in females, and similarly the generic PGWB was indicative of a poorer HRQL in females. PGWB was positively associated with age, without any effect of BMI. The association with age was maintained in female (r = 0.290; P < 0.05), not in males (r = 0.038). Both the Orwell-97 and the PGWB were associated with both BES and BDI in both genders. Conclusions: Psychological distress is common and largely variable in patients attending CBT for morbid obesity. This data should be considered for individual treatment protocols, and should be compared with similar series of patients enrolled for bariatric surgery.