Improvement in Eating Disorder Risk and Psychological Health in People with Class 3 Obesity: Effects of a Multidisciplinary Weight Management Program

Piya, Milan K.; Chimoriya, Ritesh; Yu, William; Grudzinskas, Kathy; Myint, Kyaw Phone; Skelsey, Kathryn; Kormas, Nic; Hay, Phillipa

doi:10.3390/nu13051425

Cited by 4 publications

(4 citation statements)

References 65 publications

(76 reference statements)

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“…It is important to assess for an eating disorder in people with higher weight attending for bariatric surgery assessment, as the prevalence is high [ 267 ]. People with a history of eating disorders also often plan to undergo bariatric and/or cosmetic surgery [ 268 ].…”

Section: Recommendationsmentioning

confidence: 99%

Management of eating disorders for people with higher weight: clinical practice guideline

Ralph

Brennan²,

Byrne³

et al. 2022

J Eat Disord

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Introduction The prevalence of eating disorders is high in people with higher weight. However, despite this, eating disorders experienced by people with higher weight have been consistently under-recognised and under-treated, and there is little to guide clinicians in the management of eating disorders in this population. Aim The aim of this guideline is to synthesise the current best practice approaches to the management of eating disorders in people with higher weight and make evidence-based clinical practice recommendations. Methods The National Eating Disorders Collaboration Steering Committee auspiced a Development Group for a Clinical Practice Guideline for the treatment of eating disorders for people with higher weight. The Development Group followed the ‘Guidelines for Guidelines’ process outlined by the National Health and Medical Research Council and aim to meet their Standards to be: 1. relevant and useful for decision making; 2. transparent; 3. overseen by a guideline development group; 4. identifying and managing conflicts of interest; 5. focused on health and related outcomes; 6. evidence informed; 7. making actionable recommendations; 8. up-to-date; and, 9. accessible. The development group included people with clinical and/or academic expertise and/or lived experience. The guideline has undergone extensive peer review and consultation over an 18-month period involving reviews by key stakeholders, including experts and organisations with clinical academic and/or lived experience. Recommendations Twenty-one clinical recommendations are made and graded according to the National Health and Medical Research Council evidence levels. Strong recommendations were supported for psychological treatment as a first-line treatment approach adults (with bulimia nervosa or binge-eating disorder), adolescents and children. Clinical considerations such as weight stigma, interprofessional collaborative practice and cultural considerations are also discussed. Conclusions This guideline will fill an important gap in the need to better understand and care for people experiencing eating disorders who also have higher weight. This guideline acknowledges deficits in knowledge and consequently the reliance on consensus and lower levels of evidence for many recommendations, and the need for research particularly evaluating weight-neutral and other more recent approaches in this field.

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“…Patients who are seeking bariatric surgery tend to have a higher risk of eating disorders [ 46 ]. It is therefore reassuring that we have recently shown that the eating disorder risk, psychological distress and quality of life improve over 12 months in a multidisciplinary weight management program, independent of weight loss [ 29 ], which may in turn help improve the psychological component of the EOSS score. This would also reduce the potential risk of people with eating disorders, if they did proceed to have bariatric surgery after having received multidisciplinary weight management.…”

Section: Discussionmentioning

confidence: 99%

“…All patients were seen by a physician, dietitian and psychologist. The weight management program has been described in detail previously [ 28 , 29 , 30 , 31 ]. Dietary advice was personalised, which included but was not limited to advice for a 500 Kcal reduced diet, partial meal replacement and/or a low-calorie diet.…”

Section: Methodsmentioning

confidence: 99%

Clinical Use of the Edmonton Obesity Staging System for the Assessment of Weight Management Outcomes in People with Class 3 Obesity

et al. 2022

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We aimed to assess weight loss and metabolic outcomes by severity of weight-related complications following an intensive non-surgical weight management program (WMP) in an Australian public hospital. A retrospective cohort study of all patients aged ≥18 years with body mass index (BMI) ≥ 40 enrolled in the WMP during March 2018–March 2019 with 12-month follow-up information were stratified using the Edmonton Obesity Staging System (EOSS). Of 178 patients enrolled in the WMP, 112 (62.9%) completed at least 12 months’ treatment. Most patients (96.6%) met EOSS-2 (56.7%) or EOSS-3 (39.9%) criteria for analysis. Both groups lost significant weight from baseline to 12 months; EOSS-2: 139.4 ± 31.8 kg vs. 131.8 ± 31.8 kg (p < 0.001) and EOSS-3: 141.4 ± 24.2 kg vs. 129.8 ± 24.3 kg (p < 0.001). After adjusting for baseline age, sex and employment status, mean weight loss was similar but a greater proportion of EOSS-3 achieved >10% weight loss compared to EOSS-2, (40% vs. 15.9%, p = 0.024). Changes in metabolic parameters including HbA1c, BP and lipids did not differ between EOSS-2 and 3. Despite increased clinical severity, adult patients with class 3 obesity achieved clinically meaningful weight loss and similar improvements in metabolic parameters compared to patients with less severe complications after 12 months in an intensive non-surgical WMP.

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“…People with class III obesity often have a mental problem such as depression and ED. These patients usually have disturbed body image, self-worth, empowerment, and interpersonal relationships [ 5 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

Comparison of eating disorders and eating behaviors in adults with and without type 2 diabetes prior to bariatric surgery

Mardali¹,

Farahani²,

Alemrajabi³

et al. 2022

J Eat Disord

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Background Eating disorders (ED) are group of psychological disorders that significantly impair physical health and psychosocial function. ED consists wide range of morbidity such as loss of eating control, binge eating disorder (BED), night eating syndrome, and bulimia nervosa. Eating behavior is a wide range term that includes food choices, eating patterns, eating problems. In this study, we compared eating disorders and eating behaviors in adults with and without type 2 diabetes prior to bariatric surgery. Methods 284 participants with class III obesity were included in the single center study. Each case (patients with type 2 diabetes) and control (patients without type 2 diabetes) groups consists 142 patients. Loss of eating control, BED and Bulimia nervosa, Night eating syndrome and eating behaviors and psychosocial factors were screened with standard questionnaires. SPSS version 20 was used for statistical analysis. A P-value of < 0.05 was considered significant. Results There was a significant difference between participants with and without type 2 diabetes in case of BED (76.3% vs. 47.3%, P = 0.001). The logistic regression model has shown that participants without type 2 diabetes had lower odds of exhibiting BED (OR = 0.28, 95% CI 0.142–0.552). Among participants without type 2 diabetes, men had 65% high odds of BED (OR = 1.65, 95% CI 1.13–2.53) in compare with women. Participants with and without type 2 diabetes with high school degree (OR = 5.54, 95% CI 2.46–9.45, P = 0.0001 and OR = 6.52, 95% CI 3.15–10.56, respectively) and moderate depression level (OR = 2.03, 95% CI 0.98–3.95 and OR = 3.12, 95% CI 2.12–4.56, P = 0.0001) had higher odds of BED. Conclusion These results probably indicate that people with Class III obesity are more cautious about their diet for blood glucose control if they have type 2 diabetes. Future studies are recommended to follow up these patients after surgery to compare weight loss and blood sugar control in patients with and without type 2 diabetes.

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Improvement in Eating Disorder Risk and Psychological Health in People with Class 3 Obesity: Effects of a Multidisciplinary Weight Management Program

Cited by 4 publications

References 65 publications

Management of eating disorders for people with higher weight: clinical practice guideline

Clinical Use of the Edmonton Obesity Staging System for the Assessment of Weight Management Outcomes in People with Class 3 Obesity

Comparison of eating disorders and eating behaviors in adults with and without type 2 diabetes prior to bariatric surgery

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