Psychiatric comorbidity and quality of life in obese individuals - A prospective controlled study

The multicenter prospective study which started in 2001 aimed at identifying predictors of the course of weight after conventional and surgical weight loss treatment. By means of structured psychiatric interviews and self-rating questionnaires the study evaluated prevalence and course of comorbid mental disorders of obese individuals. Of further interest were demographic, psychosocial and psychosomatic variables including quality of life. The study consisted of both cross-sectional and longitudinal analyses with follow-up assessments one, two, and four years after treatment. At baseline participants of conventional weight loss treatment (n = 251) and obesity surgery patients (gastric banding) (n = 153) were assessed and compared to random samples of obese (n = 128) and normal-weight (n = 174) residents of the City of Essen who were not participating in any weight loss treatment. Obese women, participating in conventional weight loss treatment or undergoing obesity surgery showed a higher prevalence rate of mental disorders compared to normal-weight or obese women not participating in any weight loss treatment. Compared to normal-weight men prevalence rates of mental disorders of obese men were higher independent of participating in a weight loss treatment. The number of comorbid somatic illnesses and mental disorders but not body weight had an impact on quality of life. At least in physically and mentally healthy obese individuals a higher body weight was associated with higher emotional well-being. In obesity surgery patients, weight loss was associated with a significant decrease of depressive symptoms and improvement in quality of life. When diagnosed presurgery, disordered eating patterns (,,binge eating",,grazing") or sweet eating had no influence on the course of weight after surgery. How-ever, if disordered eating patterns were diagnosed after surgery, they were associated with considerably less weight loss.