Psychopathology, psychosocial factors and obesity

Aims. The aims of this study were to evaluate the association between obesity and socio-demographic and psychopathological variables in a clinical sample of patients referred to a center for the diagnosis and treatment of obesity, compared with a homogeneous sample of normal-weight subjects. Methods. In the context of a research project regarding obesity and psychopathology, a multivariate logistic regression analysis was used to examine the association between obesity and the demographic and clinical variables, on the basis of the data set of a consecutive sample of 293 obese patients (48 males, 245 females, mean age: 45.41+/-13.55, mean body mass index [BMI] 35.6+/-6.2) compared with a control group of 293 non-obese subjects (48 males, 245 females, mean age 45.66+/-13.86, mean BMI 21.8+/-2.06). All subjects were assessed by structured clinical interview, the Structured Clinical Interview for Diagnosis for axis I DSM-IV (SCID-I) and for axis II DSM-IV (SCID-II). Results. Multivariate statistical analysis showed that the status of housewife and the presence of lifetime axis I and II psychiatric diagnosis in general, and of depressive, anxiety, eating and some personality disorders in particular, significantly increased the likelihood of being overweight/obese. The likelihood for different combinations of risk factors increased from a value of 32.3% for an individual not exposed to any risk factor, to a value of 86.7% for those exposed to all risk factors considered. Conclusions. The presence of an axis I and/or II diagnosis and housewife status are both independently associated with an increased likelihood of being overweight/obese. The interaction of these factors increases this likelihood. Even taking into account the limits of the study, in particular of its cross-sectional nature, these findings may have important implications in both prevention and treatment of obesity.