Background: The high prevalence of childhood trauma, poor quality of life and risk of eating disorders among people with class 3 obesity, may act as barriers to weight loss. The aim of this study was to examine the prevalence of psychological trauma, and its effect on weight, risk of eating disorders, and quality of life in a weight management program (WMP) for people with class 3 obesity.
Methods: Retrospective cohort study including all patients seen by a psychologist in a publicly funded multidisciplinary WMP in Sydney, first seen between March 2018 to March 2020. Data on patients reporting previous psychological trauma was collected from electronic medical records. Eating Disorder Examination Questionnaire Short (EDE-QS), Kessler Psychological Distress Scale (K10), 36-Item Short Form Survey (SF-36) were completed at baseline and after 12 months in the program, with data analysed using independent t-tests and chi-squared tests.
Results: Of the 311 people joining the WMP, 86.5% (n=269) had at least one appointment with a clinical psychologist. Previous psychological trauma was reported in 46.1% (n=124) of participants, female: 50.3% (n=95) and male: 36.3% (n=29), p<0.05. At baseline, people with previous trauma had higher K10 and SF-36 mental component summary scores compared to those with no reported trauma. Baseline weight and BMI was similar for both groups. After 12 months, there were similar improvements in weight, K10, EDE-QS, and SF36 physical and mental component summary scores, with no difference in improvements between people with and without previous psychological trauma, irrespective of gender.
Conclusion: A high prevalence of psychological trauma exists in people with class 3 obesity presenting to a weight management program, especially among women. Over 12 months, people with previous psychological trauma can achieve similar weight loss, improvements in quality of life and reduction in psychological distress compared to individuals without previous psychological trauma.