Oral Presentation Australian and New Zealand Obesity Society Annual Scientific Conference 2023

Fast Track to Health: Change in symptoms of depression and eating disorders in adolescents with obesity participating in a clinical trial  (97943)

Hiba Jebeile 1 2 , Cathy Kwok 1 , Eve T House 1 2 , Mary-Kate Inkster 3 4 , Kaitlin Day 4 , Sarah Lang 4 , Alicia M Grunseit 5 , Megan L Gow 1 , Natalie B Lister 1 2 , on behalf of the Fast Track to Health study team 1 2 3 4 5
  1. Children’s Hospital Westmead Clinical School, The University of Sydney, Sydney, NSW, Australia
  2. Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Westmead, NSW, Australia
  3. Department of Paediatric Endocrinology and Diabetes, Monash Children’s Hospital, Clayton, VIC, Australia
  4. Nutrition, Dietetics & Food, Monash University, Melbourne, VIC, Australia
  5. Weight Management Services, The Children’s Hospital at Westmead, Westmead, NSW, Australia

 

Background: Depression and eating disorder (ED) risk are heightened during adolescence and both were exacerbated during COVID-19 lockdowns. This analysis reports changes in self-reported symptoms of depression and eating disorders throughout the Fast Track to Health trial.

Methods: Fast Track to Health was a 52-week multi-site randomised-controlled trial, conducted 2018-2023, comparing intermittent (IER) and continuous energy restriction (CER) in adolescents with obesity and ≥1 associated comorbidity. The Centre for Epidemiologic Studies Depression Scale-revised 10-item version for adolescents (CESDR) assessed symptoms of depression (no symptoms, sub-threshold, or possible, probable, major depressive episode). Eating Disorder Examination Questionnaire (EDE-Q) assessed ED risk; defined as global score ≥2.7, ≥2 episodes of binge eating with/without loss of control, or ≥1 episode of purging within the last 28-days. The Binge Eating Scale (BES) assessed severity of binge eating (no binge eating, mild/moderate, severe). Adolescents were monitored for disordered eating during dietetic consults.  

Results: 141 adolescents were enrolled with median(IQR) EDE-Q score 2.28(1.43-3.14), CESDR 9.00(4.0-14.5) and BES 11.0(5.0-17.0) at baseline. EDE-Q (mean change [SE], IER -0.63[0.18], CER -0.56[0.17]) and CESDR (IER -2.70[1.15], CER -3.87[1.07]) scores reduced between baseline and week-52 in both groups (p<0.05) with no difference between groups. There was a between group difference (p=0.019) in change in BES. The IER group had a reduction between baseline and week-52 (-3.72[1.27]) and the CER group had no change. At baseline, 31(22%) adolescents were classified as having a possible/probable/major depressive episode, 110(78%) met ≥1 ED criteria and 28(21%) as mild/moderate or severe binge eating, reducing to 8(9%), 56(61%) and 15(16%) respectively at week-52. A small sub-group of adolescents required additional support for disordered eating.  

Conclusion: Treatment-seeking adolescents with obesity have symptoms of depression and ED. Although symptoms reduce for most, some required additional support. Screening and monitoring for depression and ED are important to ensure early intervention.