Mental distress in treatment seeking young adults (18–25 years) with severe obesity compared with population controls of different body mass index levels: cohort study

Abstract

Young adults (18-25) with severe obesity constitute a challenging patient group, and there is limited evidence about their mental health status compared to population controls. Mental distress in treatment seeking young adults with severe obesity (n = 121, mean body mass index [BMI] = 39.8 kg m ) was compared with matched (1:3 for age, gender and socioeconomic status) population controls of normal weight (n = 363, mean BMI = 22.4 kg m ), as well as unmatched population controls with class I obesity (n = 105, mean BMI = 32.1 kg m ) or severe obesity (n = 41, mean BMI = 39.7 kg m ). Mental distress was measured by the General Health Questionnaire-12 (GHQ-12), and we quantified physician-diagnosed depression, present anxiety and suicide attempts. Poisson regression and linear regression analysis were used for analysing differences in mental distress between groups. Treatment seekers experienced more mental distress than normal weight controls as measured by continuous (adjusted mean: 3.9 vs. 2.2 points, P <0.001) and categorical (cut-off for mental distress ≥3 points, RR: 1.76, P <0.001) GHQ-12 scores, depression (RR: 2.18, P < 0.001), anxiety (RR: 1.97, P < 0.001) and suicide attempts (RR: 2.04; P = 0.034). Treatment seekers also experienced more mental distress as measured by continuous GHQ-12 than controls with class I obesity (adjusted mean: 2.3 points) or severe obesity (adjusted mean: 2.1; both, P < 0.001). Young adult treatment seekers with severe obesity constitute a risk group for mental distress compared to population controls of different BMI levels.

Neurocognitive and behavioral functioning in adolescents with sleep-disordered breathing: a population-based, dual-energy X-ray absorptiometry study

“…Another interesting finding of our study was that DXA-measured adiposity was associated with internalizing and externalizing problems in adolescents, and more strongly in those with OSA. Our study supports the findings of others 56 – 57 that childhood and adolescent obesity is associated with increased anxiety and depression, lower self-esteem, and psychosomatic complaints as well as aggressive behaviors (see Supplemental Table 2 ), especially during this developmental period of adolescence in which psychosocial factors such as peer-pressure, bullying and discrimination peak. It is also plausible that underlying systemic mechanisms such as activation of the stress system or increased inflammation also observed in dysfunctional mood states may be at play in adolescent with OSA.…”

Psychosocial, Behavioral and Clinical correlates of children with overweight and obesity

“…However, there is evidence in the literature that lack of physical activity may be linked to the state of emotional dysregulation known to be associated with obesity. 8,48 Emerging evidence emphasizing the positive role of team sport participation on longer term mental health, especially in children who have experienced adverse childhood events 56 makes this an important consideration in youth such as those in this study. This study found no statistically significant differences in the dietary intake of foods shown to be related to risk of obesity including the servings of water, sugar sweetened beverages, fruits and vegetables, as well as the patterns of meals eaten at home and fast food intake.…”

“…[4][5][6] Additionally, they are more likely to experience asthma, 7 depression, anxiety, and poor psychological well-being. 8 There is a critical need to identify behaviorally-based interventions that will maximize health of youth with severe obesity. [9][10][11] Yet, few studies have identified psychosocial and behavioral factors for severe obesity 12 that could inform such strategies.…”

An examination of the associations between pediatric loss of control eating, anxiety, and body composition in children and adolescents

“…Some (Dreber, et al, 2017; Hillman, et al, 2010; Young-Hyman, et al, 2006) but not all (Lamertz, et al, 2002) studies support a significant and positive association between anxiety and body weight, and there is significant variation based on sample and measurement characteristics. For example, in a meta-analysis that included both children and adolescents, the relationship between anxiety and body weight was stronger among females, children under the age of 12, and when using norm-referenced measures of weight (e.g., BMI-z) (Burke & Storch, 2015).…”

“…08) (Burke & Storch, 2015). Indeed, cross-sectional studies have shown mixed findings to support the relationship between anxiety and weight status in adolescents and young adults; while some studies demonstrate a clear association (Dreber, et al, 2017; Hillman, Dorn, & Huang, 2010; Young-Hyman, et al, 2006), others do not (Lamertz, Jacobi, Yassouridis, Arnold, & Henkel, 2002). Extant prospective data found that anxiety disorders among adolescent females are associated with significant increases in body mass index (BMI) over time (Anderson, Cohen, Naumova, & Must, 2006; Rofey, et al, 2009).…”