Psychological and behavioural factors associated with long-term weight maintenance after a multidisciplinary treatment of uncomplicated obesity

Obesity is a multifactorial syndrome and the likelihood of success of a medical nutritional treatment (MNT) over the long term is low. As psychological and behavioural factors have an important role in both pathogenesis and the treatment of obesity, these issues wereinvestigated in individuals with obesity who reported a long-term success or a failure in terms of weight loss following a MNT. Eighty-eight individuals of an originalcohort of 251 subjects were re-evaluated 10 years after aMNT with cognitive-behavioural approach for uncomplicated obesity. Fifty-three participants were classified asfailure (body weight change C0.5 kg) and 35 as a success (10-year body weight change\0.5 kg) of the MNT. Priorto the beginning of the weight-management program, both the Dieting Readiness Test (DRT) and the Hospital Anxiety and Depression Scale (HADS) were administered. At a 10-year follow-up after the MNT, self-reported questionnaires were administered: quality of life was assessed bythe Obesity Related Well-Being (ORWELL 97) questionnaire, eating attitudes and behaviours by the Eating DisorderExamination Questionnaire (EDE-Q), the Binge Eating Scale (BES) investigated the presence and severity of bingeeating and the Symptom Checklist (SCL 90-R) was used to identify the psychopathological distress. The scores of the ORWELL 97 items concerning symptoms (P = 0.005), discomfort (P = 0.03) and the total score (P = 0.02) were significantly lower in the success group. The depression score of the HADS was positively correlated with the percentage of body weight change observed 10 years after theMNT (r = 0.22; P = 0.045). The scores of the shape concern (EDE-Q) (r = 0.35; P = 0.013) and of the discomfort(ORWELL 97) (r = 0.36; P = 0.012) were significantly correlated with the percentage of body weightchange 10 years after the MNT. In conclusion, this study isin agreement with the possibility that the psychological quality of life is associated even with modest amounts ofweight loss in the long run. Further research should support identifying successful predictors of weight loss.