title: Comparison of psychosocial status in treatment-seeking women with class III vs. class I-II obesity.
abstract: OBJECTIVE
  This study compared the psychosocial status and weight loss expectations of women with extreme (class III) obesity who sought bariatric surgery with those of women with class I-II obesity who enrolled in a research study on behavioral weight control.
  
  
  METHODS
  Before treatment, all participants completed the Beck Depression Inventory-II and the Weight and Lifestyle Inventory. This latter questionnaire assesses several domains including symptoms of depression and low self-esteem, history of psychiatric complications, current stressors, and weight loss expectations.
  
  
  RESULTS
  Women with class III obesity, as compared with class I-II, reported significantly more symptoms of depression. Fully 25% of women in the former group appeared to have a significant mood disorder that would benefit from treatment. As compared with women with class I-II obesity, significantly more women with class III obesity also reported a history of psychiatric complications, which included physical and sexual abuse and greater stress related to their physical health and financial/legal matters. Both groups of women had unrealistic weight loss expectations. Those who sought surgery expected to lose 47.6 +/- 9.3% of initial weight, compared with 24.8 +/- 8.7% for those who enrolled in behavioral weight control.
  
  
  CONCLUSIONS
  These findings suggest that women with extreme obesity who seek bariatric surgery should be screened for psychosocial complications. Those determined to have significant psychiatric distress should be referred for behavioral or pharmacological treatment to alleviate their suffering. Long-term studies are needed to provide definitive guidance concerning the relationship between preoperative psychopathology and the outcome of bariatric surgery.
authors.affiliation: Department of Psychiatry, Weight and Eating Disorders Program, University of Pennsylvania School of Medicine, 3535 Market Street, Suite 3029, Philadelphia, PA 19104, USA. wadden@mail.med.upenn.edu
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Wadden
authors.forename: Meghan L
authors.initials: ML
authors.lastname: Butryn
authors.forename: David B
authors.initials: DB
authors.lastname: Sarwer
authors.forename: Anthony N
authors.initials: AN
authors.lastname: Fabricatore
authors.forename: Canice E
authors.initials: CE
authors.lastname: Crerand
authors.forename: Patti E
authors.initials: PE
authors.lastname: Lipschutz
authors.forename: Lucy
authors.initials: L
authors.lastname: Faulconbridge
authors.forename: Steven E
authors.initials: SE
authors.lastname: Raper
authors.forename: Noel N
authors.initials: NN
authors.lastname: Williams
mesh_terms: D000328:Adult; D000339:Affect; D000428:Alcohol Drinking; D001007:Anxiety / Q000523:psychology; D050110:Bariatric Surgery / Q000523:psychology*; D003863:Depression / Q000523:psychology; D005260:Female; D006801:Humans; D008019:Life Style; D008875:Middle Aged; D009042:Motivation; D009767:Obesity, Morbid / Q000523:psychology* / Q000601:surgery*; D010555:Personality Inventory; D011584:Psychology; D012649:Self Concept; D020377:Self Efficacy; D012907:Smoking; D013315:Stress, Psychological / Q000523:psychology; D011795:Surveys and Questionnaires; D015431:Weight Loss