title: Poor mental health in severely obese patients is not explained by the presence of comorbidities.
abstract: The prevalence of obesity, especially severe obesity where body mass index (BMI) exceeds 40 kg m(-2) and where the physical risks are greatest, is increasing. However, little is known about the impact of severe obesity on psychological well-being and self-rated health (SRH). We aimed to investigate this relationship in patients attending an Irish weight management clinic. SRH was measured with a single-item inventory (excellent = 1, poor = 5). Well-being was measured with the validated World Health Organization-Five Well-being Index (WHO-5), in which scores <13 indicate poor well-being. Previous studies of the Irish population have reported mean SRH = 2.56 (males) and 2.53 (females) and mean well-being = 16.96. One hundred eighty-two (46.8%) completed questionnaires were returned. The sample was representative of the clinic population with a mean age of 47.1, mean baseline BMI of 51.9 kg m(-2) and 64.3% females. Mean SRH was 3.73 in males and 3.30 in females; mean well-being was 10.27 in males and 10.52 in females. In the final multivariable models, number of medications, depression and obstructive sleep apnoea, WHO-5 and current BMI were significant predictors of SRH, and secondary level education, social support and mindfulness scores were significant predictors of psychological well-being. Number of medications was not significant. The results suggest that the poor psychological well-being seen is not explained by the presence of comorbidities and that social support and mindfulness may be important targets for improving psychological well-being. Improving psychological well-being in addition to weight loss and effective management of comorbidities may be important for improving SRH.
authors.affiliation: School of Public Health Physiotherapy and Population Science, University College Dublin, Dublin, Ireland.
authors.forename: R
authors.initials: R
authors.lastname: Somerville
authors.forename: K
authors.initials: K
authors.lastname: McKenzie
authors.forename: S
authors.initials: S
authors.lastname: Eslami
authors.forename: C
authors.initials: C
authors.lastname: Breen
authors.forename: D
authors.initials: D
authors.lastname: O'Shea
authors.forename: P
authors.initials: P
authors.lastname: Wall
mesh_terms: D015897:Comorbidity; D003430:Cross-Sectional Studies; D006801:Humans; D008603:Mental Health; D009765:Obesity / Q000150:complications / Q000453:epidemiology / Q000523:psychology*; D015995:Prevalence; D011379:Prognosis; D011788:Quality of Life / Q000523:psychology*; D012649:Self Concept; D057566:Self Report; D020181:Sleep Apnea, Obstructive / Q000453:epidemiology / Q000209:etiology / Q000523:psychology*; D012944:Social Support; D011795:Surveys and Questionnaires
keywords: Comorbidities; depression; self-rated health; severe obesity