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Health related quality of life associated with extreme obesity in adolescents - results from the baseline evaluation of the YES-study. Health Qual Life Outcomes 2020; 18:58. [PMID: 32138734 PMCID: PMC7059717 DOI: 10.1186/s12955-020-01309-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Accepted: 02/26/2020] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Obesity can significantly reduce health-related quality of life (HRQoL) and may lead to numerous health problems even in youths. This study aimed to investigate whether HRQoL varies among youths with obesity depending on grade of obesity and other factors. METHODS For the Youths with Extreme obesity Study (YES) (2012-2014), a prospective multicenter cohort study, a baseline sample of 431 obese and extremely obese adolescents and young adults (age 14 to 24 years, BMI ≥30 kg/m2) was recruited at four German university medical centers and one job center. Obesity grade groups (OGG) were defined according to BMI (OGG I: 30-34.9 kg/m2, OGG II: 35-39.9 kg/m2, OGG III (extreme obesity): ≥40 kg/m2). HRQoL was measured with the Euroqol-5D-3 L (EQ-5D-3 L), DISABKIDS chronic generic (DCGM-31) and the KINDLR obesity module. Differences between OGGs were assessed with logistic and linear regression models, adjusting for age, sex, and study center in the base model. In a second regression analysis, we included other characteristics to identify possible determinants of HRQoL. RESULTS Three hundred fifty-two adolescents (mean age: 16.6 (±2.4), mean BMI: 39.1 (±7.5) kg/ m2) with available HRQoL data were analysed. HRQoL of youths in all OGGs was markedly lower than reference values of non-obese adolescents. Adjusting for age and sex, HRQoL of youths in OGG III significantly impaired compared to OGG I. Youths in OGG III were 2.15 times more likely to report problems with mobility in the EQ-5D-3 L than youths in OGG I. A mean difference of 9.7 and 6.6 points between OGG III and I were found for DCGM-31 and KINDL respectively and 5.1 points between OGG II and I for DCGM-31. Including further variables into the regression models, showed that HRQoL measured by DCGM-31 was significantly different between OGGs. Otherwise, female sex and having more than 4 h of daily screen time were also associated with lower HRQoL measured by DCGM-31 and KINDL. CONCLUSION HRQoL of adolescents with obesity is reduced, but HRQoL of adolescents with extreme obesity is particularly affected. Larger and longitudinal studies are necessary to understand the relation of extreme obesity and HRQoL, and the impact of other lifestyle or socioeconomic factors. TRIAL REGISTRATION Clinicaltrials.gov NCT01625325; German Clinical Trials Register (DRKS) DRKS00004172.
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Özalp Kızılay D, Yalın Sapmaz Ş, Şen S, Özkan Y, Ersoy B. Insulin Resistance as Related to Psychiatric Disorders in Obese Children. J Clin Res Pediatr Endocrinol 2018; 10:364-372. [PMID: 29789273 PMCID: PMC6280318 DOI: 10.4274/jcrpe.0055] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVE The current study aimed to investigate psychiatric consequences of obesity and the relationship between componenets of the metabolic syndrome and psychiatric disorders in children. Our second aim was to elucidate which of the anthropometric parameters or metabolic components were most strongly associated with psychiatric disorders. METHODS The study included 88 obese and overweight children with a body mass index (BMI) greater than 85th percentile. The patients were evaluated for psychiatric disorders by a single child and adolescent psychiatrist. Forty patients diagnosed with psychiatric disorders and 48 patients with normal psychiatric evaluation were compared in terms of anthropometric and metabolic parameters. BMI, BMI-standard deviation score and BMI percentile, waist circumference, waist to hip ratio, blood pressure and pubertal stage of all patients were recorded. Fasting serum glucose, insulin, lipid profile and homeostatic model assessments of insulin resistance (HOMA-IR) were measured to evaluate the metabolic parameters. Serum and 24 hour urine cortisol levels were measured. RESULTS HOMA-IR in the group with psychiatric disorders was found to be significantly higher than in the group without psychiatric disorders (6.59±3.36 vs 5.21±2.67; p=0.035). Other anthropometric measurements and metabolic parameters were not significantly different between the two groups. CONCLUSION An understanding of the relationships between obesity related medical comorbidities and psychiatric pathologies is important to encourage patients and their families to make successful healthy lifestyle changes and for weight management in terms of appropriate treatment.
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Affiliation(s)
- Deniz Özalp Kızılay
- Çiğli State Training Hospital, Clinic of Pediatrics, Division of Pediatric Endocrinology, İzmir, Turkey
| | - Şermin Yalın Sapmaz
- Manisa Celal Bayar University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Manisa, Turkey
| | - Semra Şen
- Manisa Celal Bayar University Faculty of Medicine, Department of Pediatrics, Division of Pediatric Infectious Disease, Manisa, Turkey,* Address for Correspondence: Manisa Celal Bayar University Faculty of Medicine, Department of Pediatrics, Division of Pediatric Infectious Disease, Manisa, Turkey Phone: +90 505 727 84 11 E-mail:
| | - Yekta Özkan
- Manisa Celal Bayar University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Manisa, Turkey
| | - Betül Ersoy
- Manisa Celal Bayar University Faculty of Medicine, Department of Pediatrics, Division of Pediatric Endocrinology and Metabolism, Manisa, Turkey
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Do adolescents with extreme obesity differ according to previous treatment seeking behavior? The Youth with Extreme obesity Study (YES) cohort. Int J Obes (Lond) 2018; 43:103-115. [PMID: 30368525 DOI: 10.1038/s41366-018-0237-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Revised: 07/25/2018] [Accepted: 08/29/2018] [Indexed: 11/08/2022]
Abstract
OBJECTIVES Adolescent extreme obesity is associated with somatic and psychiatric comorbidity, low quality of life, and social dysfunction. Nevertheless, few adolescents seek obesity treatment, thus many may elope appropriate care. We examine whether previous treatment seeking relates to disease burden, and whether previously non-treatment seeking adolescents accept diagnostic and therapeutic offers. This information is important to inform intervention strategies. METHODS The Youth with Extreme obesity Study (YES) is a prospective, multicenter cohort study. We developed a novel recruitment strategy to span medical and vocational ascertainment settings and directly compare previously treatment seeking and non-treatment seeking youth. Participants aged 14-24 years; BMI ≥ 30 kg/m2 were enrolled at four medical- and one job centers. We present comorbidity and psycho-social baseline data by sex, obesity WHO grade I-III, and treatment-seeking status, defined as self-reported previous participation in a weight-loss program. RESULTS Of 431 participants, 47% were male; mean age 16.6 (standard deviation 2.3) years, BMI 39.2 (7.5) kg/m2. Somatic comorbidity increased with obesity grade, p < 0.05: hypertension (42, 55, 64%), dyslipidemia (28, 24, 37%,), dysglycemia (9, 19, 20%,), elevated transaminases (15, 26, 30%). Quality of life (EQ5 D) decreased (74, 71, 70). Rates of psychiatric disorders were stable: depression 11%, attention deficit disorder 6%, substance use disorder 2%, self-injurious behavior 5%, suicide attempt 3%. Only 63% (56, 64, 69%) reported previous treatment seeking. Acceptance of the diagnostic (89%) or therapeutic (28%) program, medical or psychosocial situation did not differ by treatment seeking status. Acceptance of the therapeutic program was generally low, but high at the job center (92%). CONCLUSION Irrespective of previous treatment seeking, adolescent extreme obesity was associated with high comorbidity and psychosocial burden. Acceptance of the diagnostic program overall and the therapeutic program at the job center were high. This underscores the need of innovative, accessible programs beyond the currently offered care.
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Riquin E, Schmitt F, Bouhours-Nouet N, Beaumesnil M, Dinomais M, Malka J, Robin M, Coutant R, Duverger P. Laparoscopic adjustable gastric banding in adolescents with severe obesity: Psychological aspects, decision makers of surgery, and 2-year outcomes. A case series. Arch Pediatr 2018; 25:269-273. [PMID: 29656036 DOI: 10.1016/j.arcped.2018.02.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Revised: 01/31/2018] [Accepted: 02/18/2018] [Indexed: 11/18/2022]
Abstract
BACKGROUND The results of medical treatment of severe obesity in the adolescent population (balanced diet and physical activity) are often unsatisfactory, and bariatric surgery is questioned. The psychological determinants for requesting bariatric surgery in these adolescents are unclear. The objective of this study was to report the psychiatric and psychological aspects as well as the determinants of the medical decision for surgery in a cohort of obese adolescents requesting bariatric surgery by laparoscopic adjustable gastric banding. METHODS Thirty-five adolescents (12.3-17.7 years of age), were recruited from January 2007 to December 2012. Semistructured interviews were conducted. RESULTS Fifty-four percent of the adolescents had a psychiatric history and 85% had psychiatric comorbidities. In adolescents undergoing surgery, excess weight loss was 46% after 1 year and 51% after 2years. For patients not receiving surgery, excess weight loss was 0.43% after 1 year (P=0.001). Compliance with medical treatment was the only significant element contributing to the decision to perform surgery. Results in terms of satisfaction and perception 1 and 2years after surgery were encouraging. CONCLUSION Bariatric surgery is feasible in young patients and produces good results in terms of excess weight loss. We argue that compliance with medical treatment is probably one of the most important elements for making the decision to perform bariatric surgery and in excess weight loss after surgery. We probably need to focus on the compliance of young patients and evaluate how this can be improved.
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Affiliation(s)
- E Riquin
- Pediatric Psychiatry Department, University Hospital of Angers, 4, rue Larrey, 49933 Angers cedex 9, France.
| | - F Schmitt
- Pediatric Surgery Department, University Hospital of Angers, 4, rue Larrey, 49933 Angers cedex 9, France
| | - N Bouhours-Nouet
- Pediatric Endocrinology Department, University Hospital of Angers, 4, rue Larrey, 49933 Angers cedex 9, France
| | - M Beaumesnil
- Centre de rééducation des Capucins, 28, rue des Capucins, B.P. 40329, 49103 Angers cedex 02, France
| | - M Dinomais
- Centre de rééducation des Capucins, 28, rue des Capucins, B.P. 40329, 49103 Angers cedex 02, France
| | - J Malka
- Pediatric Psychiatry Department, University Hospital of Angers, 4, rue Larrey, 49933 Angers cedex 9, France
| | - M Robin
- Pediatric Psychiatry Department, institut mutualiste Montsouris, 42, boulevard Jourdan, 75014 Paris, France
| | - R Coutant
- Pediatric Endocrinology Department, University Hospital of Angers, 4, rue Larrey, 49933 Angers cedex 9, France
| | - P Duverger
- Pediatric Psychiatry Department, University Hospital of Angers, 4, rue Larrey, 49933 Angers cedex 9, France
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Ewald DR, Bond SH, Haldeman LA. Hypertension in Low-Income Adolescents. Glob Pediatr Health 2017; 4:2333794X17741819. [PMID: 29204459 PMCID: PMC5703095 DOI: 10.1177/2333794x17741819] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Accepted: 10/03/2017] [Indexed: 12/27/2022] Open
Abstract
Disadvantaged adolescents are at higher risk for undiagnosed and untreated obesity and hypertension. Using nurse-measured weight, height, and blood pressure (BP) as well as self-reported age and activity/lifestyle behaviors, we assessed the prevalence of obesity and hypertension in 573 adolescent patients aged 13.0 to 17.9 years (females: n = 267, 46.6%; males: n = 306, 53.4%) from a clinic serving low-income, ethnically diverse pediatric patients. Body mass index distribution was as follows: 11, underweight (1.9%); 330, healthy weight (57.6%); 105, overweight (18.3%); and 127, obese (22.2%). The age-adjusted height percentile was normally distributed, but distribution by BP category was 326 normotensive (56.9%), 147 prehypertensive (25.7%), 60 with stage 1 hypertension (10.5%), and 40 with stage 2 hypertension (7.0%). Activity and lifestyle behaviors did not adequately explain obesity and hypertension rates. Efforts to prevent/reduce childhood overweight, obesity, and hypertension in underserved populations need to include dietary education, weight control interventions, and physical activity programs specifically tailored to overweight/obese youth and parents.
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Affiliation(s)
- D Rose Ewald
- The University of North Carolina at Greensboro, NC, USA
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Mühlig Y, Scherag A, Bickenbach A, Giesen U, Holl R, Holle R, Kiess W, Lennerz B, Brintrup DL, Moss A, Neef M, Ose C, Reinehr T, Teuner CM, Wiegand S, Wolters B, Wabitsch M, Hebebrand J. A Structured, Manual-Based Low-Level Intervention vs. Treatment as Usual Evaluated in a Randomized Controlled Trial for Adolescents with Extreme Obesity - the STEREO Trial. Obes Facts 2017; 10:341-352. [PMID: 28787738 PMCID: PMC5644941 DOI: 10.1159/000475717] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Accepted: 04/03/2017] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND To compare efficacy and safety of a manual-based low-level psychological intervention with treatment as usual (weight loss treatment). METHODS A two-armed randomized controlled trial without blinding and computer-based stratified block randomization included adolescents and young adults (14.0-24.9 years) with a BMI ≥ 30 kg/m2 at five German university hospitals. Primary outcomes were adherence (participation rate ≥ 5/6 sessions) and quality of life (DISABKIDS-37) 6 months after randomization. Secondary outcomes included depression, self-esteem, and perceived stress scores. RESULTS Of 397 screened adolescents, 119 (mean BMI 40.4 ± 7.0 kg/m2, 49.6% female) were randomized to the manual-based low-level intervention (n = 59) or treatment as usual (n = 60). We observed no group difference for adherence (absolute risk reduction 0.4%, 95% CI -14.7% to 15.5%; p = 1.0) or health-related quality of life (score difference 8.1, 95% CI -2.1 to 18.3; p = 0.11). Among all secondary outcomes, we detected explorative evidence for an effect on the DISABKIDS-37 'social exclusion' subscale (score difference 15.5; 95% CI 1.6-29.4; p = 0.03). 18/19 adverse events occurred in 26 participants, none were classified as serious. CONCLUSION Adherence to a coping-oriented intervention was comparable to weight loss treatment, although it was weak in both interventions. Psychological interventions may help to overcome social isolation; further confirmation is required.
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Affiliation(s)
- Yvonne Mühlig
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - André Scherag
- Research Group Clinical Epidemiology, Integrated Research and Treatment Center, Center for Sepsis Control and Care (CSCC), Jena University Hospital, Jena, Germany
| | - Annika Bickenbach
- Ambulatory Obesity Center, Charité - University Hospital Berlin, Berlin, Germany
| | - Ulrike Giesen
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Reinhard Holl
- Institute for Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - Rolf Holle
- Institute of Health Economics and Health Care Management, Helmholtz Zentrum München - German Research Center for Environmental Health, Munich, Germany
| | - Wieland Kiess
- Hospital for Children and Adolescents, Department of Women and Child Health, University of Leipzig, Leipzig, Germany
| | - Belinda Lennerz
- Division of Pediatric Endocrinology and Diabetes, Interdisciplinary Obesity Unit, Department of Pediatrics and Adolescent Medicine, University of Ulm, Ulm, Germany
| | - Diana Lütke Brintrup
- Institute for Medical Informatics, Biometry and Epidemiology and Center for Clinical Trials Essen (ZKSE), University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Anja Moss
- Division of Pediatric Endocrinology and Diabetes, Interdisciplinary Obesity Unit, Department of Pediatrics and Adolescent Medicine, University of Ulm, Ulm, Germany
| | - Madlen Neef
- Hospital for Children and Adolescents, Department of Women and Child Health, University of Leipzig, Leipzig, Germany
| | - Claudia Ose
- Institute for Medical Informatics, Biometry and Epidemiology and Center for Clinical Trials Essen (ZKSE), University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Thomas Reinehr
- Vestische Childrens Hospital Datteln, University Witten/Herdecke, Datteln, Germany
| | - Christina M. Teuner
- Institute of Health Economics and Health Care Management, Helmholtz Zentrum München - German Research Center for Environmental Health, Munich, Germany
| | - Susanna Wiegand
- Ambulatory Obesity Center, Charité - University Hospital Berlin, Berlin, Germany
| | - Barbara Wolters
- Vestische Childrens Hospital Datteln, University Witten/Herdecke, Datteln, Germany
| | - Martin Wabitsch
- Division of Pediatric Endocrinology and Diabetes, Interdisciplinary Obesity Unit, Department of Pediatrics and Adolescent Medicine, University of Ulm, Ulm, Germany
| | - Johannes Hebebrand
- Institute for Medical Informatics, Biometry and Epidemiology and Center for Clinical Trials Essen (ZKSE), University Hospital Essen, University of Duisburg-Essen, Essen, Germany
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Beamish AJ, Reinehr T. Should bariatric surgery be performed in adolescents? Eur J Endocrinol 2017; 176:D1-D15. [PMID: 28174231 DOI: 10.1530/eje-16-0906] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Revised: 12/08/2016] [Accepted: 01/10/2017] [Indexed: 12/26/2022]
Abstract
Adolescent obesity has markedly increased worldwide in both its extent and prevalence in recent decades and obesity prevention strategies are failing. As a result, effective treatment strategies are urgently needed. As behavioral and pharmacological treatment approaches have only moderate effects in severe obesity, bariatric surgery has begun to emerge as a treatment option. In this debate article, we offer arguments opposing and supporting bariatric surgery in the treatment of severe obesity in adolescents. Bariatric surgery has superior therapeutic outcomes with respect to weight loss and resolution of comorbid diseases over other existing treatments. However, long-term outcomes after bariatric surgery in adolescents are only just beginning to emerge. Furthermore, the procedures are generally considered irreversible, apart from gastric banding. Most importantly, not all adolescents seem to benefit greatly from bariatric surgery and we are not yet able to reliably identify those who stand to gain the greatest benefit. The authors agree that adolescent bariatric surgery should be offered exclusively within formal adolescent obesity programs, delivered by specialist multidisciplinary child/adolescent obesity teams, and within specialist centers, in order to optimize outcomes and minimize potential detrimental effects. Patients and their family/carers must be educated regarding the benefits and risks, potential side effects, expected changes in eating behavior and the lifelong requirement for regular medical follow-up after surgery. Before embarking upon a surgical treatment pathway in adolescents with severe obesity, it may also be beneficial to ensure compliance to treatment is demonstrated, in order to minimize the risk of nutritional deficiencies and associated potential complications.
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Affiliation(s)
- Andrew J Beamish
- Department of Gastrosurgical ResearchInstitute of Clinical Sciences, Gothenburg University, Gothenburg, Sweden
- Research DepartmentThe Royal College of Surgeons of England, London, UK
| | - Thomas Reinehr
- Vestische Hospital for Children and Adolescents University of Witten/Herdecke Department of Pediatric EndocrinologyDiabetes, and Nutrition Medicine, Datteln, Germany
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Ewald DR, Haldeman PhD LA. Risk Factors in Adolescent Hypertension. Glob Pediatr Health 2016; 3:2333794X15625159. [PMID: 27335997 PMCID: PMC4784559 DOI: 10.1177/2333794x15625159] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2015] [Revised: 11/27/2015] [Accepted: 11/30/2015] [Indexed: 12/12/2022] Open
Abstract
Hypertension is a complex and multifaceted disease, with many contributing factors. While diet and nutrition are important influences, the confounding effects of overweight and obesity, metabolic and genetic factors, racial and ethnic predispositions, socioeconomic status, cultural influences, growth rate, and pubertal stage have even more influence and make diagnosis quite challenging. The prevalence of hypertension in adolescents far exceeds the numbers who have been diagnosed; studies have found that 75% or more go undiagnosed. This literature review summarizes the challenges of blood pressure classification in adolescents, discusses the impact of these confounding influences, and identifies actions that will improve diagnosis and treatment outcomes.
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Affiliation(s)
- D Rose Ewald
- The University of North Carolina at Greensboro, NC, USA
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Gowey MA, Reiter-Purtill J, Becnel J, Peugh J, Mitchell JE, Zeller MH. Weight-related correlates of psychological dysregulation in adolescent and young adult (AYA) females with severe obesity. Appetite 2016; 99:211-218. [PMID: 26775646 DOI: 10.1016/j.appet.2016.01.020] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Revised: 01/03/2016] [Accepted: 01/12/2016] [Indexed: 12/22/2022]
Abstract
OBJECTIVE Severe obesity is the fastest growing pediatric subgroup of excess weight levels. Psychological dysregulation (i.e., impairments in regulating cognitive, emotional, and/or behavioral processes) has been associated with obesity and poorer weight loss outcomes. The present study explored associations of dysregulation with weight-related variables among adolescent and young adult (AYA) females with severe obesity. METHODS Fifty-four AYA females with severe obesity (MBMI = 48.71 kg/m(2); Mage = 18.29, R = 15-21 years; 59.3% White) completed self-report measures of psychological dysregulation and weight-related constructs including meal patterns, problematic eating behaviors, and body and weight dissatisfaction, as non-surgical comparison participants in a multi-site study of adolescent bariatric surgery outcomes. Pearson and bivariate correlations were conducted and stratified by age group to analyze associations between dysregulation subscales (affective, behavioral, cognitive) and weight-related variables. RESULTS Breakfast was the most frequently skipped meal (consumed 3-4 times/week). Eating out was common (4-5 times/week) and mostly occurred at fast-food restaurants. Evening hyperphagia (61.11%) and eating in the absence of hunger (37.04%) were commonly endorsed, while unplanned eating (29.63%), a sense of loss of control over eating (22.22%), eating beyond satiety (22.22%), night eating (12.96%), and binge eating (11.11%) were less common. Almost half of the sample endorsed extreme weight dissatisfaction. Dysregulation was associated with most weight-related attitudes and behaviors of interest in young adults but select patterns emerged for adolescents. CONCLUSIONS Higher levels of psychological dysregulation are associated with greater BMI, problematic eating patterns and behaviors, and body dissatisfaction in AYA females with severe obesity. These findings have implications for developing novel intervention strategies for severe obesity in AYAs that may have a multidimensional impact on functioning (e.g., psychosocial health, weight loss behaviors).
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Affiliation(s)
- Marissa A Gowey
- Nutrition Obesity Research Center, University of Alabama at Birmingham, United States.
| | - Jennifer Reiter-Purtill
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, United States
| | - Jennifer Becnel
- School of Human Environmental Sciences, Program in Human Development and Family Sciences, University of Arkansas, United States
| | - James Peugh
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, United States
| | - James E Mitchell
- Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, United States
| | - Meg H Zeller
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, United States
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Dreber H, Reynisdottir S, Angelin B, Hemmingsson E. Who is the Treatment-Seeking Young Adult with Severe Obesity: A Comprehensive Characterization with Emphasis on Mental Health. PLoS One 2015; 10:e0145273. [PMID: 26694031 PMCID: PMC4687938 DOI: 10.1371/journal.pone.0145273] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Accepted: 12/02/2015] [Indexed: 01/16/2023] Open
Abstract
OBJECTIVE To characterize treatment-seeking young adults (16-25 years) with severe obesity, particularly mental health problems. STUDY DESIGN AND PARTICIPANTS Cross-sectional study of 165 participants (132 women, 33 men) with BMI ≥35 kg/m2 or ≥30 kg/m2 with comorbidities, enrolling in a multidisciplinary obesity treatment program. METHOD Data collection at admission of present and life-time health issues including symptomatology of anxiety, depression (Hospital Anxiety and Depression Scale) and attention-deficit/hyperactivity disorder (Adult ADHD Self-Report scale); self-esteem (Rosenberg Self-Esteem Scale), suicide attempts, health-related quality of life (Short Form-36 Health Survey), psychosocial functioning related to obesity (Obesity-related Problems Scale), cardiorespiratory fitness (Astrand's bicycle ergometer test), somatic and psychiatric co-morbidities, cardiometabolic risk factors, and micronutritional status. We used multiple regression analysis to identify variables independently associated with present anxiety and depressive symptomatology. RESULTS Mean body mass index was 39.2 kg/m2 (SD = 5.2). We found evidence of poor mental health, including present psychiatric diagnoses (29%), symptomatology of anxiety (47%), depression (27%) and attention-deficit/hyperactivity disorder (37%); low self-esteem (42%), attempted suicide (12%), and low quality of life (physical component score = 46, SD = 11.2; mental component score = 36, SD = 13.9, P<0.001 for difference). Variables independently associated with present anxiety symptomatology (R2 = 0.33, P<0.001) included low self-esteem (P<0.001) and pain (P = 0.003), whereas present depressive symptomatology (R2 = 0.38, P<0.001) was independently associated with low self-esteem (P<0.001), low cardiorespiratory fitness (P = 0.009) and obesity-related problems (P = 0.018). The prevalence of type 2 diabetes was 3%, and hypertension 2%. Insulin resistance was present in 82%, lipid abnormality in 62%, and poor cardiorespiratory fitness in 92%. Forty-eight percent had at least one micronutritional deficiency, vitamin D being the most common (35%). CONCLUSION A wide range of health issues, including quite severe mental health problems, was prevalent in treatment-seeking young adults with severe obesity. These are likely to constitute a major treatment challenge, including options relating to bariatric surgery.
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Affiliation(s)
- Helena Dreber
- Obesity Center, Karolinska University Hospital, Department of Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Signy Reynisdottir
- Obesity Center, Karolinska University Hospital, Department of Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Bo Angelin
- Department of Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Erik Hemmingsson
- Obesity Center, Karolinska University Hospital, Department of Medicine, Karolinska Institutet, Stockholm, Sweden
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Cardiovascular risk factors in severely obese adolescents. ACTA ACUST UNITED AC 2015; 9:584-5. [PMID: 26142649 DOI: 10.1016/j.jash.2015.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2015] [Accepted: 05/09/2015] [Indexed: 11/21/2022]
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Daniels SR, Kelly AS. Pediatric severe obesity: time to establish serious treatments for a serious disease. Child Obes 2014; 10:283-4. [PMID: 24983291 PMCID: PMC4239673 DOI: 10.1089/chi.2014.1041] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Stephen R. Daniels
- Department of Pediatrics, University of Colorado School of Medicine, and Children's Hospital Colorado, Aurora, CO
| | - Aaron S. Kelly
- Departments of Pediatrics and Medicine, University of Minnesota Medical School, and University of Minnesota Children's Hospital, Minneapolis, MN
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