Psychological Distress and Disordered Eating in Adults Attending an Obesity Outpatient Clinic

Katarzyna Cyranka,1– 3 Zofia Zych,4 Katarzyna Cyganek,3,5 Maciej T Maecki,3,5 Krzysztof Stycze,2,3 Martyna Pietru,1,3 Dominika Dudek,2,3 Tomasz Klupa,3,6 Bartomiej Matejko1,3,6 1Psychodiabetology Unit, Department of Metabolic Diseases, Jagiellonian University Medical College, Krakow, Poland; 2Department of Psychiatry, Jagiellonian University Medical College, Krakow, Poland; 3University Hospital in Krakow, Krakow, Poland; 4Student Scientific Association of Diabetology, Jagiellonian University Medical College, Krakow, Poland; 5Department of Metabolic Diseases, Jagiellonian University Medical College, Krakow, Poland; 6Center for Advanced Technologies in Diabetes, Department of Metabolic Diseases, Jagiellonian University Medical College, Krakow, PolandCorrespondence: Katarzyna Cyranka, Email katarzyna.cyranka@gmail.comIntroduction: Obesity is recognized as a major global health challenge and is associated not only with metabolic complications but also with substantial psychological consequences. The bidirectional relationship between obesity and mental disorders—such as depression, anxiety, and maladaptive eating behaviors—plays a critical role in the development, maintenance, and treatment resistance of obesity. This study aimed to examine the psychological dimensions of obesity and to emphasize their clinical relevance in comprehensive obesity care.Methods: The study was conducted between January and December 2024 at the Obesity Treatment Outpatient Clinic of the University Hospital in Krakow. Psychological parameters were assessed in 48 adults with obesity using standardized psychometric instruments, including the WHO-5 Well-Being Index, the Quick Inventory of Depressive Symptomatology (QIDS), the Eating Attitudes Test-26 (EAT-26), and the KO “O” Symptom Questionnaire.Results: Moderate to very severe depressive symptoms were identified in 54.2% (n = 26) of participants, while 62.5% (n = 30) met the WHO-5 criteria for poor psychological well-being and reduced quality of life. An elevated risk of disordered eating behaviors was observed in 43.8% (n = 21) of the study population, with 14.6% (n = 7) meeting criteria indicative of a full eating disorder. Anxiety symptom severity was significantly associated with glycated hemoglobin (HbA1c) levels and percent body fat, highlighting links between emotional distress and metabolic regulation in individuals with obesity.Conclusion: The results highlight the need for an integrated, multidisciplinary approach to obesity treatment that addresses both metabolic and psychological dimensions of the disease. Given the high prevalence of affective symptoms and disordered eating patterns, incorporating structured psychological and behavioral interventions—such as strategies targeting emotion regulation, eating behaviors, and adherence to medical, nutritional, and physical activity recommendations—should be considered an essential component of standard obesity care to improve both clinical outcomes and patient well-being.Keywords: obesity, depression, anxiety, eating disorders, BMI