Thèse de doctorat
Résumé : Background: Obesity has been identified as a global epidemic and is associated with significant morbidity and mortality. Although obesity has been widely recognized for its consequences on physical health, its psychological burden in the adult populations remains unclear. Objectives: Our purpose was to address the relationship between Obesity status and psychological health within the adult young population in the Middle East and particularly in Lebanon (first aim). In addition, we intended to develop and validate a screening tool for the assessment of psychological distress (PD) in the obese young adult populations (second aim). Methods: To achieve the first aim, three studies were conducted. The first study was a systematic review and meta-analysis of observational studies that investigate the association between obesity and depression among adult populations in Middle Eastern countries. The second study was a cross sectional that aimed to explore the relationship between obesity and PD among the Lebanese University Students. The third study was conducted to examine the effects of actual body weight and body image on PD using a convenient sample of obese Lebanese young adults. The second aim was accomplished by conducting a fourth study to develop and validate a measure of PD related to obesity using three different samples of obese young adults. Results: The systematic review identified eight observational studies from six countries of the Middle East. Meta-analysis showed a significant positive association between obesity and depression (OR 1.27; 95% CI 1.11–1.44) particularly in women (Study1). Among the Lebanese university students, no evidence of a positive association was found between obesity and PD for both genders (Study 2). This result was confirmed in our third study in which body image dissatisfaction rather than obesity per se was associated with greater risk for PD. Finally, the “Obesity Specific Distress scale” (OSD) developed to measure distress in the obese young adult population demonstrated good psychometric properties regarding internal consistency, test-retest reliability, and construct validity (Study 4). Conclusions: Our meta-analysis suggests a positive association between obesity and depression among adult population in the Middle East which appeared to be more marked among women. This is of public health significance and provides a framework for establishing policy interventions to diagnose and treat depression in obese adults. In Lebanon, young obese adults who suffer from body image dissatisfaction are at increased risk of PD. Public health interventions targeting PD at the population level may need to promote healthy attitudes towards body weight, body shape and self-acceptance, regardless of weight status. Finally, the developed instrument used to assess young obese persons with high risk of PD can help promote a better understanding of the association between PD and obesity. This might improve the outcome and provide the patients with more efficient treatment.