The Obesity Adjustment Survey: Development of a scale to assess psychological adjustment to morbid obesity

OBJECTIVE: To develop a reliable and valid measure of distress, related to extreme obesity. DESIGN: Items related to distress over obesity were selected from the liter ature, clinical experience and from input provided by a gastroplasty patien t support group. The items were assessed in a longitudinal study, with the body mass index (BMI) and psychological assessment occurring 2-6 months pri or to, and 12 months following, gastroplasty surgery. SUBJECTS: 81 females and eight males (mean age 35.9 y) who had been accepte d for gastroplasty surgery. Ail but two of the patients had BMIs > 40 (Mean = 48.11, s.d. = 6.84). MEASUREMENTS: BMls were calculated using weight and height. Psychological c haracteristics were assessed using the Mental Health Inventory (MHI), the S ickness Impact Profile (SIP), and the Eating Inventory (El). Demographic in formation was collected with a questionnaire. RESULTS: Attempts to factor analyse the 95 item questionnaire were unsucces sful. Alternatively, a shorter, 20 item questionnaire was developed. The qu estionnaire shows good test-retest reliability (r = 0.867), good internal c onsistency (coefficient alpha = 0.719), good face and construct validity, a nd is sensitive to pre-post surgical change. CONCLUSIONS: The Obesity Adjustment Survey (OAS) may be useful as a brief m easure of distress in obese individuals. This measure can be used to index the psychological impact of gastroplasty surgery on psychological functioni ng, and can be used in future research as a disease-specific measure to pre dict success of surgery.