Obesity-related coping and distress and relationship to treatment preference

Objectives. The primary purpose was to define obesity-related strategies fo r coping with psychological problems connected with obesity. We also wanted to identify obesity-related distress and explore the effect of coping on d istress. Thirdly, we wanted to investigate differences in coping and distre ss related to choice of surgery or conventional treatment. Design. Cross-sectional data from patients in the Swedish Obese Subjects (S OS) intervention study. Methods. An obesity-related questionnaire concerning coping and distress wa s created and evaluated in 2510 patients from the SOS study, using multitra it, exploratory and confirmatory factor analysis procedures. Results. Three coping Factors were defined. Social Trust and Fighting Spiri t were problem-focused, whereas Wishful Thinking was emotion-focused. Surgi cal candidates displayed lower levels of problem-focused and higher levels of emotion-focused coping. We also identified two distress factors: Intrusi on and Helplessness. Wishful Thinking was positively related to distress, a nd Social Trust and Fighting Spirit were inversely related, thus explaining the higher levels of distress reported by the surgical candidates. Conclusions. In our sample, emotion-focused coping proved maladaptive and w as associated with increased distress. Problem-focused coping, however, was adaptive and associated with reduced distress. These findings partly expla in psychological morbidity and should be taken into consideration in the tr eatment of obese people.