Trajectories and predictors of psychological distress during the first 6 months of weight loss among adults with obesity: a prospective longitudinal cohort study
- 1Department of Nursing, The First Affiliated Hospital of Nanchang University , ,
- 2Department of Cardiovascular Medicine, First Affiliated Hospital of Gannan Medical University , ,
Abstract
Objectives: To characterize longitudinal trajectories of psychological distress from first presentation to a weight management clinic through 6 months of weight loss.
Methods: Adults with obesity (body mass index, BMI ≥28 kg/m²) were consecutively recruited from October 2024 to May 2025. Psychological distress was evaluated at four time points: initial clinic presentation (T1), 1 month (T2), 3 months (T3), and 6 months (T4) after weight loss initiation. Latent class growth modeling (LCGM) was applied to identify heterogeneous psychological distress trajectories. Multinomial logistic regression was used to explore baseline predictors for trajectory membership, with the persistently no/low distress group as the reference group (C3).
Results: LCGM identified three distinct longitudinal trajectories of psychological distress: Trajectory 1 (C1, 63.7%): gradually decreasing distress over 6 month s; Trajectory 2 (C2, 21.1%): continuously increasing distress; Trajectory 3 (C3, 15.2%): persistently no or low-level distress. Multinomial regression results showed that C1 membership was independently associated with younger age (OR=0.858, 95%CI: 0.745 to 0.988), history of chronic disease (OR = 1.293, 95%CI: 1.018 to 1.642), higher negative coping (OR = 1.445, 95%CI: 1.166 to 1.791), lower perceived social support (OR = 0.912, 95%CI: 0.832 to 1.000), and more negative illness perception (OR = 1.064, 95%CI: 1.002 to 1.163). C2 membership was independently associated with younger age (OR = 0.827, 95%CI: 0.760 to 0. 988), female sex (male vs female OR = 0.131, 95%CI: 0.024 to 0.708), higher BMI (OR = 1.337, 95%CI: 1.055 to 1.695), higher negative coping (OR = 1.319, 9 5%CI: 1.043 to 1.667), lower perceived social support (OR = 0.867, 95%CI:0.79–3 to 0.947), and more negative illness perception (OR = 1.080,95%CI:1.002 to 1.164).
Conclusions: Psychological distress among obese adults during early weight loss presents obvious heterogeneity. Nearly one-fifth of patients experience progressive elevation in distress, which requires close clinical attention. Routine assessment of baseline psychosocial and clinical indicators can support early risk stratification and facilitate delivery of timely psychological and behavioral interventions within the first 6 months of weight loss.
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BibTeX
@article{cheng2026trajectories,
title = {{Trajectories and predictors of psychological distress during the first 6 months of weight loss among adults with obesity: a prospective longitudinal cohort study}},
author = {Zhiqiang Cheng and Jiaoyun Xia and Jincheng Liu and Baozhen Zhang and Jinming Liu},
journal = {Frontiers in psychiatry},
year = {2026},
month = sep,
doi = {10.3389/fpsyt.2026.1883542},
url = {https://europepmc.org/article/PMC/PMC13664284},
note = {CC BY},
}
RIS
TY - JOUR
TI - Trajectories and predictors of psychological distress during the first 6 months of weight loss among adults with obesity: a prospective longitudinal cohort study
AU - Zhiqiang Cheng
AU - Jiaoyun Xia
AU - Jincheng Liu
AU - Baozhen Zhang
AU - Jinming Liu
PY - 2026
DA - 2026/09/30
JO - Frontiers in psychiatry
DO - 10.3389/fpsyt.2026.1883542
UR - https://europepmc.org/article/PMC/PMC13664284
AB - Objectives: To characterize longitudinal trajectories of psychological distress from first presentation to a weight management clinic through 6 months of weight loss. Methods: Adults with obesity (body mass index, BMI ≥28 kg/m²) were consecutively recruited from October 2024 to May 2025. Psychological distress was evaluated at four time points: initial clinic presentation (T1), 1 month (T2), 3 months (T3), and 6 months (T4) after weight loss initiation. Latent class growth modeling (LCGM) was applied to identify heterogeneous psychological distress trajectories. Multinomial logistic regression was used to explore baseline predictors for trajectory membership, with the persistently no/low distress group as the reference group (C3). Results: LCGM identified three distinct longitudinal trajectories of psychological distress: Trajectory 1 (C1, 63.7%): gradually decreasing distress over 6 month s; Trajectory 2 (C2, 21.1%): continuously increasing distress; Trajectory 3 (C3, 15.2%): persistently no or low-level distress. Multinomial regression results showed that C1 membership was independently associated with younger age (OR=0.858, 95%CI: 0.745 to 0.988), history of chronic disease (OR = 1.293, 95%CI: 1.018 to 1.642), higher negative coping (OR = 1.445, 95%CI: 1.166 to 1.791), lower perceived social support (OR = 0.912, 95%CI: 0.832 to 1.000), and more negative illness perception (OR = 1.064, 95%CI: 1.002 to 1.163). C2 membership was independently associated with younger age (OR = 0.827, 95%CI: 0.760 to 0. 988), female sex (male vs female OR = 0.131, 95%CI: 0.024 to 0.708), higher BMI (OR = 1.337, 95%CI: 1.055 to 1.695), higher negative coping (OR = 1.319, 9 5%CI: 1.043 to 1.667), lower perceived social support (OR = 0.867, 95%CI:0.79–3 to 0.947), and more negative illness perception (OR = 1.080,95%CI:1.002 to 1.164). Conclusions: Psychological distress among obese adults during early weight loss presents obvious heterogeneity. Nearly one-fifth of patients experience progressive elevation in distress, which requires close clinical attention. Routine assessment of baseline psychosocial and clinical indicators can support early risk stratification and facilitate delivery of timely psychological and behavioral interventions within the first 6 months of weight loss.
SN - 1664-0640
ER -