Assessing Life Stress: A Critical Priority in Obesity Research and Treatment

Abstract

Significant childhood adversity and chronic life stress are highly prevalent in patients with severe obesity. Such stress has been found to increase risk of adulthood obesity by up to 50%, and it can also substantially degrade the effectiveness of evidence-based treatments for this chronic disease condition. Despite general appreciation of these facts, though, stress is not frequently measured in obesity research or routinely assessed during treatment for obesity or obesity-related complications. To address this important issue, we describe several validated tools that can be used for assessing life stress and discuss how information obtained from these instruments can be integrated into obesity treatment and research. Given the documented relevance of stress for obesity, we argue that stress assessment and management should be included in clinical treatments for obesity and that stress should be routinely measured in studies examining the long-term effects of obesity and obesity treatment.

© 2020 The Obesity Society.

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Figure 1.

Assessing stress in obesity treatment. Stress assessment can be helpful at all stages of the treatment process, including case conceptualization, treatment planning, treatment, and follow-up. It can help reveal potential risk factors and causes of obesity and obesity comorbidities, identify modifiable psychosocial treatment targets, guide adjunctive stress management strategies, and help patients and treatment providers monitor risk factors for relapse and weight regain. Potential patient outcomes can include a better understanding of life stress and the role it plays in obesity, increased motivation to reduce stress and enhanced empowerment to make beneficial lifestyle changes, greater stress reduction and improved treatment response to weight loss interventions, and a reduced risk of weight regain and improved overall quality of life following treatment.