Background
Aboriginal people are disproportionately affected by overweight, obesity and their associated comorbidities, being 1.16 times more likely to be living with overweight or obesity compared to non-Aboriginal population. Approximately 13% live with severe obesity, defined as BMI ³ 35kg/m2. However, there is limited research on the health outcomes of Aboriginal adults living with severe obesity managed in a multidisciplinary program. The aim of this study was to describe the baseline physical and mental health characteristics of Aboriginal adults undergoing multidisciplinary care in a culturally responsive, holistic indigenised metabolic program, and their weight outcomes at 6 and 12 months
Methods
Adults with Confirmation of Aboriginality living with severe obesity were eligible to attend the multidisciplinary metabolic program based in the local Aboriginal Medical Service. A longitudinal cohort study was conducted with participant data collected at baseline, 6 months, 12 months using survey instruments (K-10, DASS-21, EDE-QS, EQ-5D-5L) on REDCap in addition to standard approach anthropometric and clinical measurements.
Results
Of 45 patients who had data captured at baseline had mean age (±SD) 43.7±13.8 years, 84.4% were female, weight 130.0±23.4kg, BMI 46.4±7.6kg/m2. Of these individuals, 43.6% had type 2 diabetes, 38.5% hypertension, 38.9% sleep apnoea and 26.3% dyslipidaemia. There was a high psychological distress level (K-10 score 26.2±8.0), and risk of moderate depression, anxiety and stress (DASS-21 scores 7.9±5.5, 6.1±4.7 and 9.7±5.0 respectively). Participants experienced statistically significant weight reductions at both the 6-month (3.3kg, p<0.05) and 12-month follow-up (3.7kg, p<0.05), and there was a statistically significant decrease in psychological distress, risk of anxiety, and stress (p<0.05 for all 3) at 6 months.
Discussion and conclusion
Culturally responsive multidisciplinary weight loss programs, designed and implemented in partnership with the community, appear to be effective in addressing the physical and mental health needs of Aboriginal Australians living with severe obesity.