Prevalence and Correlates of Night Eating Syndrome, Insomnia, and Psychological distress in Primary Care Patients with Obesity: A Cross-Sectional Study

Abstract

Introduction: Management of obesity is challenging for both patients and healthcare workers. Considering the low success rate of current interventions, this study aimed to explore the prevalence and associated factors of night eating syndrome (NES), insomnia, and psychological distress among individuals with obesity in order to plan comprehensive obesity management interventions. Methods: A cross-sectional study on a convenient sample from five primary healthcare centers in Port Said, Egypt, was conducted from November 2020 to March 2021. Socio-demographic and clinical characteristics were collected in addition to the assessment of NES, insomnia, and psychological distress using the Arabic versions of the Night Eating Diagnostic Questionnaire (NEQ), the Insomnia Severity Index (ISI), and the Patient Health Questionnaire -4 (PHQ-4) scales, respectively. Associations of NES, insomnia and psychological distress were assessed by multiple regression analysis. We performed Bonferroni adjustments for multiple comparisons. Results: We included 425 participants with obesity with a mean age of 45.52 ± 6.96 years. 54.4% were females and the mean body mass index (BMI) was 35.20 ± 4.41 kg/m2. The prevalence rates of NES, insomnia, and psychological distress were 21.6% (95% CI: 17.7 – 25.6%), 15.3% (95% CI: 11.9 – 18.7%), and 18.8% (95% CI: 15.1 – 22.6%), respectively. NES was significantly associated with younger age (OR 0.974, p=0.016), physical inactivity (OR 0.485, p=0.010), insomnia (OR 2.227, p=0.014), and psychological distress (OR 2.503, p=0.002). Insomnia showed strong associations with NES (OR 2.255, p=0.015), and psychological distress (OR 5.990, p<0.001). Associated factors of psychological distress symptoms included insomnia (OR 6.098, p<0.001) and NES (OR 2.463, p=0.003). Conclusion: The prevalence rates of NES, insomnia, and psychological distress were high among primary care patients with obesity, and these conditions were interrelated. Optimal obesity management necessitates individualized and targeted multidisciplinary care plans that take into consideration individual patients’ mental, behavioral, and dietary habits needs.