Introduction: Comorbid obesity and mental illness is associated with increased morbidity and mortality. Untreated or sub-optimally treated mental illness can impact on weight management. The Canberra Obesity Management Service (OMS) is a publicly-funded multi-disciplinary program for patients with BMI>40kg/m2 and comorbidity. In January 2023, the OMS introduced a half-day in-house Psychiatry clinic to optimise the care of select patients with comorbid mental illness.
Aim: To describe the establishment of the OMS Psychiatry clinic and to review patient characteristics and management during the first 12 months of operation.
Methods: A descriptive outline of the OMS Psychiatry clinic and a retrospective review of patient encounters, demographics, BMI, psychiatric diagnoses and initial management. Simple statistical analysis was performed. Reference 2024.LRE.00027 (quality improvement project).
Results: The scope of clinic was outlined with clear referral and discharge processes, as well as patient inclusion and exclusion criteria. Of the 22 patients referred, 20 attended an initial psychiatry assessment and at least one review. There was a total of 104 clinical encounters. Females outnumbered males (82%). Mean age was 44 years (range 18-73 years). Mean BMI was 51.74kg/m2 (range 29.36-74.23kg/m2). Two patients were referred post-bariatric surgery with BMIs <40kg/m2. Of the 31 pre-existing psychiatric diagnoses, depression and anxiety were most prevalent (n=16, n=9). Of the 24 new diagnoses identified, trauma/stressor-related disorder and feeding/eating disorder were most common (n=9, n=5). Initial management comprised psychotropic medications, supportive psychotherapy and referral for external psychological interventions.
Conclusion: To the authors’ knowledge, the OMS is the first Australian publicly-funded specialist obesity service to embed a regular weekly Psychiatry clinic into its standard model of care. The OMS Psychiatry clinic allows patients to receive specialist level psychiatric care which may have clinical benefits in terms of managing comorbid obesity and mental illness.