Insight and comparison of different insight scales in patients with obesity

AIM: This study aimed to evaluate the extent to which insight scales originally developed for major psychopathologies and non-psychotic psychiatric disorders are effective in measuring insight in individuals with obesity. Additionally, it examined the relationship between obesity severity and insight levels. MATERIALS AND METHODS: The study included 120 patients aged 18 years and older who were diagnosed with obesity and applied to the Psychiatry Consultation-Liaison Clinic, Internal Medicine–Endocrinology Clinic, and Family Medicine Obesity Clinic of Sakarya Education and Research Hospital. Patients identified from hospital records were contacted by phone and invited for a structured clinical interview. Sociodemographic data, clinical obesity indicators, and insight levels were assessed using multiple insight scales. RESULTS: Body image concerns and restrained eating behaviors were common among participants. Women scored higher than men on both total scores and subdomains of the EDE-Q. These concerns increased with obesity stage, particularly in stages 2 and 3. Women also demonstrated significantly higher OASIS scores in domains such as general illness awareness, perceived treatment need, and awareness of negative consequences. The OASIS total score showed a moderate positive correlation with BMI and body fat percentage. Among all insight measures administered, only the OASIS total score significantly predicted both BMI and obesity stage, indicating that it may more accurately capture clinically relevant insight in obesity. CONCLUSION: The OASIS total score demonstrated consistent associations with obesity-related severity indicators, including BMI, body fat percentage, and obesity stage. Higher insight levels were associated with higher obesity stages. Insight scales developed for general psychiatric conditions appear insufficient for evaluating insight in obesity. As an obesity-specific tool, OASIS provides a clinically meaningful framework for assessing insight and may support more targeted and personalized interventions in routine practice. Keywords: Awareness, insight, insight scales, metacognition, obesity