To examine the prevalence of psychological trauma and its effect on 12-month weight change, eating disorder risk, and health-related quality of life (HRQOL), among individuals with class 3 obesity (BMI ≥40 kg/m2) attending an intensive multidisciplinary weight management program (WMP). This retrospective cohort study included patients in a Sydney hospital-based WMP (2018-2021) who consulted a clinical psychologist. The Eating Disorder Examination Questionnaire-Short (EDE-QS), Kessler Psychological Distress Scale (K10), and 36-Item Short Form Survey (SF-36) were completed at baseline and 12 months. Mental and physical component summary (MCS and PCS) scores were derived from SF-36. History of trauma was extracted from clinical notes in electronic medical records. Of 269 participants, 46.1 % (n = 124) reported previous psychological trauma. At baseline, participants with trauma had higher K10 and lower MCS scores than individuals without trauma. After 12 months, there were similar improvements in weight change, EDE-QS, K10, PCS and MCS scores, with no significant differences between participants with or without trauma. Presence of trauma was associated with baseline EDE-QS, K10 and MCS scores, but not with changes over 12 months. There is a high prevalence of psychological trauma among individuals with class 3 obesity presenting to a multidisciplinary WMP. Similar 12-month weight loss and HRQOL improvements were observed among those with or without trauma when access to a mental healthcare professional was embedded within the team.

Vitamin D deficiency has been implicated in various metabolic disorders, but its relationship with adiposity and atherogenic risk remains not fully elucidated. We assessed associations between serum vitamin D levels and a wide range of metabolic, atherogenic, and adiposity-related markers in adults stratified by weight status. A cross-sectional analysis was conducted on 130 adults categorized according to their body weight status into: normal weight, overweight, and obesity. Additionally, participants were grouped based on serum vitamin D levels (threshold 20 ng/mL) Clinical, metabolic, and anthropometric variables were compared across groups. A principal component analysis (PCA) was applied to explore underlying patterns of association. As expected, significant differences in cardiometabolic parameters emerged across weight categories (p < 0.05). However, vitamin D levels showed no significant correlation with most metabolic variables in either univariate or multivariate analysis. PCA revealed that vitamin D and body mass index (BMI) were consistently represented as opposing vectors, suggesting distinct but potentially interacting influences on metabolic risk. While BMI was associated with indices such as TG/HDL, atherogenic index of plasma, and cardiometabolic risk index, vitamin D correlated more closely with HDL, total cholesterol, and Triglyceride-Cholesterol Body Index. Findings indicate that vitamin D may influence cardiometabolic profiles through mechanisms that are at least partially independent of adiposity. Despite the lack of direct correlations, the divergent associations observed in PCA suggest possible interaction effects between BMI and vitamin D. Further longitudinal studies are needed to evaluate vitamin D's role as a context-dependent modulator of metabolic risk.