Expressed emotion and panic-fear in the prediction of diet treatment compliance.

The 'expressed emotion' (EE) of the key relatives of 30 severely obese patients was assessed on intake to a calorie-restricted diet programme. At the same time the patients and 30 matched controls were administered the MMPI 'panic-fear' scale. After five months on the diet the weight of the patients was measured, and weight loss or gain in the five-month period was used as an indicator of compliance or non-compliance with the treatment. The results indicated that the obese patients showed more anxiety (measured by the panic-fear scale) than did the control subjects. Compliant patients had lower panic-fear scores than did non-compliant patients, and patients living with a high EE relative were much less likely to comply with treatment than were those living with a low EE relative. Patients with a high EE relative were more likely to have a high panic-fear score. The results suggest that dietary treatments for obesity need to be accompanied by both individual and family behavioural interventions.