Psychological Issues Associated With Obesity

What is Psychological Issues Associated With Obesity?

Obesity is a medical condition where a person has too much body fat. It usually happens when the amount of calories eaten is more than the energy used up by the body. To identify obesity, health professionals use the Body Mass Index (BMI). Anyone with a BMI of 30 kg/m2 or more is considered obese. Obesity is a major health issue around the world because it can lead to diseases like diabetes, high blood pressure, heart disease, and cancer. Factors such as genetics, environment, biology, and behaviors can contribute to obesity.

In 2022, obesity was a global problem, with 1 in 8 people around the world being obese. Since 1990, the number of adults with obesity has more than doubled, and the number of obese children and teens has quadrupled. In 2022, around 2.5 billion adults over the age of 18 were overweight, and about 890 million of them were obese. This means 43% of adults were overweight and 16% were obese. The situation for children is also worrying. In 2022, 37 million children under the age of 5 were overweight, and among children and teenagers aged 5 to 19, over 390 million were overweight, including 160 million who were obese.

Despite the global increase in obesity, people struggling with this condition often feel judged and discriminated against. This can lead to many psychological problems such as low self-esteem, a negative body image, dissatisfaction with their appearance, and a negative view of themselves. This social pressure can make people feel isolated, sad, and anxious, increasing the likelihood of mental health issues like depression and anxiety. It can also lead to unhealthy eating habits as individuals try to cope with emotional stress or societal pressures. Obesity can cause and be caused by stress because people have to deal with health problems, social norms, and personal goals, leading to chronic stress and emotional upheaval. Fear of social judgment can often lead to withdrawal from social activities, creating a cycle of isolation and despair. Furthermore, the negative views of obesity can lead to discrimination in different areas of life, damaging mental well-being and reducing the overall quality of life.

What Causes Psychological Issues Associated With Obesity?

The mental effects of obesity are a result of a mix of biological, psychological, and social factors.

Biological Factors

Our genes can shape our physical and mental health, including making us more susceptible to obesity and related mental health conditions. Patterns in obesity can interrupt the balance of certain hormones related to hunger, satisfaction from food, and stress. This can lead to stress, anxiety, and depression. Moreover, obesity is linked to chronic low-level inflammation, which can influence the brain and increase the risk of depression. Also, Insulin resistance, another issue from obesity, can affect mood and thinking. Research also points out that obesity can alter the structure and activity of the brain, particularly in areas connected to handling emotions, reward processing, and decision-making, potentially resulting in mental disorders. Changes in gut bacteria due to obesity can also influence the production of neurotransmitters and behavior.

Psychological Factors

Emotional and behavioral factors deeply connect with the psychological effects of obesity. Emotional stress pushes people toward food as a coping mechanism, leading to a vicious cycle of emotional eating and weight gain. The stigma surrounding obesity can lead to feelings of guilt, social isolation, low self-esteem, body dissatisfaction, and consequent mental health problems. Social isolation can worsen these problems as it can diminish social support and increase feelings of loneliness, making it challenging to adopt healthier habits or seek help. Societal pressure around body image can lead to a negative self-image, low self-esteem and even contribute to mood disorders, anxiety, and eating disorders. Childhood experiences and trauma can also affect long-term weight by shaping eating behaviors and self-esteem.

Social Factors

The societal reasons for the psychological effects of obesity include factors like differences in obesity levels in different geographical areas, the availability and quality of food, and neighborhood walkability. This means that the area you live in can affect your physical activity levels and weight. The socioeconomic status of a neighborhood as well as the crime and safety perceptions can influence physical activity and eating choices, which adds to the obesity problem. Discrimination in healthcare, employment and social interactions towards people with obesity can increase stress and worsen the mental impact of obesity. Society’s stigma against obesity can also discourage individuals from seeking medical care or participating in physical activities, leading to a vicious cycle of adverse mental effects and unhealthy behaviors.

In summary, all these biological, psychological, and social factors contribute to creating a cycle that amplifies the psychological effects of obesity.

Risk Factors and Frequency for Psychological Issues Associated With Obesity

Obesity and mental health issues, like mood disorders including depression, are tightly linked. This link is evident worldwide and is more significant in women compared to men. It’s worth noting that the connection is complex and can work in both ways – depression can lead to obesity and vice versa. Factors like age and gender can also impact the relationship between the two. Below are some key points drawn from various studies:

• People with obesity have an 18% to 55% higher chance of developing depression. Similarly, the likelihood of becoming obese for people already suffering from depression increases by 37% to 58%.
• An Austrian study found that, among people who are overweight or obese, two in five are diagnosed with a psychiatric disorder. These disorders often include mood disorders, anxiety, eating disorders, and psychosis spectrum disorders.
• Between 2010 and 2021, there was a substantial increase in the global burden of both obesity and mood disorders. In particular, the rate of anxiety disorders and depressive disorders increased by 16.7% and 16.4% respectively. At the same time, there was a 25.9% increase, globally, in the rates of diabetes related to obesity and specifically type 2 diabetes.
• In the USA, the link between obesity and mood disorders is more robust amongst younger people, non-Hispanic white people, and those with a higher educational level.
• Some studies have found that depression can lead to obesity, specifically atypical depression. In contrast, other studies revealed that obesity can cause depression. However, the effects of having both obesity and depression vary with factors like the type of depression, age, and gender impacting the relationship.

Signs and Symptoms of Psychological Issues Associated With Obesity

When assessing people who are overweight, it is important to understand the potential psychological impacts. Healthcare professionals should gather a complete range of information, which includes:

• Medical history
• Psychiatric history
• Weight history
• Diet and nutrition history
• Physical activity
• Sleeping habits and patterns
• Social background and lifestyle

Moreover, healthcare providers should conduct a thorough physical examination which should involve:

• Calculation of Body Mass Index (BMI)
• Measurement of weight circumference
• Observation of body shape and structure
• Checking of vital signs like heart rate and blood pressure
• Evaluation of mental status

Testing for Psychological Issues Associated With Obesity

Assessing the psychological impacts of obesity requires a comprehensive approach that looks at both mental and physical aspects of obesity.

To identify obesity, a standard tool is often used, such as the body mass index (BMI) measurement. This calculation includes a person’s weight in kilograms divided by their height in meters squared.

The assessment typically begins with an in-depth interview. This includes questions about the patient’s weight history, their eating and exercise patterns, and their previous weight loss attempts. An important part of this interview is talking about emotional and psychological well-being, particularly any worries about their body image or experiences of weight-related bullying or discrimination.

People’s weight is influenced by many factors. These can be biological, psychological, or linked to social or cultural backgrounds.

The process of assessing a patient can include:

– Discussing medical history and doing a physical exam: This helps to understand if medical conditions or medications could be causing weight gain. The physical exam can flag health issues that might be longer-term effects of obesity, like high blood pressure or joint problems.
– Looking at food and nutrition: This part of the assessment takes a deep dive into the person’s eating habits, what they eat, their eating patterns, and any food-related issues. It helps to understand if the person might be eating too much or too little of certain nutrients.
– Discussing physical activity: Looking at how physically active the person is can help identify any issues. For instance, not getting enough exercise is a common contributor to obesity.
– Talking about psychological and emotional aspects: This involves exploring the person’s mental relationship with food, eating behaviors, and body image. It often involves looking for signs of depression, anxiety, or other mental health issues, which could contribute to overeating or other unhealthy eating patterns.
– Understanding social and environmental aspects: This involves understanding the person’s living situation, cultural factors, socio-economic status, and access to healthy eating and exercise opportunities. These factors can greatly influence a person’s ability to maintain a healthy weight.
– Discussing behavior and coping mechanisms: This explores how the person deals with stress and what behaviors they have around food.
– Motivation and readiness for change: Examining the person’s willingness and readiness to make lifestyle changes is important. It involves talking about the person’s goals and any obstacles that they see in making healthier lifestyle changes.
– Identifying support and resources: This involves making a list of support systems and resources that the person can use to help make and maintain lifestyle changes. These could include family support, healthcare professionals, and mental health services.
– Creating an action plan and setting goals: Creating a treatment plan with the person helps to address their needs, preferences, and goals. The treatment plan may include changes to diet, increased exercise, psychological therapy, or medical treatments.
– Having follow-up appointments: Making regular appointments to track progress, provide ongoing support, and adjust the treatment plan based on changes or new circumstances.

Additionally, understanding the patient’s psychological history is crucial. This can involve looking into past or current signs of depression, anxiety, eating disorders, mood swings, or other mental health issues. Using set mental health screening tools can help identify symptoms of common psychological conditions that are often linked with obesity.

Checking the impact of obesity on the patient’s quality of life can provide further insights. One common tool used to measure this is the Impact of Weight on Quality of Life-Lite (IWQOL-Lite) questionnaire.

Additional lab tests like blood tests, thyroid function tests, and tests for electrolytes and vitamins can help rule out physical causes of obesity and psychological symptoms.

Treatment Options for Psychological Issues Associated With Obesity

There are many treatment options for people struggling with both obesity and mental health issues. The best results usually come from using a combination of these treatments.

Maintaining a healthy diet and regular exercise routine is vital. It’s not only beneficial for physical health but also for mental well-being. This lifestyle should be adopted in conjunction with any other recommended treatments.

There are several psychological therapies available. These include motivational interviewing, cognitive behavior therapy, dialectical behavior therapy, and interpersonal psychotherapy. Mindfulness-based therapies have also gained popularity. They focus on managing stress, negative thoughts, and eating behaviors. When combined with a healthy diet and regular exercise, these behavioral interventions can achieve positive results.

Various medications can be prescribed for obesity and mental health conditions. The Food and Drug Administration (FDA) has approved several drugs for treating obesity, including phentermine, orlistat, liraglutide, semaglutide, diethylpropion, phentermine/topiramate, naltrexone/bupropion, setmelanotide, and phendimetrazine. For depression and anxiety, medications like Selective Serotonin Reuptake Inhibitors (SSRIs), Serotonin/norepinephrine reuptake inhibitors (SNRIs), Atypical antidepressants, Serotonin-Dopamine Activity Modulators (SDAMs), Tricyclic Antidepressants (TCAs), and Monoamine Oxidase Inhibitors (MAOIs) may be used.

A newer technique called repetitive Transcranial Magnetic Stimulation (rTMS) involves using a magnetic coil to stimulate specific areas of the brain directly. Targeting the dorsolateral prefrontal cortex (DLPFC) with rTMS has been found to be effective in reducing food intake and aiding weight loss, as well as treating treatment-resistant depression.

Bariatric surgery is another option for people who are severely obese, have tried other weight loss methods without success, have obesity-related health conditions, and are ready and able to make significant lifestyle changes after surgery.

Before having weight loss surgery, an obese person will need a psychological evaluation to determine if they’re mentally prepared for the procedure and the lifestyle changes that follow. This evaluation involves a clinical interview, discussing their reasons for wanting the surgery, their understanding of what it entails, their dieting history, and their support system, amongst other things. They may also undergo psychological testing. This comprehensive evaluation is vital in ensuring the individual is mentally prepared for the major physical and behavioral changes necessary for long-term weight loss success following surgery.

What else can Psychological Issues Associated With Obesity be?

Obesity can sometimes be associated with mental health issues, which can take various forms. When a person who is obese is assessed for mental health, several possible conditions need to be considered:

1. If a person is feeling depressed, they could be dealing with major depression, consistent low-grade depression (known as dysthymia), bipolar disorder, an emotional reaction to changes in their life, or they could be dealing with grief or loss.

2. Signs of anxiety could be caused by several conditions, such as generalized anxiety disorder, panic disorder, social anxiety disorder, specific phobias, obsessive-compulsive disorder, or post-traumatic stress disorder (PTSD).

3. Eating disorders could include binge eating disorder, bulimia, avoidant/restrictive food intake disorder (where a person avoids certain foods or eats very little), other specified feeding or eating disorders, or issues like rumination disorder or pica (where non-food materials are eaten).

4. If someone is overly concerned about their appearance, they could be dealing with obsessive-compulsive disorder, social anxiety disorder, gender dysphoria, imagining physical defects that aren’t there (a delusional disorder), or they could be experiencing symptoms of certain psychotic disorders.

5. Low self-esteem and poor body image could be symptoms of adjustment disorder with both anxiety and depression, social anxiety disorder, body dysmorphic disorder, or personality disorders where people avoid social situations or have an inflated self-importance.

6. Difficulty in dealing with stress and coping could be due to adjustment disorders, post-traumatic stress disorder, generalized anxiety disorder, depression, or they might be focusing excessively on physical symptoms or health concerns.

7. Impulsive behavior might be caused by binge eating disorder, sudden explosive anger, compulsive buying, kleptomania, or gambling disorder.

8. Issues with substance use could be due to alcohol use disorder, or addictions to stimulants, opioids, or even some weight management medications, such as appetite suppressants.

9. Problems with cognitive functioning and executive skills might be due to attention-deficit/hyperactivity disorder (ADHD), mild cognitive impairment, or cognitive disorders due to conditions like an underactive thyroid or diseases that cause the brain to deteriorate.

10. Sleep issues could be due to conditions like obstructive sleep apnea, insomnia, excessive sleepiness, or disorders related to the timing of sleep.

11. Those who have experienced trauma might be dealing with PTSD, adjustment disorders, acute stress disorder, other types of anxiety disorders, or depression.

In order to figure out the specific mental health issue someone might be dealing with, a full assessment should be carried out. Treatment plans should also be tailored to suit the individual’s needs. This might require help from a team of health professionals such as mental health specialists, doctors, dietitians, and others. This would allow for dealing with the complex connection between obesity and mental health effectively.

What to expect with Psychological Issues Associated With Obesity

Being overweight can have serious psychological impacts which can affect a person’s overall health. However, many people see improvements in their mental well-being when they receive the right treatment and support.

The outlook for those struggling with the psychological effects of obesity depends on several factors. These include how severe the symptoms are, how easily the person can access treatment, and how effective the treatments are at addressing both physical and mental health issues. It’s important to quickly identify and manage any psychological distress in people who are overweight. Doing so can enhance their long-term health and improve their overall outlook.

Possible Complications When Diagnosed with Psychological Issues Associated With Obesity

Obesity-related psychological issues can lead to multiple complications that affect the mental and physical health, eventually causing a decline in total well-being. Some of these complications may include:

• Worsening mental health conditions: Issues like depression, anxiety, and low self-esteem can worsen an existing mental health condition or cause new ones. In some cases, the stigma and discrimination linked to obesity can lead to increased social anxiety or body image worries.
• Poor treatment adherence: People with obesity along with psychological issues might find it hard to stick to the recommended lifestyle changes or medical treatments. This can lead to worse health outcomes and increased chances of complications.
• Increased risk of eating disorders: Psychological conditions like binge eating disorder or emotional eating can worsen or develop in individuals with obesity, leading to unhealthy eating patterns that contribute to weight gain and health issues.
• Social isolation and relationship difficulties: The stigma related to obesity and body image worries can hinder social relationships, causing feelings of isolation, loneliness, and communication difficulties.
• Reduced quality of life: Psychological issues linked to obesity can significantly decrease quality of life, affecting physical functioning, emotional well-being, social relationships, and overall life satisfaction.
• Increased risk of substance use: Some people may turn to substances like alcohol or drugs to cope with the psychological distress related to obesity, leading to an increased risk of substance abuse disorders.
• Impaired coping skills and stress management: Psychological problems can hinder an individual’s ability to manage stress effectively, leading to unhealthy coping strategies such as emotional eating, boosting weight gain, and psychological distress.
• Sleep disturbances: Obesity along with psychological issues like anxiety or depression can increase the risk of sleep issues like insomnia or obstructive sleep apnea, worsening mental health, and heightening obesity-related health issues.
• Chronic health conditions: Psychological issues linked to obesity can worsen or cause the development of chronic health conditions like cardiovascular disease, diabetes, hypertension, and metabolic syndrome, further compromising overall health and well-being.
• Increased mortality risk: Obesity alongside psychological issues can increase the risk of premature mortality, underscoring the importance of addressing both physical and mental health issues in this group.