Obesity: Is it a Mental Disorder?

Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania 15213, USA.
International Journal of Eating Disorders (Impact Factor: 3.13). 01/2014; 42(8):739-53. DOI: 10.1002/eat.20725
Source: PubMed


Using Wakefield's conceptualization of mental disorder as "harmful mental dysfunction" (Wakefield, Am Psychol, 47, 373-388, 1992), we examined the evidence for including obesity as a mental disorder in DSM-V.
We searched computer databases and examined reference lists from review articles published in the last 10 years to identify empirical papers relevant to the present review.
Obesity is a condition of heterogeneous etiology that is harmful for most individuals. However, there is scant evidence that obesity, in general, is caused by mental dysfunction. Although recent work examining the neurocircuitry of energy balance has suggested that mental dysfunction may be involved in the etiology of specific obesity phenotypes, findings are too preliminary to support classification of obesity as a mental disorder. Nevertheless, there is evidence that obesity is related to mental disorder and many of the medications used to treat psychiatric illness.
There is little evidence for including obesity as a mental disorder in DSM-V. However, results confirm the importance of monitoring adiposity routinely among patients with psychiatric illness.

Download full-text


Available from: Jennifer E Wildes,
1 Follower
44 Reads
  • Source
    • "Such conditions include not only type 2 diabetes, but also cardiovascular diseases, hypertension, dyslipidemia, hypercholesterolemia, cancer, and various psychosocial and psychopathological disorders (Wadden et al., 2002; Byrne et al., 2004; Flegal et al., 2005; Whitlock et al., 2009; Castelnuovo et al., 2014). The etiology of obesity is universally recognized as multifactorial with a complex interaction between genetic, behavioral and environmental factors (Marcus and Wildes, 2009). Genetics plays an important role, but behavioral factors, such as dysfunctional eating habits and low levels physical activity, are among the main modifiable and proximal causes strictly connected to "
    [Show abstract] [Hide abstract]
    ABSTRACT: Obesity and being overweight could be real chronic conditions above all if there are other complications such as type 2 diabetes, cardiovascular diseases, hypertension, dyslipidemia, hypercholesterolemia, cancer, and various psychosocial and psychopathological disorders. Due to the multifactorial etiology of obesity, evidence-based interventions to improve weight loss, maintain a healthy weight, and reduce related comorbidities combine different treatment approaches: dietetic, nutritional, physical, behavioral, psychological, and, in some situations, pharmacological and surgical. There are significant limitations in this multidisciplinary chronic care management of obesity, most notably those regarding costs and long-term adherence and efficacy. Programs including eHealth platforms and new technologies could overcome limitations connected to the traditional in-patient chronic care management of obesity, thus providing promising opportunities in enhancing weight reduction and reducing complications in terms of long-term efficacy and effectiveness across clinical, organizational, and economic perspectives.
    Frontiers in Psychology 10/2015; 6. DOI:10.3389/fpsyg.2015.01557 · 2.80 Impact Factor
  • Source
    • "Our study also shows that obesity in young Lebanese university students was not associated with having PD symptoms. In fact, it is well known that mental health risks increase considerably among the obese (Marcus & Wildes, 2009), particularly the severe cases (class III) (Onyike, Crum, Lee, Lyketsos, & Eaton, 2003). Knowing that, the inadequate number of severe cases of obesity (class I: 91 students ~ 2.7%; class II: 15 students ~ .4%; "
    [Show abstract] [Hide abstract]
    ABSTRACT: Studies investigating the association between body mass index (BMI) and psychological distress (PD) have shown contradictory results. The present study examined the relationship between BMI and PD among Lebanese university students and tested its moderation by gender. A cross-sectional study was conducted using a proportionate cluster sampling of university students. Data concerning socio-demographic characteristics, body weight and height, tobacco consumption, physical activity, presence of chronic diseases and self-rated global health were collected. PD was assessed using Beirut Distress Scale (BDS-22). Students were classified as underweight (BMI <18.5 kg/m2), normal weight (BMI 18.5–24.9 kg/m2), overweight (BMI 25– 29.9 kg/m2) and obese (BMI >30 kg/m2). The association between BMI and BDS-22 differed by gender (p-value for interaction: .02). Being overweight was inversely associated with BDS-22 for females only (adjusted OR .5, 95% CI: .4–.8, p-value .02). Neither obesity nor underweight was associated with PD for both genders.
    International journal of adolescence and youth 09/2015;
  • Source
    • "Recent studies have underlined the role of the neural reward system in the development and maintenance of obesity: " dysfunction of brain reward circuitry in response to food cues may predispose some individuals to obesity via an increased likelihood of overeating, particularly excessive consumption of palatable foods " (p. 744, Marcus and Wildes, 2009). Thus some kinds of obesity may be considered an expression of food " addiction, " problem that typically requires a long-term treatment (Wang et al., 2001, 2002, 2004, 2009; Gearhardt et al., 2009, 2011a,b,c,d, 2012, 2013; Gearhardt and Corbin, 2011; Gearhardt and Brownell, 2013). "
    [Show abstract] [Hide abstract]
    ABSTRACT: Obesity is currently an important public health problem of epidemic proportions (globesity). Inpatient rehabilitation interventions that aim at improving weight-loss, reducing obesity-related complications and changing dysfunctional behaviors, should ideally be carried out in a multidisciplinary context with a clinical team composed of psychologists, dieticians, psychiatrists, endocrinologists, nutritionists, physiotherapists, etc. Long-term outpatient multidisciplinary treatments are likely to constitute an essential aspect of rehabilitation. Internet-based technologies can improve long-term obesity rehabilitation within a collaborative approach by enhancing the steps specified by psychological and medical treatment protocols. These outcomes may be augmented further by the mHealth approach, through creating new treatment delivery methods to increase compliance and engagement. mHealth (m-health, mobile health) can be defined as the practice of medicine and public health, supported by mobile communication devices for health services and information. mHealth applications which can be implemented in weight loss protocols and obesity rehabilitation are discussed, taking into account future research directions in this promising area.
    Frontiers in Psychology 06/2014; 5:559. DOI:10.3389/fpsyg.2014.00559 · 2.80 Impact Factor
Show more