Obesity, Psychiatric Status, and Psychiatric Medications

Children's Hospital of Philadelphia, and Center for Weight and Eating Disorders, Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, 3535 Market Street, Suite 3029, Philadelphia, PA 19104, USA.
The Psychiatric clinics of North America (Impact Factor: 1.87). 12/2011; 34(4):747-64. DOI: 10.1016/j.psc.2011.08.007
Source: PubMed


This article has shown that obesity is related to several psychiatric disorders, the most thoroughly researched of which is depression. In both community and clinical populations, the observed relationship is more consistent in women than in men, and is stronger in more severely obese individuals. The presence of BED also is associated with elevated risk of additional psychopathology. Longitudinal research provides evidence to support a pathway from obesity to depression, as well as one from depression to obesity. Weight loss, particularly with nonpharmacologic methods, appears to have favorable group-level effects on mood, but may be associated with adverse outcomes for some individuals. Persons who require antipsychotic medications are at risk for weight gain and metabolic abnormalities, and their management should be informed by consensus guidelines.

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    • "We found that mood disorders are directly associated with high BMI (Fig 1A). Relationship between obesity and mood disorders is by far the most studied in the literature[11,14151617181920, and the majority of studies have focused on depression23412,13,21222324 . Our findings are concordant with previous studies since there is enough evidence to accept that mood disorders are directly associated with obesity. "
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    ABSTRACT: Background: Mental and body weight disorders are among the major global health challenges, and their comorbidity may play an important role in treatment and prevention of both pathologies. A growing number of studies have examined the relationship between psychiatric status and body weight, but our knowledge is still limited. Objective: The present study aims to investigate the cross-sectional relationships of psychiatric status and body mass index (BMI) in Málaga, a Mediterranean city in the South of Spain. Materials and methods: A total of 563 participants were recruited from those who came to his primary care physician, using a systematic random sampling, non-proportional stratified by BMI categories. Structured clinical interviews were used to assess current Axes-I and II mental disorders according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR). BMI was calculated as weight (Kg) divided by square of height in meters (m2). Logistic regression was used to investigate the association between BMI and the presence of any mental disorder. BMI was introduced in the models using restricted cubic splines. Results: We found that high BMI values were directly associated with mood and adjustment disorders, and low BMI values were directly associated with avoidant and dependent personality disorders (PDs). We observed an inverse relationship between low BMI values and cluster A PDs. There were not significant relationships between anxiety or substance-related disorders and BMI. Conclusion: Psychiatric status and BMI are related in a Mediterranean Spanish population. A multidisciplinary approach to both pathologies becomes increasingly more necessary.
    Full-text · Article · Dec 2015 · PLoS ONE
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    • "For instance, depression has been suggested to be a moderator of impulsivity toward immediate palatable food reward in overweight/obese individuals (Privitera, McGrath, Windus, & Doraiswamy, 2015), thereby saliency attribution to food might be modulated by psychopathological factors. However, most obese people do not show clear psychopathological condition related to behavioral disinhibition, such as binge eating disorder or depression , and obesity is not classified as a mental disorder (Berkowitz & Fabricatore, 2011;Carpiniello et al., 2009;Fabricatore, Wadden, Sarwer, & Faith, 2005;Malik, Mitchell, Engel, Crosby, & Wonderlich, 2014). An alternative explanation may lay in the repeated stimulation of the reward system induced by prolonged exposure to the rewarding stimulus (i.e., food), which would lead to maladaptive stimulus-reward associations. "
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    ABSTRACT: Obesity is a medical condition frequently associated with psychopathological symptoms and neurocognitive and/or personality traits related to impulsivity. Impulsivity during intertemporal choices seems to be typical of obese individuals. However, so far, the specific relationship between different types of reward and neuropsychological and psychopathological profile are yet to be unravelled. Here, we investigated impulsive choice for primary and secondary reward in obese individuals and normal-weight controls with comparable neuropsychological and psychopathological status. Participants performed three intertemporal choice tasks involving food, money, and discount voucher, respectively. Moreover, they completed a battery of neuropsychological tests and psychometric questionnaires assessing psychopathological state, impulsivity, and personality traits. Obese individuals showed increased preference for immediate food reward compared with controls, whereas no group difference emerged concerning money and discount voucher. Moreover, the higher the body mass index (BMI), the steeper the food discounting. These findings emerged in light of comparable neuropsychological and psychopathological profile between groups. Steeper food discounting in obese individuals appears to be related to BMI but not to psychopathological and neuropsychological profile. We suggest using intertemporal choice in the clinical practice as measure of the effectiveness of different types of intervention (e.g., educational, psychological, pharmacological or surgical) aimed at reducing impulsivity toward food and increasing cognitive control during food intake in obese individuals.
    Full-text · Article · Oct 2015 · Brain and Cognition
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    • "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). Moreover binge eating disorder (BED) is typically connected with obesity (American Psychiatric Association, 2000; Hill, 2005; Berkowitz and Fabricatore, 2011; Gearhardt et al., 2011c; Wilson, 2011; Schag et al., 2013; Faulconbridge and Bechtel, 2014), even if not occurring exclusively in conjunction with overweight conditions . According to Hill (2005, p. 27), " it is apparent that BED is more common in the obese than in normal-weight individuals. "
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    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.
    Full-text · Article · Jun 2014 · Frontiers in Psychology
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