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Obesity and Mental Health – Complicated and Complex



To round up my posts on the obesity articles of the January issue of the Canadian Journal of Psychiatry, I would like to briefly highlight some of my comments published in an editorial I wrote for this issue.

Reader will by now be familiar of the many links between obesity and mental health problems. With regard to this relationship, I write:

“Thus, while it is not complicated to appreciate the fact that mental health is an important determinant of body weight, it is also important to recognize that this relationship is complex.

While the links between mental illness and weight gain can be as simple as the induction of ‘hedonic hyperphagia’ with the use of ‘atypical’ antipsychotics, they can be as complex as the link between early childhood trauma and binge eating disorder or the recurrence of addictions following bariatric surgery.”

I conclude with what I have said often enough:

“It is therefore of considerable importance that mental health practitioners familiarize themselves with the complexity of obesity and its management whilst, by the same notion, anyone attempting to manage obesity requires at least basic competencies in the art and science of assessing mental health.

Indeed, nowhere are mental and physical health closer related to one another than in the context of the mental health and obesity epidemics – close enough perhaps to consider them close cousins, if not siblings. While reducing the burden of mental health on Canadians may well go a long way in improving their physical health, reducing the burden of obesity on Canadians without also addressing their often underlying mental health problems will prove virtually impossible.”

I do hope that this issue of the Canadian Journal of Psychiatry, will draw more attention to this relationship and will hopefully receive feedback on this from my readers and colleagues.

AMS
Edmonton, Alberta

p.s. Readers in Edmonton may be interested in attending a CIHR Café Scientifique: Is Canada ignoring obesity in men? Wednesday, February 15, 2012, 5:00 p.m. to 7:00 p.m. Edmonton City Hall (Hosted by the CIHR Institute of Gender and Health and the Canadian Obesity Network).

5 Comments

  1. You say that anyone managing obesity needs basic competencies in assessing mental health.

    What about the cost-control programs that move obesity management to the personnel with the lowest possible level of professional training.

    In the medical clinic here, weight control to treat obesity is relegated to LPN’s who just weigh the patients and admonish them to eat right, and record in a chart that the patients weight has been monitored and counselling has been provided.

    I think giving routine work to people who do it well makes sense, and I think a good LPN can vastly improve the quality of life when they’re providing personal care for a patient.

    But, treating obesity is not routine work,
    and I doubt the licensed practical nurse or equivalent qualification includes training to assess the mental health conditions you talk about.

    By the way , I think this goes for other medical problems as well. Serious problems go unaddressed because symptoms are treated by people who are doing their best but don’t have the training to diagnose the underlying cause.

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  2. I cannot speak for the system in Canada, but in the U.S., seeking adequate treatment for serious mental health disorders can quickly bankrupt a family, even when there is supposedly “good” medical insurance coverage. It is peculiar and note worthy, from a critical and/or scientific standpoint, that “mental health” is viewed (in my culture) as a separate category from most other forms of medical care (as is, incidentally, dental or oral health, and even many kinds of vision or hearing-related health issues). Except for ear, nose, and throat medicine (and diagnoses such as brain cancer and head injuries), the head region–which of course contains our brains, eyes, ears and mouths–is often medically insured and medically treated in a strangely separate sphere of health care reality.

    On a separate note, this has been an interesting series, especially for someone like myself (with an RN background) who has lost a significant amount of weight (without bariatric treatment) and has discovered a whole world of “mental health issues” I could never have anticipated. My problems are far more driven by cultural biases and social values (especially a lack of useful social supports for differently-abled people) than by any intrinsic physical “illnesses” that require (or would benefit from) medicalization–in other words, my new reality is profoundly strange and jolting: something like gradually realizing one requires a wheel chair in a world where no ramps or elevators exist.

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  3. I think part of the mental health issue is how obese people are treated…shunned because of their size, made fun of by people around them, and criticized for how they eat. My daughter and I were sitting in a restaurant eating our lunch when I noticed a women sitting a few tables over making fun of us and giving us dirtly looks. I wanted to walk over to her to ask her what her problem was, instead I gave her a dirty look. My daughter is 350lbs and I am 300lbs. This skinny looking thing was pointing us out to her friends at her table and they all started to stare. My daughter started to cry and I threw my napkin down on the table. We decided to leave and as I walked by her table she said I should thank her for ruining my appetite, now maybe I will start to do something about my weight and stop eating. To me this is mental cruelty. This was a total stranger. My daughter and I discussed what was bringing attention to us and all we could think about was that we were fat. We have very good table manners and we dont gulp our food down. We eat slowly and politely.

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  4. Hi Jessica,

    off course its a mental health issue.Don’t take those people comments into your mind..

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