Patients are often pushed over the edge by the disdain of society for overweight people and the taunts they receive for not reaching their goals quickly enough. The treatment outcomes are poor. Doctors argue that obesity treatment must be multidisciplinary, with mental health specialists included in the therapy protocol.
It is comforting to continue your old lifestyle habits, even though you know they are harmful. You’re not appreciated by the world for your small efforts. Sounds familiar. This is because the battle against obesity can only be won if it starts in the mind.
Studies conducted around the world have revealed that obesity has a direct link to a substantial psychosocial burden. Obese people struggle with their mood, body image, self-esteem, and quality of life. The pressure from societal disdain and the ridicule they receive for not reaching their goals quickly enough can push patients to the brink. Emotional distress is a major factor in poor treatment outcomes. Mental health professionals are now included in the treatment protocols for obesity.
Why is obesity of particular concern to Indians, and why should it be addressed immediately?
The risk of obesity is increased for a variety of life-threatening diseases, such as diabetes, heart disease, and certain cancers. It is caused by a complex interaction between hormonal and inflammatory reactions. “Obesity has been strongly linked with various chronic conditions, including heart disease and type 2 diabetes.” It is also associated with high blood pressure, strokes, some types of cancer, and respiratory problems. These conditions can reduce the length and quality of life”, says Dr. Sharad, Consultant, Robotic and Laparoscopic GI, and Bariatric Surgeon, Fortis Hiranandani Hospital, Mumbai.
What mental conditions are associated with obesity?
In fact, the “obesity crisis” and the necessity to adhere to strict diets have widened the two poles to the point that the chances of developing an eating disorder have increased. Some experts believe that weight loss diets may be more dangerous than beneficial because they take longer to achieve the desired results and the brain cannot cope with the delay. Patients often give up halfway and suffer from anxiety, low self-esteem, and issues with body image. “People who have larger bodies are more likely than others to be bullied and stigmatized.” Uncertainty surrounds the reasons why people with larger bodies are more likely to suffer anxiety. It is possible that anxiety is due to weight discrimination. There are also secondary problems, such as sleep apnea. This is common in patients with neuropsychiatric disorders,” explains Dr. Santosh Bangar, senior consultant psychiatrist at Global Hospitals, Mumbai.
Lethargy can be a result of a reduced level of physical activity. Sedentary living may also be linked to laziness. These factors can affect overall mental health and quality of life. “Obesity can affect all aspects of healthy lifestyles and limit participation in various activities. It also impacts relationships and decreases overall satisfaction in life,” Dr. Sharma says.
He warns against atypical anorexia, which is when anorexia occurs but the person is not underweight. It is also often misdiagnosed. Anorexia is associated with a high risk of metabolic disturbance, anxiety, depression, and suicide. He says that parents’ ignorance and lack of awareness about obesity can lead to them being unable to guide their kids and sometimes even increase mental anxiety.
Dr. Aparna Govil Bhasker is a consultant bariatric surgeon and laparoscopic surgeon at Saifee Hospital. She advocates for a change in family behavior and the involvement of parents and children to combat child obesity. Children with obesity are often neglected and poorly treated by their families. This can cause increased stress, which in turn leads to emotional eating, fatigue, and poor sleep, leading to further weight gain.
Is a weight-loss program better if it involves a psychiatrist?
Some studies have found that individuals who lose weight may experience the return of psychopathology they already had or develop new psychosocial problems. Weight gainers, regardless of how they lost weight, are at risk of re-developing unwanted psychological symptoms. This is why Dr. Bangar advocates a holistic treatment for obesity. A typical team in such a treatment line includes a nutritionist and endocrinologist, as well as a behavioral counselor and psychiatrist. Cognitive behavioral therapy is the cornerstone for psychological issues related to obesity and its emotional consequences. “A psychiatrist may be needed to treat comorbid disorders like clinical depression or body dysmorphic disorder, says Dr. Bangar.
Why is intensive behavioral therapy recommended for obesity?
Johns Hopkins Medicine says intensive behavioral therapy is goal-oriented, and it helps obese patients overcome the difficult phase of losing weight before other treatments can take effect. The intervention protocol states that it “targets poor habits that lead to obesity”. This may include eating unhealthy foods and not exercising. Treatment involves interventions that fix bad habits. A therapist will be working closely with you. You can work with a therapist one-on-one or in a small group. You will learn to alter your lifestyle in order to lose weight. You may learn to:
- Track your food.
- Avoid overeating by changing your environment.
- Increase your level of activity.
- Exercise plan
- Realistic goals are important.
- You may lose weight by making these changes. It is also possible to maintain weight loss. Some aspects of behavioral therapy are similar to those found in other weight-loss programs. Self-help groups are included.