Obesity and psychiatric disorders have a bi-directional relationship. Persons with mental illness are at a higher risk of developing obesity and vice-versa.
The quality of life in patients with both psychiatric disorders and obesity can be compromised.
psychological issues
Although there does not appear to be an increased association of severe psychopathology among obese patients, there are several psychological issues that should be looked for and explored if necessary.
A body mass index (BMI) over 25 is considered overweight, over 30 is obese and over 40 is morbidly obese. In India, obesity is prevalent in about 40.3% of estimated adults in the age bracket of 18 to 80 years. Southern India (46.51%) shows the highest prevalence of obesity, while it is lowest in Eastern India (32.96%).
prevelence increasing faster
Prevalence of overweight issues and obesity in India is increasing faster than the world average. Umpteen research studies have shown that obese people have an at least 55% chance of developing various mental health disorders such as major depression, bipolar disorder, anxiety disorder, panic disorder, eating disorder, and body image issues besides obesity-related physical ailments such as cardio-vascular diseases, coronary artery diseases, hypertension, diabetes, fatty liver disease, gastrointestinal cancers, stroke, osteoarthritis and obstructive sleep apnoea . The younger people are worse affected.
The hypothalamus area of the brain produces two hormones, leptin and ghrelin. While leptin is associated with satiety, ghrelin is associated with hunger. In obese people, the secretion of leptin decreases while the secretion of ghrelin increases. The imbalance in the level of these two hormones releases the stress hormone cortisol, which is also associated with stress or binge eating disorder.
gene pool
Obesity shares a gene pool with disorders such as bipolar mood disorder, anxiety disorder, hypertension, stroke and diabetes. People with bipolar disorder have higher chances of developing obesity and vice-versa.
Obese people have a higher risk of developing various mental health disorders along with other cardio-vascular diseases and stroke.This happens mainly through hormonal and neuro-chemical imbalance. However, a little modification in lifestyle can go a long way in addressing these issues and reducing dependency on medicines.
Depression is the most common mental ailment due to obesity, accounting for more than half the cases of mental ailments associated with obesity. In people with depression, there is hypo activity in the pre-frontal cortex – the part of the brain that is responsible for inhibiting the impulses. This happens due to decreased blood flow and reduced oxygen uptake. As a result, people with depression cannot control their impulses when it comes to eating.
It is to be noted that society and the environment favour non-obese people. Their confidence and energy levels are higher and they also tend to display better leadership skills. So they have a more positive body image than their obese counterparts.
(Dr Naresh Purohit is Advisor for Advisor- National Mental Health Programme, National Reproductive and Child Health Programme (RCH), Executive Member of the Federation of Reproductive Health Services – India (FRHS – India). The views expressed here are of the author)