How obesity can be a mental burden

The degree to which a person is overweight is generally described by body mass index (BMI). The BMI defines overweight as starting at 25 kg per m² and obesity as starting at 30 kg per m². There are significant health risks involved with overeating such as the development of metabolic or cardiovascular diseases. But recent studies suggest an interdependency between overeating and mental illnesses. Epidemiological studies have shown that overweight and obesity among psychiatric patients are more common than among the whole population. Especially patients with depression and bipolar disorders appear to be affected more often, but anxiety and panic disorders as well as substance abuse correlate with overweight. Although no causal relationship between overweight and psychiatric disorders has been found yet, both conditions seem to considerably influence each other.

Overweight and obesity are often associated with low self-esteem, low physical activity, social stigma and discrimination, and may promote the development of depression or an anxiety disorder. The occurrence of overweight in mentally ill patients can be due to the mental illness itself or its therapy. Often mentally ill patients adopt an unhealthy lifestyle and show a lack of awareness and motivation for health-promoting behavior. Furthermore, posttraumatic stress disorders (PTSD), depression and anxiety disorders often act as a coping strategy for stress and negative emotions. Medication plays another central role in the development of overweight and obesity, since the intake of psychopharmaceuticals often causes weight gain. Another theory looks at the hypothalamic–pituitary–adrenal axis as a possible link between mental disorders and obesity, since it has far-reaching influence on the body's functions. When under chronic stress, hormonal dysregulation can occur, which studies have proven to also occur with many mental disorders as well as with overweight.

The interdependency between obesity and mental disorders is dependent on many factors and requires further research, although concrete evidence of these causal relation is still missing. Still, monitoring their weight seems a sensible preventive measure, also in regard to other weight-related diseases. In addition, the consequences of overeating have a negative impact on the prognosis and life expectancy of mentally ill patients, so that they benefit greatly from regular weight controls and corresponding treatment.

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