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Your Mental Health

Obesity

By now, pretty much everyone is very aware of the growing obesity epidemic in most Western countries.

Although obesity rates among our American neighbours get the majority of the media attention, the percentage of obese people in Canada has also increased dramatically in the past 20 years.

According to Statistics Canada, two thirds of Canadian adults are now overweight or obese and the proportion of obese children has tripled in the last 25 years.

Interestingly, the percentage of people who are overweight but not obese (those with body mass index of 25-29.9 kg/m2) has remained relatively stable over time while the percentage of people who are obese or extremely obese has increased quite dramatically.

Many factors have contributed to the obesity epidemic including changes in the type of work most of us do, the amount of leisure time and type of activities, eating patterns and food environment.

Regardless of cause, the increasing obesity is a major health concern for Canadians as obesity is associated with many health problems. Type II diabetes, hypertension, elevated cholesterol, hernias, urinary incontinence, gastroesophageal reflux, cardiovascular disease, osteoarthritis, sleep apnea, increased risk of many cancers and increased need for joint replacements are just a few health complications linked to obesity.

Less widely known is that obesity is also associated with depression and psychological distress - which results from the obesity rather than being the cause of weight gain. One study found obese adults are more than twice as likely to suffer from depression and anxiety as adults of normal weight.

Research indicates a strong link between obesity and impaired quality of life for a variety of reasons both physical and emotional.

Prejudice and discrimination against obese individuals is widespread with studies showing it occurs regularly in the workplace, college admissions and even by healthcare providers.

People who experience obesity also have fewer social interactions, lower income and lower marriage rates.

However, apart from the psychological effects of the obesity itself, other forms of major mental illness are no more frequent among the obese than in the general population. Very often, when a person returns to the normal weight range, depression and other psychological symptoms disappear.

Unfortunately, those who live with obesity know that most diets and other treatment programs have modest effects at best and often do not result in significant weight loss that is sustainable over time.

Today, most experts in obesity treatment agree that for the morbidly obese, bariatric surgery such as gastric bypass or banding is often the treatment of choice. As with any medical treatment, weight loss surgery does have risks associated with it and does require some post-treatment lifestyle changes in order to ensure its ongoing safety and effectiveness.

Under the right circumstances it provides permanent weight loss and restores the health of those who receive it. Not only is bariatric surgery curative of some obesity related ailments such as diabetes and sleep apnea, but patients typically see an improvement in psychological health as well.

Candidates for bariatric surgery should receive a psychiatric assessment as part of the pre-surgery process and those with major mental illness need to have treatment before and after the surgical procedure. A diagnosis of mental illness is not generally a reason to deny this form of treatment as long as a degree of stability has been achieved with treatment.

If you are obese and can’t seem to lose weight on your own, speak with your doctor about all of your options.



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About the author...

Paul Latimer has over 25 years experience in clinical practice, research and administration. After obtaining his medical degree from Queen's University in Kingston, Ontario, he did psychiatric training at Queen's, Oxford and Temple Universities. After his residency he did a doctorate in medical science at McMaster University where he was also a Medical Research Council of Canada Scholar. Since 1983 he has been practicing psychiatry in Kelowna, BC where he has held many administrative positions and has done numerous clinical trials. He has published many scientific papers and one book on the psychophysiology of the functional bowel disorders. He is an avid photographer, skier and outdoorsman.



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The views expressed are strictly those of the author and not necessarily those of Castanet. Castanet presents its columns "as is" and does not warrant the contents.


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