You want to lose that weight, knowing it’s hurting you, but you don’t have the willpower to overcome your faulty lifestyle habits and dive deeper into them because they’re comforting. Besides, the world doesn’t even appreciate you for the little effort you make. Sounds familiar. This is because the fight against obesity can only be successful if it starts in the mind.
Global studies have shown that obesity is directly associated with a significant psychosocial burden. Obese people struggle with issues related to their mood, self-esteem, quality of life and body image. Often the pressure of society’s contempt for being overweight and even the sneers they receive for not achieving their goals soon enough drives patients over the edge. This emotional distress plays an important role in poor treatment outcomes. This is why the treatment of obesity is becoming multidisciplinary, with mental health experts being included in treatment protocols.
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First, why is obesity a concern, especially among Indians, and why does it need to be addressed immediately?
Obesity increases the risk of a number of serious and life-threatening diseases, including diabetes, heart disease and certain malignancies. This is due to a complex interplay of hormonal and inflammatory responses. “Obesity is strongly linked to various chronic diseases, including heart disease, type 2 diabetes, high blood pressure, stroke, certain types of cancer and respiratory problems. These conditions can significantly reduce the quality and length of life,” says Dr. Sharad Sharma, Consultant, Robotic, Laparoscopic Gastrointestinal and Bariatric Surgeon, Fortis Hiranandani Hospital, Mumbai.
What mental health issues are linked to obesity?
The “obesity epidemic” and the need to follow strict diets expand the two polarities to such an extent that there is an increased risk of having an eating problem. Indeed, some experts believe that dieting may carry more risks than benefits because the desired results take longer and the mind cannot process this delay. This is why patients give up halfway and develop issues with anxiety, self-esteem and body confidence. “People with larger bodies are more likely to be stigmatized and bullied. It is unclear why people with larger bodies are more prone to suffer from anxiety. One possibility is that their anxiety is caused by weight discrimination. Then there are secondary issues like sleep apnea, which is common in patients with neuropsychiatric symptoms,” says Dr. Santosh Bangar, Senior Consultant-Psychiatrist, Global Hospitals, mumbai.
Reduced levels of physical activity can lead to feelings of lethargy and a sedentary lifestyle, which may be associated with laziness. “These factors can impact overall mental well-being and quality of life. Obesity can impede all aspects of a healthy life and, in turn, limit participation in activities, affect relationships and decrease overall satisfaction with life,” says Dr. Sharma.
He also warns of atypical anorexia, which occurs when someone with anorexia is not considered underweight and is often misdiagnosed. “Anorexia carries a significant risk of metabolic imbalance, depression, anxiety, and suicide. Parents’ lack of knowledge and awareness about obesity leads to an inability to guide their children and can sometimes lead to anxiety heightened mentality in both,” he says.
Dr. Aparna Govil Bhasker, consultant in bariatric and laparoscopic surgery at Saifee Hospital, advocates for behavior change within the family and their participation in the fight against childhood obesity. “Obese children tend to suffer from neglect and are poorly treated within family structures. Together, this can lead to increased stress, which further worsens emotional eating behavior, lack of sleep and fatigue, in turn leading to greater weight gain,” she says.
Should a weight loss diet involve a psychiatrist for best results?
Studies have shown that some people who lose weight experience a return of pre-existing psychopathology or the development of new psychosocial problems. Those who experience weight regain, regardless of weight loss approach, also remain at risk for the return of adverse psychological symptoms. This is why Dr. Bangar advocates for a holistic approach to treating obesity. In such a line of treatment, a typical team includes a nutritionist, an endocrinologist, a behavioral counselor, and a psychiatrist. “Cognitive-behavioral therapy (CBT) is the cornerstone of addressing the psychological issues of obesity and its emotional effects. A psychiatrist may be needed to address comorbid issues like clinical depression, body dysmorphic disorder, or other anxiety disorders,” says Dr. Bangar.
Why is Intensive Behavioral Therapy recommended for obesity?
According to Johns Hopkins Medicine, intensive behavioral therapy is very goal-oriented and helps obese patients get through the stubborn phase of weight loss for other therapies to take effect. Its intervention protocol says, “It targets the bad habits that lead to obesity. These can include poor diet and not exercising. Treatment uses interventions to correct these bad habits. You will work closely with a therapist. This can be done one-on-one or in a group session. You will learn how to change your lifestyle to lose weight. Specifically, you can learn to:
- Track your diet
- Change your environment to avoid overeating
- Increase your activity level
- Create an exercise plan
- Set realistic goals
- By making these changes, you may be able to lose a lot of weight. You are also likely to keep the pounds off. Parts of behavior therapy are often the same as other weight loss programs. These include self-help groups.