Obesity is a complex disease that affects a large proportion of the global population. While obesity is often linked to physical health problems such as heart disease and diabetes, its impact on mental health is often overlooked. Clinicians consider depression to be bidirectional with obesity: obesity increases the risk for depression, and depression increases the risk of obesity. This seems to be more common in women than in men. Weight loss can sometimes improve these symptoms. Women with obesity are often at a higher risk of experiencing mental health conditions that can make losing weight harder. This article aims to explore the complex relationship between women, obesity, and mental health and examine how healthcare professionals can help women manage their weight and improve their overall well-being.
Here are some of the most common mental health conditions that women with obesity experience:
Depression or Anxiety: Depression and/or anxiety in women with obesity can be caused by various factors, including hormonal changes, social stigma, and reduced physical activity. Symptoms of depression can include feelings of sadness, hopelessness, and a loss of interest in activities. The culture around body image may significantly impact women who internalize the bias and stigma around weight. This can lead to stress and depression which is why focusing on the health benefits of treating weight is so important.
Eating disorders: Women with obesity are at higher risk of developing eating disorders such as binge eating disorder or bulimia nervosa. These disorders involve episodes of binge eating, often followed by purging behaviors such as vomiting or excessive exercise. It’s important to treat eating disorders first before focusing on weight loss.
Body image issues: Women with obesity may also struggle with a negative body image, which can lead to feelings of shame, low self-esteem, and social isolation. A negative body image can also lead to eating disorder behaviors and a range of additional mental health issues.
Social isolation: Women with obesity may experience social isolation and stigma due to their weight, which can lead to loneliness, anxiety, and depression. Social isolation can also lead to reduced physical activity and further weight gain.
Another common condition clinicians see in female patients struggling with weight is ADHD. ADHD can make it easier to eat when bored or struggle with impulses around food. It can also make it harder to plan and follow through with plans to change health.
It is important to note that not all women with obesity will experience these mental health issues and that individual experiences may vary. However, by addressing both physical and psychological concerns, women with obesity can improve their overall well-being and quality of life. Seeking support from healthcare professionals or mental health professionals can be an important step in addressing these issues.
Clinicians can play an important role in addressing mental health issues in women with obesity. During the initial evaluation of a patient, clinicians should screen for mental health conditions such as depression, anxiety, and eating disorders. Early detection and treatment of these conditions can improve the patient’s overall well-being and increase the likelihood of success in their weight loss journey. Women with obesity may experience social stigma and discrimination, which can negatively impact their mental health. Clinicians can create a supportive and non-judgmental environment by using respectful language, avoiding assumptions about the patient’s lifestyle or habits, and focusing on the patient’s overall health and well-being rather than their weight.
Physical activity can also have a positive impact on mental health, reducing symptoms of depression and anxiety and improving overall well-being. Clinicians can encourage women with obesity to engage in physical activity that is appropriate for their level of fitness and health status.
Treating underlying mental health conditions is essential to treating obesity in women, but we must be cautious as some of the medications used for mood disorders can cause weight gain. When prescribing medications, if a weight-neutral medication is as likely to help the mental health disorder, the preference would be to use a weight-neutral medication over a medication known to cause weight gain.
To help women with obesity, clinicians should work to address both the physical and mental health concerns of a patient, rather than just one or the other. In doing so, we can help women with obesity improve their overall well-being and quality of life.
The Obesity Algorithm from the Obesity Medicine Association has more detailed information about why obesity and mental health are linked, and about which medications may be better for treating mental health conditions without causing weight gain.