Obesity: psychological factors involved in overweight.

Psychological and psychiatric keys for diagnosis and intervention in obese people.

Obesity is considered a pandemic in western countries. Unhealthy habits, stress, sedentary life and poor diet are the most frequent causes of excess weight. It is a disease that comes hand in hand with a work context that forces us to sit in an office and pay little interest in our health.

Of course, there are several disorders that can also be the cause of obesity.. Medical problems such as endocrine or hormonal imbalances. These are separate cases that should be treated from a primarily medical perspective.

Psychological and psychiatric factors of excess weight.

Scientific research has put the spotlight on this disease, obesity. In the United States, more than two-thirds of adult women and up to 75% of men are overweight.

Overweight and obesity: differences

It is useful to differentiate between overweight and obesityIt is useful to differentiate between overweight and obesity, as they are related but not identical concepts. Both have in common that they refer to excess accumulated fat. However, people are considered overweight when they have a Body Mass Index (BMI) of 25 to 29.9, being people who should reduce their weight in order to be healthier.

Obesity is a quantitatively and qualitatively more serious problem. Obese people exceed 30 points of BMI, and their health is at significant risk.

Treating obesity from Psychology

The causes of obesity are various and, on many occasions, comorbid. This means that the treatments to overcome this problem must be multifactorial.From the medical and endocrinological field, to psychology and psychiatry can help people suffering from this problem.

Over the last decades, a good number of therapies and treatments have been developed against this disease, mainly focused on improving eating habits and promoting physical exercise. These two factors are closely linked to the reduction of body volume.

However, professionals who treat obesity have been realizing that it is necessary to intervene in this problem with more specific and personalized approaches, through medical, nutritional, psychiatric and psychological intervention. This deployment of professionals to tackle this problem is motivated by the human, social and economic costs generated by obesity.

Risks of obese people

Obesity is a disease that not only affects the quality of life of those affected, but also entails other important problems:

1. Comorbidity

Obesity is a risk factor for the development of other pathologies: hypertension, Heart disease, cancer, sleep apnea, etcetera.

2. Social stigma

Unfortunately, people suffering from this health problem are strongly stigmatized both at school and at work. This leads to a lowering of self-concept, increasing anxiety and worsening personal relationships.

3. Psychological and psychiatric disorders

Obesity has a high rate of comorbidity with psychopathologies, such as anxiety, addictions, depression, eating disorders, among others.

Relevant psychological aspects

As mentioned above, obesity has biological, psychological and cultural causes. As for the psychological aspects associated with excess weight, there are different approaches and studies that point to certain possible causes, although none with a high degree of consensus.

For example, from Psychoanalysis, obesity is usually attributed to the symbolic nature of the act of eating, and overweight is usually associated as an externalization of neurosis, associated with depression, guilt and anxiety. It is also common to associate obesity to certain underlying emotional conflicts, or to another previous mental disorder.

The psychological etiology of obesity is unclear, so intervention efforts are focused on assessing and re-educating certain beliefs of patients, in addition to knowing the affective variables (emotional management) and environmental variables (eating habits, habits, etc.). This variety of psychological processes involved in obesity raises the need to approach each patient's situation individually, assessing his or her personality and environment.

Psychological evaluation

Psychologists and psychiatrists can investigate and intervene in the intervene in the beliefs and emotional states of obese patients in order to improve their quality of life.. It is important that the therapist creates an environment conducive for the patient to expose and express their affective and cognitive conflicts. Usually, obese people experience low self-esteem and have a poor self-image of their own body.

Self-esteem, eating habits and perception of intake

In short, the therapist should not only promote changes in eating habits and lifestyle, but also find ways to reinforce the self-concept in order to focus on weight loss. In this sense, it is important to emphasize the importance of offering the patient tools for controlling emotions and impulses, as well as anxiety management techniques.

It is noteworthy that patients with obesity tend to underestimate their caloric intake compared to people without weight problems. They minimize the amount of food they eat, not being fully aware that their intake is excessive. This is a common characteristic with people suffering from other types of addictions. To control this, the psychotherapist should accompany the patient and make live records to show what quantities should be acceptable for each meal. for each meal.

In short, therapy should focus not only on weight loss, but also on the process of psychological maturation to become aware of the problem, improving the quality of life and establishing healthy habits, such as physical activity, a better self-concept and perception of one's own body and healthier eating habits. It is also key to co make the patient aware that obesity is a disease, and emphasize that he/she should be aware of the fact that he/she shouldand to emphasize that they must make an effort to avoid relapses. One of the most successful treatments is cognitive-behavioral therapy.

Psychiatric aspects to be taken into account

The role of the psychiatrist is also relevant in the treatment of people with obesity.. Psychiatrists are in charge of deciding which patients are suitable to undergo surgery, and which are not. Traditionally, it has been considered that patients with psychotic conditions are not suitable to undergo surgical procedures, nor are those with a history of alcohol or other drug abuse or dependence.

Another group of patients who have serious difficulties to follow a psychiatric treatment linked to excess weight are those who have a personality disorder.

Approximately 30% of obese people who come to therapy express bulimic impulses. In addition, 50% of patients with bulimic implusions also have depression, as opposed to only 5% of patients without such urges.

Treating affective disorders such as anxiety or depression in obese people is key to a good prognosis. It is the necessary basis for the patient to commit to treatment and change his or her lifestyle habits.

Concluding

Patients with obesity definitely require a global treatment: physicians, psychiatrists, nutritionists and psychologists must intervene in order to diagnose and treat each person correctly and in a personalized way. Although there is no broad consensus on the psychological causes of obesity, we find some points in common in many obese patients: low self-esteem, poor self-concept, poor eating habits and comorbidity with other psychopathologies.

This should make us appreciate the relevance of the role of mental health professionals in improving the quality of life and the chances of recovery of these patients. and the possibilities of recovery of these patients.

Bibliographic references:

• WHO. (2014). Descriptive note N°311
• Banegas, J.R. (2007). The challenge of obesity for public health. I NAOS Convention. Spanish Agency for Food Safety and Nutrition. Madrid, 27 March 2007.
• Estrategia, N. A. O. S. (2005). Strategy for nutrition, physical activity and obesity prevention. Ministry of Health and Consumer Affairs. Spanish Food Safety Agency. Madrid.
• Stunkard, A. J. (2000). Determinants of obesity: current thinking. Obesity in poverty: a new challenge for public health, 576, 27-32.
• McRoberts, C., Burlingame, G. M., & Hoag, M. J. (1998). Comparative efficacy of individual and group psychotherapy: A meta-analytic perspective. Group Dynamics: Theory, Research, and Practice, 2(2), 101.