Social Policy in Ontario

Mental health linked to losing battle against obesity

Posted on March 3, 2013 in Health Debates

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TheProvince.com – life/health
June 18, 2012. Postmedia News

Canada is losing the war against obesity because we’re ignoring one of its major drivers, doctors say: the state of our mental well-being.

Some say obesity and mental health are so intricately entwined, they should be considered a “double epidemic.”

Depression, anxiety, sleep disorders, attention-deficit disorders, post-traumatic stress, addictions – all can cause changes in appetite, energy and metabolism that can prime people to gain weight. What’s more, antidepressants, mood stabilizers and newer generation antipsychotics – drugs Canadians are being prescribed in record numbers -can them-selves cause rapid and dramatic weight gain.

No one is suggesting that everyone with a weight problem has a mental illness.

But missing in the relentless drumbeat to “eat less, move more” is any public discussion about the role common mental-health problems are playing in the obesity dilemma, observers say.

“We absolutely have not looked at this issue at all,” says Dr. Valerie Taylor, chief psychiatrist at Toronto’s Women’s College Hospital.

“This is probably one of the No. 1 reasons that we’re not getting anywhere in terms of battling the obesity epidemic.”

The relationship works both ways.

Fat tissue isn’t inert. It’s bio-logically active. It produces cortisol, a stress hormone, as well as inflammatory chemicals, both of which have been linked to mental illness. Cortisol is neuro-toxic. It can act on the brain in vulnerable people – putting them at increased risk for depression.

Conversely, people with depression produce excess cortisol. And one of the effects of cortisol on the body, Taylor and her colleagues recently reported in the Canadian Journal of Psychiatry, is a propensity to accumulate fat around the abdomen.

The interplay between obesity and mental health is complex, but “we have not had a public discourse on how tightly these two epidemics are linked,” says Dr. Arya Sharma, professor of medicine and chairman in obesity research and management at the University of Alberta.

Nowhere in the recent report from Canada’s mental-health commission is there a mention of obesity, he says. “And vice versa. With all the talk about healthy weights, there’s a lot of focus on diet and exercise, but I don’t see any focus on improving the mental health of our kids and our adults. And that is a huge part of what is really driving the obesity epidemic.”

Studies have found that 66 per cent of those seeking bariatric, or weight-loss surgery, have had a history of at least one mental-health disorder. Attention-deficit disorder occurs in an estimated one in four. “These people really struggle with being able to eat healthy – they make impulsive choices, they can never make it to the gym or they get to the gym they’ve forgotten half their stuff,” Taylor says. “If you get that illness under control, they can be successful in losing weight.”

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Tags: Health, mental Health, participation, poverty, standard of living

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