NEW DELHI: About one fourth of individuals with obesity have undiagnosed psychiatric comorbidity, including depression and other disorders, reports a latest study by AIIMS Delhi. "The psychological effects of obesity are not screened, and ignoring these aspects may act as a deterrent in effective management. Evidence suggests that stigmatising experiences occur frequently in the context of personal relationships with family, friends, and coworkers," the study noted.
"This negative social atmosphere has been implicated in the development of depressive symptoms, feelings of helplessness, isolation, and poor general psychological functioning among obese people with obesity. Strong evidence has established bidirectional association of obesity and depression. There is modest evidence for association of obesity with anxiety disorders and inadequate for other psychiatric conditions," the study said.
"People with a disorder like depression are more prone to develop obesity due to eating habits, lack of physical activities and medicines. Those who are obese may have hidden psychiatric problem which remains unnoticed. In managing patients, it is necessary to screen them to detect the underline psychiatric problem," said Dr Naval Vikram, Professor, Metabolic Research Group Department of Medicine who conducted the study.
Out of 150 sample size, 68.6% (103) were females and 31.1% (47), males. Majority subjects were in the BMI group of 25.0 to <30.0 kg/m2 and the number of patients decreased towards the upper extreme of BMI.
The mean BMI (SD) of the total study population was 30.2 (4.4) kg/m2. All the female subjects and 80.8 per cent (38) of male subjects had abdominal obesity. The prevalence of major depression was higher in the higher BMI categories, and the reverse trend was observed in panic disorder cases.
In the sampled population who have lifetime diagnosis of psychiatric illness, average score in the physical, psychological, social and environmental domains, were lesser and statistically significant as compared to those without psychiatric illness.
"All patients who felt that they were thin i.e., having lesser weight than ideal had BMI 25.0 to <30.0 kg/m2. Nearly two thirds of patients who felt that they had appropriate weight had BMI 25.0 to <30.0 kg/m2 and the rest had BMI 30.0 to <35 kg/m2. Hence nearly 96 (63.8%) subjects failed to recognise themselves as obese or very obese," the study found.
Way out
As the burden of added psychiatric comorbidity decreases the quality of life, patients should be screened with counseling and other obesity management strategies