Doctors use the term obesity to describe levels of body weight that are high enough to seriously endanger one or more aspects of a person’s health. Specific problems linked to the presence of obesity include type 2 diabetes, strokes, hypertension, arthritis, high cholesterol, heart disease and certain types of cancer. Obesity is also frequently a negative factor in the health of people affected by a variety of mental disorders. Fortunately, with the assistance of their doctors, obese people with mental health problems can take a number of steps to lower their weight and increase both their physical and mental wellbeing.
Doctors diagnose obesity with the help of a calculation called the body mass index, or BMI. To make this calculation, they take a person’s height and weight and plug them into a standard, relatively simple mathematical equation. Next, they take the result of the BMI calculation and place it on a spectrum of potential outcomes known as the BMI scale. Normal-weight people receive scores that range from 18.5 to 24.9 on this scale, while underweight people receive scores that fall below 18.5. The overweight range on the BMI scale includes all results between 25.0 and 29.9. There are actually two levels to the scale’s obesity range. People with BMI scores between 30.0 and 39.9 receive an “obese” diagnosis, while people with scores of 40.0 or higher receive an “extremely or morbidly obese” diagnosis.
Rates in People With Mental Health Issues
People with mental health problems have a much greater chance of falling into the obese range of the BMI scale than the general adult population, according to the authors of a study review and report published in July 2013 in Psychiatric Times. In individuals affected by schizophrenia, obesity rates rise as high as 250 percent above average, while the rates in individuals affected by bipolar disorder or major depression rise as high as 50 percent above average. A separate study, published in 2008 in the Journal of Psychosomatic Research, also links higher-than-average levels of obesity to a number of conditions collectively known as anxiety disorders, as well as to post-traumatic stress disorder or PTSD (a condition once classified as an anxiety disorder but now classified in its own category of mental illness).
One of the reasons for the high rate of obesity in people affected by mental disorders is the unique set of obesity-related risks faced by this segment of the population. On top of such general risks as lack of exercise and a poorly balanced diet, individuals with mental health issues must also commonly deal with the weight gain-promoting effects of the medications used to treat their illnesses. In addition, they frequently must deal with specific factors (such as a diminished capacity for mental awareness) that increase their risks for eating an imbalanced diet or otherwise leading an obesity-prone lifestyle.
The authors of the review and report in Psychiatric Times outline several approaches to help reduce obesity levels in people affected by mental disorders. First, they strongly recommend that mental health professionals discuss weight-related issues with their patients whenever medications form part of a treatment plan. They also recommend that doctors avoid using additional medications to address weight increases and rely instead on educational efforts, increased participation in exercise, and diet improvement. One specific lifestyle modification program, called Solutions for Wellness, was especially created to meet the weight-loss needs of people diagnosed with mental disorders. Reported benefits of participation in this program include meaningful reductions in waist size, blood pressure levels and BMI scores. The federal Substance Abuse and Mental Health Services Administration considers Solutions for Wellness to be well supported by scientific evidence.
The authors of the report in Psychiatric Times also note that increased cooperation between mental health professionals and doctors in other fields can potentially significantly decrease obesity levels in people affected by mental illness. One sign of this type of cooperation is an increasing tendency for teaching hospitals and other facilities to treat issues of mental and physical health as part of a single, connected continuum, rather than as separate considerations in a patient’s well-being. This change is significant because people with mental disorders often have fairly limited access to health care and frequently develop physical problems (like obesity) that either go undetected or unaddressed by emergency rooms or mental health professionals.