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Weight loss closely associated with psychiatric illness outcomes

Weight loss in obese psychiatric patients may have the potential to not only improve physical health but also improve mental health outcomes, a review investigating the relationship between psychiatric disorders and obesity has found.

Murdoch University PhD student and clinical psychologist, Adrian Lopresti, reviewed evidence on the correlation between psychiatric disorders and obesity, with an emphasis on the shared dysregulated biological pathways of both disorders.

People with psychiatric disorders, particularly women, experience greater rates of obesity than the general population.

Of the psychiatric patient population, 29–41 per cent of men, and 50–60 per cent of women are obese. Comparatively, in the general population, only 17-20 per cent men and 27 per cent women are obese.

The inverse is also true­—obesity has been found to significantly increase the likelihood of psychiatric disorders­, co-morbid psychiatric disorders, and poorer physical and mental health functioning.

“This relationship is likely the result of a combination of genetic, environmental, social and lifestyle influences such as diet, exercise, past stress, past abuse, and sleep disorders,” Mr Lopresti says.

Research has found genetic factors appear to influence the likelihood of medication-induced weight gain in some individuals.

In addition, “both obesity and psychiatric disorders are associated with dysfunction in similar biological pathways, such as increased inflammation, oxidative stress [increased levels of free radicals in the body and lowered antioxidant defence systems], mitochondrial dysfunction [associated with energy production], and dysregulated stress response,” Mr Lopresti says.

Numerous studies on non-psychiatric populations have demonstrated that weight loss reduces markers of oxidative stress and inflammation, and increases antioxidant enzymes.

These biological pathways are also the same as those disrupted in mental health disorders.

In addition, the limited research conducted on the effect of weight loss and mental health benefits in psychiatric populations have demonstrated significant improvements on depression, quality of life and bodily pain.

“The question then remains, does losing weight improve these biological pathways [in psychiatric populations] and therefore improve mental health?” Mr Lopresti says.

“… preliminary research suggests that it does, however this is an area that requires considerably more research.”

Other significant future research areas highlighted were; specific mechanisms that underlie weight loss, mental health improvements, genetic testing for medication-induced weight gain, and finding the most appropriate weight loss interventions for psychiatric populations.

This research could help expand the current understanding of obesity in psychiatric populations, and enable the development of appropriate guidelines for weight loss.

 

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