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An Overview of Links Between Obesity and Mental Health

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Abstract

The American Medical Association recently recognized obesity as both an illness and a leading cause of preventable death and chronic disease. This association is not only linked to physical health outcomes, however, as obesity has also been extensively associated with mental illness as well. Both obesity and severe mental illness decrease quality of life and are associated with an increase in disability, morbidity, and mortality, and when they occur together, these adverse health outcomes are magnified. Despite educational campaigns, increased awareness, and improved treatment options, the high prevalence of mental illness and comorbid obesity remains a serious problem. This review examines this overlap, highlighting clinical and biological factors that have been linked to this association in order to improve our understanding and help elucidate potential therapeutic avenues.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance

  1. Park E. Gender as a moderator in the association of body weight to smoking and mental health. Am J Public Health. 2009;99(1):146–51.

    Article  PubMed Central  PubMed  Google Scholar 

  2. Hedley AA, Ogden CL, Johnson CL, et al. Prevalence of overweight and obesity among US children, adolescents, and adults, 1999–2002. JAMA. 2004;291:2847–50.

    Article  CAS  PubMed  Google Scholar 

  3. Gadalla TM. Association of obesity with mood and anxiety disorders in the adult general population. Chronic Dis Can. 2009;30(1):29–36.

    CAS  PubMed  Google Scholar 

  4. Vanasse A, Demers M, Hemiari A, et al. Obesity in Canada: where and how many? Int J Obes. 2006;30:677–83.

    Article  CAS  Google Scholar 

  5. Wilborn C, Beckham J, Campbell B, et al. Obesity: prevalence, theories, medical consequences, management, and research directions. J Int Soc Sports Nutr. 2005;2:4–31.

    Article  PubMed Central  PubMed  Google Scholar 

  6. Alwan A, Armstrong T, Bettcher D, et al. Global status report on non communicable diseases 2010. World Health Organization; 2011. http://www.who.int/nmh/publications/ncd_report_full_en.pdf.

  7. Zhao L. The gut microbiota and obesity: from correlation to causality. Nat Rev Microbiol. 2013;11(9):639–47.

    Article  CAS  PubMed  Google Scholar 

  8. American Psychiatric Association. Diagnostic and statistical manual of mental disorders (Fifth ed.). Arlington: American Psychiatric Publishing; 2013. p. 5–25.

    Google Scholar 

  9. Ferrari AJ, Norman RE, Freedman G, et al. The burden attributable to mental and substance use disorders as risk factors for suicide: findings from the Global Burden of Disease Study 2010. PLoS One. 2014;9(4):e91936.

    Article  PubMed Central  PubMed  Google Scholar 

  10. Substance Abuse and Mental Health Services Administration, Results from the 2012 National Survey on Drug Use and Health: Mental Health Findings, NSDUH Series H-47, HHS Publication No. (SMA) 13-4805. Rockville: Substance Abuse and Mental Health Services Administration; 2013. http://store.samhsa.gov/home.

  11. Kivimäki M, Batty GD, Singh-Manoux A, et al. Association between common mental disorder and obesity over the adult life course. Br J Psychiatry. 2009;195(2):149–55.

    Article  PubMed Central  PubMed  Google Scholar 

  12. Nicholson WM. Emotional factors in obesity. Am J Med Sci. 1946;211:443–7.

    Article  CAS  PubMed  Google Scholar 

  13. Cameron AJ, Magliano DJ, Dunstan DW, et al. A bi-directional relationship between obesity and health-related quality of life: evidence from the longitudinal AusDiab study. Int J Obes (Lond). 2012;36(2):295–303.

    Article  CAS  Google Scholar 

  14. De Hert M, Correll CU, Bobes J, et al. Physical illness in patients with severe mental disorders. I. Prevalence, impact of medications and disparities in health care. World Psychiatry. 2011;10(1):52–77.

    Google Scholar 

  15. Remington G. Schizophrenia, antipsychotics, and the metabolic syndrome: is there a silver lining? Am J Psychiatry. 2006;163(7):1132–4.

    Article  PubMed  Google Scholar 

  16. National Institute of Mental Health (NIMH). Attention Deficit Hyperactivity Disorder (ADHD) Rev. 2013. http://www.nimh.nih.gov/health/topics/attention-deficit-hyperactivity-disorder-adhd/index.shtml.

  17. Fliers EA, Buitelaar JK, Maras A, et al. ADHD is a risk factor for overweight and obesity in children. J Dev Behav Pediatr. 2013;34(8):566–74.

    Article  PubMed  Google Scholar 

  18. Pagoto SL, Curtin C, Lemon SC, et al. Association between adult attention deficit/hyperactivity disorder and obesity in the US population. Obesity. 2009;17(3):539–44.

    Article  PubMed Central  PubMed  Google Scholar 

  19. Taylor VH, McIntyre RS, Remington G, et al. Beyond pharmacotherapy: understanding the links between obesity and chronic mental illness. Can J Psychiatry. 2012;57(1):5–12. This review elucidate the complex interplay between psychiatric illness and weight gain.

    PubMed  Google Scholar 

  20. Cook BG, Li D, Heinrich KM. Obesity, physical activity, and sedentary behavior of youth with learning disabilities and ADHD. J Learn Disabil. 2014.

  21. Harvey WJ, Reid G, Grizenko N, et al. Fundamental movement skills and children with attention-deficit hyperactivity disorder: peer comparisons and stimulant effects. J Abnorm Child Psychol. 2007;35(5):871–82.

    Article  PubMed  Google Scholar 

  22. Harvey WJ, Reid G, Bloom GA, et al. Physical activity experiences of boys with and without ADHD. Adapt Phys Act Q. 2009;26:131–50.

    Google Scholar 

  23. Cortese S, Angriman M, Maffeis C, et al. Attention deficit/hyperactivity disorder (ADHD) and obesity: a systematic review of the literature. Crit Rev Food Sci Nutr. 2008;48(6):524–37.

    Article  PubMed  Google Scholar 

  24. Levitan RD, Masellis M, Lam RW, et al. Childhood inattention and dysphoria and adult obesity associated with the dopamine D4 receptor gene in overeating women with seasonal affective disorder. Neuropsychopharmacology. 2004;29(1):179–86.

    Article  CAS  PubMed  Google Scholar 

  25. Comings DE, Blum K. Reward deficiency syndrome: genetics aspects of behavioral disorders. Prog Brain Res. 2000;126:325–41.

    Article  CAS  PubMed  Google Scholar 

  26. Hudson JI, Lalonde JK, Berry JM, et al. Binge-eating disorder as a distinct familial phenotype in obese individuals. Arch Gen Psychiatry. 2006;63(3):313–9.

    Article  PubMed  Google Scholar 

  27. Stanford C, Tannock R. Obesity and ADHD: clinical and neurobiological implications. In: Behavioral neuroscience of attention deficit hyperactivity disorder and its treatment. Ed Springer; 2012.

  28. Ranjba S, Deng C. The association of antidepressant medication and body weight gain. Online J Health Allied Sci Mangalore South India. 2013;12:ISSN 0972-5997.

  29. Hall KS, Hoerster KD, Yancy WS Jr. Post-traumatic stress disorder, physical activity, and eating behaviors. Epidemiol Rev. 2015.

  30. Mitchell KS, Aiello AE, Galea S, et al. PTSD and obesity in the Detroit neighborhood health study. Gen Hosp Psychiatry. 2013;35(6):671–3.

    Article  PubMed  Google Scholar 

  31. Kubzansky LD, Bordelois P, Jun HJ, et al. The weight of traumatic stress: a prospective study of posttraumatic stress disorder symptoms and weight status in women. JAMA Psychiatry. 2014;71(1):44–51.

    Article  PubMed Central  PubMed  Google Scholar 

  32. Maguen S, Madden E, Cohen B, et al. The relationship between body mass index and mental health among Iraq and Afghanistan veterans. J Gen Intern Med. 2013;28 Suppl 2:S563–70. This study evaluated almost 500.000 veterans exploring the relationship between body mass index and posttraumatic stress disorder over 3 years.

    Article  PubMed  Google Scholar 

  33. Smith TJ, White A, Hadden L, et al. Associations between mental health disorders and body mass index among military personnel. Am J Health Behav. 2014;38(4):529–40.

    Article  PubMed  Google Scholar 

  34. Babić R, Maslov B, Babić D, et al. The prevalence of metabolic syndrome in patient with posttraumatic stress disorder. Psychiatr Danub. 2013;25 Suppl 1:45–50.

    PubMed  Google Scholar 

  35. Roenholt S, Beck NN, Karsberg SH, et al. Post-traumatic stress symptoms and childhood abuse categories in a national representative sample for a specific age group: associations to body mass index. Eur J Psychotraumatol. 2012;3(17188):1–9.

    Google Scholar 

  36. Williamson DF, Thompson TJ, Anda RF, et al. Body weight and obesity in adults and self-reported abuse in childhood. Int J Obes Relat Metab Disord. 2002;26(8):1075–82.

    Article  CAS  PubMed  Google Scholar 

  37. D’Argenio A, Mazzi C, Pecchioli L, et al. Early trauma and adult obesity: is psychological dysfunction the mediating mechanism? Physiol Behav. 2009;98(5):543–6.

    Article  PubMed  Google Scholar 

  38. Singh M. Peripheral system in regulation of mood, food and obesity. Front Psychol. 2014;5:925.

    Article  PubMed Central  PubMed  Google Scholar 

  39. de Assis MA, de Mello MF, Scorza FA, et al. Evaluation of physical activity habits in patients with posttraumatic stress disorder. Clinics (Sao Paulo). 2008;63(4):473–8.

    Article  Google Scholar 

  40. Hirth JM, Rahman M, Berenson AB. The association of posttraumatic stress disorder with fast food and soda consumption and unhealthy weight loss behaviors among young women. J Womens Health (Larchmt). 2011;20(8):1141–9.

    Article  Google Scholar 

  41. Russell E, Koren G, Rieder M, et al. Hair cortisol as a biological marker of chronic stress:current status, future directions and unanswered questions. Psychoneuroendocrinology. 2012;37(5):589–601.

    Article  CAS  PubMed  Google Scholar 

  42. Kuo LE, Kitlinska JB, Tilan JU, et al. Neuropeptide Y acts directly in the periphery on fat tissue and mediates stress-induced obesity and metabolic syndrome. Nat Med. 2007;13(7):803–11.

    Article  CAS  PubMed  Google Scholar 

  43. Mason SM, Flint AJ, Roberts AL, et al. Posttraumatic stress disorder symptoms and food addiction in women by timing and type of trauma exposure. JAMA Psychiatry. 2014;71:1271–8.

    Article  PubMed  Google Scholar 

  44. Weiner M, Warren L, Fiedorowickz JG. Cardiovascular morbidity and mortality in bipolar disorder. Ann Clin Psychiatry. 2011;23(1):40–7.

    PubMed Central  PubMed  Google Scholar 

  45. Opel N, Redlich R, Grotegerd D, et al. Obesity and major depression: body-mass index (BMI) is associated with a severe course of disease and specific neurostructural alterations. Psychoneuroendocrinology. 2015;51:219–26.

    Article  PubMed  Google Scholar 

  46. Liu CS, Carvalho AF, McIntyre RS. Towards a “metabolic” subtype of major depressive disorder: shared pathophysiological mechanisms may contribute to cognitive dysfunction. CNS Neurol Disord Drug Targets. 2014;13(10):1693–707.

    Article  PubMed  Google Scholar 

  47. Taylor V, MacQueen G. Associations between bipolar disorder and metabolic syndrome: a review. J Clin Psychiatry. 2006;67(7):1034–41.

    Article  PubMed  Google Scholar 

  48. Musselman DL, Betan E, Larsen H, et al. Relationship of depression to diabetes types 1 and 2: epidemiology, biology, and treatment. Biol Psychiatry. 2003;54(3):317–29.

    Article  PubMed  Google Scholar 

  49. Mansur RB, Brietzke E, McIntyre RS. Is there a “metabolic-mood syndrome”? A review of the relationship between obesity and mood disorders. Neurosci Biobehav Rev. 2015.

  50. Brumby S, Chandrasekara A, Kremer P, et al. The effect of physical activity on psychological distress, cortisol and obesity: results of the Farming Fit intervention program. BMC Public Health. 2013;13:1018.

    Article  PubMed Central  PubMed  Google Scholar 

  51. Adam TC, Epel ES. Stress, eating and the reward system. Physiol Behav. 2007;91(4):449–58.

    Article  CAS  PubMed  Google Scholar 

  52. Shelton RC, Miller AH. Inflammation in depression: is adiposity a cause? Dialogues Clin Neurosci. 2011;13(1):41–53.

    PubMed  Google Scholar 

  53. Palinkas LA, Wingard DL, Barrett-Connor E. Depressive symptoms in overweight and obese older adults: a test of the ‘jolly fat’ hypothesis. J Psychosom Res. 1996;40:59–66.

    Article  CAS  PubMed  Google Scholar 

  54. Lago F, Dieguez C, Gómez-Reino J, et al. Adipokines as emerging mediators of immune response and inflammation. Nat Clin Pract Rheumatol. 2007;3(12):716–24.

    Article  CAS  PubMed  Google Scholar 

  55. Degawa-Yamauchi M, Moss KA, Bovenkerk JE, et al. Regulation of adiponectin expression in human adipocytes: effects of adiposity, glucocorticoids, and tumor necrosis factor alpha. Obes Res. 2005;13(4):662–9.

    Article  CAS  PubMed  Google Scholar 

  56. Taylor VH, MacQueen GM. The role of adipokines in understanding the associations between obesity and depression. J Obes. 2010;2010.

  57. De Wit L, Luppino F, van Straten A, et al. Depression and obesity: a meta-analysis of community-based studies. Psychiatry Res. 2010;178(2):230–5.

    Article  PubMed  Google Scholar 

  58. Soczynska JK, Kennedy SH, Woldeyohannes O, et al. Mood disorders and obesity: understanding inflammation as a pathophysiological nexus. Neuromol Med. 2011;13:93–116.

    Article  CAS  Google Scholar 

  59. Dent R, Blackmore A, Peterson J, et al. Changes in body weight and psychotropic drugs: a systematic synthesis of the literature. PLoS One. 2012;7(6):e36889.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  60. Kemp DE. Managing the side effects associated with commonly used treatments for bipolar depression. J Affect Disord. 2014;169S1:S34–44.

    Article  Google Scholar 

  61. Mueser KT, McGurk SR. Schizophrenia. Lancet. 2004;363(9426):2063–72.

    Article  PubMed  Google Scholar 

  62. Bouza C, López-Cuadrado T, Amate JM. Physical disease in schizophrenia: a population-based analysis in Spain. BMC Public Health. 2010;10:745.

    Article  PubMed Central  PubMed  Google Scholar 

  63. Hsu WY, Lane HY, Lin CL, et al. A population-based cohort study on deep vein thrombosis and pulmonary embolism among schizophrenia patients. Schizophr Res. 2015;162(1–3):248–52.

    Article  PubMed  Google Scholar 

  64. Davidson M. Risk of cardiovascular disease and sudden death in schizophrenia. Clin Psychiatry. 2002;63 suppl 9:5–11.

    Google Scholar 

  65. Jeste DV, Gladsjo JA, Lindamer LA, et al. Medical comorbidity in schizophrenia. Schizophr Bull. 1996;22:412–30.

    Article  Google Scholar 

  66. Kohen D. Diabetes mellitus and schizophrenia: historical perspective. Br J Psychiatry Suppl. 2004;47:S64–6.

    Article  PubMed  Google Scholar 

  67. Compton MT, Daumit GL, Druss BG. Cigarette smoking and overweight/obesity among individuals with serious mental illnesses: a preventive perspective. Harv Rev Psychiatry. 2006;14(4):212–22.

    Article  PubMed  Google Scholar 

  68. Newcomer JW. Second-generation (atypical) antipsychotics and metabolic effects: a comprehensive literature review. CNS Drugs. 2005;19 Suppl 1:1–93.

    CAS  PubMed  Google Scholar 

  69. Correll CU, Leucht S, Kane JM. Lower risk for tardive dyskinesia associated with second-generation antipsychotics: a systematic review of 1-year studies. Am J Psychiatry. 2004;161(3):414–25.

    Article  PubMed  Google Scholar 

  70. Zipursky RB, Gu H, Green AI, et al. Course and predictors of weight gain in people with first-episode psychosis treated with olanzapine or haloperidol. Br J Psychiatry. 2005;187:537–43.

    Article  PubMed  Google Scholar 

  71. Correll CU, Manu P, Olshanskiy V, Napolitano B, Kane JM, Malhotra AK. Cardiometabolic risk of second-generation antipsychotic medications during first-time use in children and adolescents. JAMA. 2009;302(16):1765–73.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  72. Alvarez-Jimenez M, Gonzalez-Blanch C, Crespo-Facorro B, Hetrick S, Rodriguez-Sanchez JM, Perez-Iglesias R, et al. Antipsychotic-induced weight gain in chronic and first-episode psychotic disorders: a systematic critical reappraisal. CNS Drugs. 2008;22(7):547–62.

    Article  CAS  PubMed  Google Scholar 

  73. Amani R. Is dietary pattern of schizophrenia patients different from healthy subjects? BMC Psychiatry. 2007;7:15.

    Article  PubMed Central  PubMed  Google Scholar 

  74. Britvic D, Maric NP, Doknic M. Metabolic issues in psychotic disorders with the focus on first-episode patients: a review. Psychiatr Danub. 2013;25(4):410–5.

    PubMed  Google Scholar 

  75. Correll CU, Lencz T, Malhotra AK. Antipsychotic drugs and obesity. Trends Mol Med. 2011;17(2):97–107.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  76. Lencz T et al. DRD2 promoter region variation predicts antipsychotic-induced weight gain in first episode schizophrenia. Pharmacogenet Genomics. 2010;20:569–72.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  77. Cowley MA, Cone R, Enriori P, et al. Electrophysiological actions of peripheral hormones on melanocortin neurons. Ann N Y Acad Sci. 2003;994:175–86.

    Article  CAS  PubMed  Google Scholar 

  78. Zhou L, Williams T, Lachey JL, et al. Serotonergic pathways converge upon central melanocortin systems to regulate energy balance. Peptides. 2005;26(10):1728–32. Review.

    Article  CAS  PubMed  Google Scholar 

  79. Taveira TH, Wu WC, Tschibelu E, et al. The effect of naltrexone on body fat mass in olanzapine-treated schizophrenic or schizoaffective patients: a randomized double-blind placebo-controlled pilot study. J Psychopharmacol. 2014;28(4):395–400.

    Article  PubMed  Google Scholar 

  80. Nothdurfter C, Schmotz C, Sarubin N, et al. Effects of escitalopram/quetiapine combination therapy versus escitalopram monotherapy on hypothalamic-pituitary-adrenal-axis activity in relation to antidepressant effectiveness. J Psychiatr Res. 2014;52:15–20.

    Article  PubMed  Google Scholar 

  81. De Silva PN. Does the association with diabetes say more about schizophrenia and its treatment?--the GLUT hypothesis. Med Hypotheses. 2011;77(4):529–31.

    Article  PubMed  Google Scholar 

  82. Chintoh AF, Mann SW, Lam L, et al. Insulin resistance and secretion in vivo: effects of different antipsychotics in an animal model. Schizophr Res. 2009;108(1–3):127–33.

    Article  PubMed  Google Scholar 

  83. Hahn M, Chintoh A, Giacca A, et al. Atypical antipsychotics and effects of muscarinic, serotonergic, dopaminergic and histaminergic receptor binding on insulin secretion in vivo: an animal model. Schizophr Res. 2011;131(1–3):90–5.

    Article  PubMed  Google Scholar 

  84. Ballon JS, Pajvani U, Freyberg Z, et al. Molecular pathophysiology of metabolic effects of antipsychotic medications. Trends Endocrinol Metab. 2014;25(11):593–600. This manuscript describes antipsychotics putative mechanisms on weight gain as well as metabolic risks of schizophrenia itself.

    Article  CAS  PubMed  Google Scholar 

  85. Stone WS, Faraone SV, Su J, et al. Evidence for linkage between regulatory enzymes in glycolysis and schizophrenia in a multiplex sample. Am J Med Genet B Neuropsychiatr Genet. 2004;127B(1):5–10.

    Article  PubMed  Google Scholar 

  86. Sahoo S, Ameen S, Akhtar S. Metabolic syndrome in drug-naïve first-episode psychosis treated with atypical antipsychotics. Aust N Z J Psychiatry. 2007;41(7):629.

    PubMed  Google Scholar 

  87. Lee AK, Bishop JR. Pharmacogenetics of leptin in antipsychotic-associated weight gain and obesity-related complications. Pharmacogenomics. 2011;12(7):999–1016. doi:10.2217/pgs.11.45.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  88. De Domingo Bartolomé M, López Guzmán J. The social stigma of obesity. Cuad Bioet. 2014;25(84):273–84.

    PubMed  Google Scholar 

  89. Taylor VH, Curtis CM, Davis C. The obesity epidemic: the role of addiction. CMAJ. 2010;182(4):327–8.

    Article  PubMed Central  PubMed  Google Scholar 

  90. Marcus M, Wildes J. Obesity in DSM-5. Psychiatr Ann. 2012;42:431–5.

    Article  Google Scholar 

  91. Manasse SM, Forman EM, Ruocco AC, et al. Do executive functioning deficits underpin binge eating disorder? A comparison of overweight women with and without binge eating pathology. Int J Eat Disord. 2015.

  92. Mauro M, Taylor V, Wharton S, et al. Barriers to obesity treatment. Eur J Intern Med. 2008;19(3):173–80.

    Article  PubMed  Google Scholar 

  93. Barry D, Clarke M, Petry M. Obesity and its relationship to addictions: is overeating a form of addictive behavior? Am J Addict. 2009;18(6):439–51.

    Article  PubMed Central  PubMed  Google Scholar 

  94. Swinburn BA, Caterson I, Seidell JC, et al. Diet, nutrition and the prevention of excess weight gain and obesity. Public Health Nutr. 2004;7:123–46.

    CAS  PubMed  Google Scholar 

  95. Fairburn C, Brownell K. Eating disorders and obesity: a comprehensive handbook. 2002.

  96. Schreiber LR, Odlaug BL, Grant JE. The overlap between binge eating disorder and substance use disorders: diagnosis and neurobiology. J Behav Addict. 2013;2(4):191–8.

    Article  PubMed Central  PubMed  Google Scholar 

  97. Goracci A, Casamassima F, Iovieno N, et al. Binge eating disorder: from clinical research to clinical practice. J Addict Med. 2015;9(1):20–4.

    Article  PubMed  Google Scholar 

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Christian Avila declares that he has no conflict of interest.

Alison C. Holloway declares that she has no conflict of interest.

Margaret K. Hahn declares that she has no conflict of interest.

Katherine M. Morrison declares that she has no conflict of interest.

Maria Restivo declares that she has no conflict of interest.

Rebecca Anglin declares that she has no conflict of interest.

Valerie H. Taylor declares that she has no conflict of interest.

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Avila, C., Holloway, A.C., Hahn, M.K. et al. An Overview of Links Between Obesity and Mental Health. Curr Obes Rep 4, 303–310 (2015). https://doi.org/10.1007/s13679-015-0164-9

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