Mental Health and Obesity

| May 1, 2022

Jennifer C. Seger, MD, FOMA, is the Co-clinical Editor of Bariatric Times; Diplomate, American Board of Obesity Medicine; Medical Director, Bariatric Medical Institute of Texas, San Antonio, Texas.

Dear Readers,

The month of May is national Mental Health Awareness Month, so I wanted to mention it here, since mental health disorders and obesity both share the unfortunate commonality of being traditionally associated with negative bias and stigma. For patients who struggle with both, we can certainly appreciate the negativity they have likely experienced over the course of their disease.  

Nowadays, healthcare providers are busier than ever, often having to see more patients in less time. These shortened appointments make it challenging to cover new or chronic medical conditions, let alone screen for anxiety and depression. Sadly, this means opportunities to address both mental health and obesity can be missed or overlooked. 

It takes a lot of courage for a patient to speak about these difficult issues. When they are ready to discuss sensitive subjects, such as feelings of sadness, loneliness, or anxiety, it can be particularly off-putting if the doctor appears rushed or dismissive. Just think about stories your patients have shared with you about how their other doctors dismissed or even shamed them when the topic of weight was discussed.  

For myself, I know it can sometimes be challenging to pause when I think I am ready to move on to the next patient, but there is clearly more the patient wants to discuss; particularly, if it is related to symptoms suggestive of an underlying mental health disorder, we need to take the time. It doesn’t mean we have to make the diagnosis and initiate treatment right then, but if we just keep going, we might cause that patient to never speak up again.  

Simply listening and validating the patient’s feelings can be what helps that patient move forward with further evaluation and treatment. If you are in the position to help further, perhaps schedule a short turnaround appointment where you can focus solely on this issue, and if you are not, refer the patient promptly to someone who can help them. 

The World Health Organization (WHO) estimates a 25 percent worldwide increase in prevalence of anxiety and depression.1 According to the United States (US) Centers for Disease Control and Prevention, (CDC), there was a four-fold increase in anxiety and depression in the US during the first year of the COVID-19 pandemic.2 Deaths related to alcohol went up 25 percent and drug overdoses 30 percent in the first year of the pandemic, compared to the previous year.3 

Even if it’s not in your wheelhouse, when your patient trusts you enough to share, please take a minute to validate them for their courage and truly hear them. It will make all the difference. 

In health,

Jenny Seger, MD, FOMA

References

  1. World Health Organization. COVID-19 pandemic triggers 25% increase in prevalence of anxiety and depression worldwide. 2 Mar 2022. https://www.who.int/news/item/02-03-2022-covid-19-pandemic-triggers-25-increase-in-prevalence-of-anxiety-and-depression-worldwide. Accessed 28 Apr 2022.
  2. Centers for Disease Control and Prevention. National Center for Health Statistics Household Pulse Survey data on anxiety and depression collected between April 23, 2020, and Oct. 11, 2021. www.cdc.gov/nchs/covid19/pulse/mental-health.htm. Accessed 22 Apr 2022.
  3. White AM, Castle IP, Powell PA, et al. Alcohol-related deaths during the COVID-19 pandemic. JAMA. 2022:e224308.

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