Obesity: psychological factors involved in overweight

Obesity is considered a pandemic in Western countries. Bad habits, stress, a sedentary lifestyle and poor diet are the most common causes of overweight. It is a disease that comes from the hand of a work context that forces us to sit in an office and pay little interest for our health.

Of course, there are several disorders that can also be the cause of obesity. Medical problems such as endocrine or hormonal disorders. These are separate cases which will have to be treated from a primarily medical point of view.

    The psychological and psychiatric factors of overweight

    Scientific research has focused on this disease, obesity. In the United States, more than two-thirds of adult women and up to 75% of men are overweight.

    Overweight and obesity: differences

    It helps to differentiate between overweight and obesity, As they are related concepts but not identical. The two have in common to denote an excess of accumulated fat. However, people with a body mass index (BMI) of 25 to 29.9 are considered overweight, being people who should reduce their weight for better health.

    Obesity is a more serious problem quantitatively and qualitatively. Obese people exceed 30 BMI points and their health is at significant risk.

    Treating obesity from psychology

    The causes of obesity are diverse and, in many cases, comorbid. That means treatments to overcome this problem must be multifactorial: From the medical and endocrinological field, to psychology and psychiatry can help people suffering from this problem.

    Over the past decades, a number of therapies and treatments have been developed against this disease, mainly focused on improving eating habits and promoting physical exercise. These two factors are closely related to the reduction in body volume.

    However, obesity professionals have become aware of the need to intervene on this issue with more specific and personalized approaches, through medical, nutritional, psychiatric and psychological interventions. This deployment of professionals to put an end to this problem is motivated by the human, social and economic costs generated by obesity.

    Risks of obese people

    Obesity is a disease that not only affects the quality of life of those affected, but also leads to other significant problems:

    1. Comorbidity

    Obesity is a risk factor for the development of other pathologies: hypertension, heart disease, cancer, sleep apnea, etc.

    2. Social stigma

    Unfortunately, people suffering from this health problem are strongly stigmatized both in school and in the workplace. It involves declining self-concept, increasing anxiety, and worsening personal relationships.

    3. Psychological and psychiatric disorders

    Obesity has a high rate of comorbidity with psychopathologies, such as anxiety, substance abuse, depression, eating disorders, among others.

    Relevant psychological aspects

    As I mentioned before, obesity has biological, psychological and cultural causes. When it comes to the psychological aspects associated with being overweight, there are different approaches and studies that highlight some possible causes, but none has a high consensus.

    For example, since psychoanalysis, obesity is often attributed to the symbolic act of eating, and overweight is often associated with an externalization of neurosis, associated with depression, guilt and anxiety. It’s also common to associate obesity with some underlying emotional conflict or other previous mental disorder.

    The psychological etiology of obesity is puzzling, so intervention efforts focus on assessing and rehabilitating certain patients’ beliefs, as well as knowledge of affective (emotional management) and environmental (habits) variables. food, habits, etc.). ). This variety of psychological processes involved in obesity raises the need to approach the situation of each patient individually, assessing their personality and environment.

    Psychological assessment

    Psychologists and psychiatrists can investigate and intervene in the beliefs and emotional states of obese patients in order to improve their quality of life. It is important for the therapist to create the right environment for the patient to exhibit and express their emotional and cognitive conflicts. Usually, obese people have low self-esteem and poor self-image.

    Self-esteem, eating habits and perception of intake

    Ultimately, the therapist must not only promote changes in eating habits and lifestyle, but must also find ways to strengthen self-concept to focus on weight loss. In this regard, the importance of providing the patient with tools for controlling emotions, impulses, as well as anxiety management techniques should be emphasized.

    It should be noted that obese patients tend to underestimate their calorie intake compared to people without weight problems. They minimize the amount of food they eat, not fully aware that they are eating too much. This is a characteristic common to people with other types of addictions. To control this, the psychotherapist should accompany the patient and make live recordings to show what amounts should be acceptable for each meal.

    In short, therapy should focus not only on weight loss, but on the process of psychological maturation that allows you to become aware of the problem, improve your quality of life, and establish healthy habits, such as physical activity, a better self-image and perception of one’s own body, and healthier eating habits. It is also the key cmake the patient aware that obesity is a disease, And insist that efforts must be made to avoid relapses. One of the most effective treatments has been cognitive behavioral therapy.

    Psychiatric aspects to consider

    The role of the psychiatrist is also relevant in the treatment of obese people. Psychiatrists are responsible for deciding which patients are eligible for surgery and which are not. Traditionally, it has been considered that patients with psychotic disorders are unsuitable for surgery, nor are those with a history of abuse or dependence on alcohol or other drugs.

    Another group of patients who have serious difficulties following psychiatric treatment related to being overweight are those with a personality disorder.

    About 30% of obese people who undergo therapy report having bulimic impulses. In addition, 50% of patients with bulimic implants also suffer from depression, compared to only 5% of patients without this type of impulse.

    Treating affective disorders such as anxiety or depression in obese people is key to a good prognosis. It is the basis necessary for the patient to engage in the treatment and change his lifestyle.


    Clearly, obese patients require comprehensive treatment: doctors, psychiatrists, nutritionists and psychologists must intervene to diagnose and treat each person correctly and in a personalized way. Although there is not a large consensus on the psychological causes of obesity, we find common threads in many obese patients: low self-esteem, poor self-image, poor eating habits, and poor eating habits. comorbidity with other psychopathologies.

    This should make us appreciate the relevance of the role of mental health professionals in improving the quality of life and the chances of recovery for these patients.

    Bibliographical references:

    • WHO. (2014). Descriptive note n ° 311
    • Banegas, JR (2007). The public health challenge of obesity. I NAOS Convention. Spanish Agency for Food Security and Nutrition. Madrid, March 27, 2007.
    • Strategy, NAOS (2005). Strategy for nutrition, physical activity and obesity prevention. Ministry of Health and Consumer Affairs. Spanish Food Safety Agency. Madrid.
    • Stunkard, AJ (2000). Determinants of Obesity: Current Opinion. Obesity in Poverty: A New Public Health Challenge, 576, 27-32.
    • McRoberts, C., Burlingame, GM and Hoag, MJ (1998). Comparative effectiveness of individual and group psychotherapy: a meta-analytical perspective. Group dynamics: theory, research and practice, 2 (2), 101.

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