Beyond Pharmacotherapy: Understanding the Links between Obesity and Chronic Mental Illness

Taylor, Valerie H.; McIntyre, Roger S.; Remington, Gary; Levitan, Robert D.; Stonehocker, Brian; Sharma, Arya M.

doi:10.1177/070674371205700103

Cited by 70 publications

(44 citation statements)

References 132 publications

(150 reference statements)

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“…38 Complex links between weight, psychosociological factors, and psychiatric illness have been described. 39,40 Our analyses show that the results for the mental health subscale differ strongly between men and women. A clear progressive negative effect of excess weight was evidenced in women, whereas a plateau was reached in men.…”

Section: Sex Differences In Impact Of Excess Weight On Hrqolmentioning

confidence: 87%

Gender-Related Differential Effects of Obesity on Health-Related Quality of Life via Obesity-Related Comorbidities

Audureau

Pouchot

Coste

2016

Circ: Cardiovascular Quality and Outcomes

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T he prevalence of obesity has increased dramatically over the last decades in many industrialized countries, such that they are experiencing what has often been referred to as an obesity epidemic.1 Average body mass index (BMI) worldwide has increased by ≈0.5 kg/m 2 per decade since the 1980s, and an estimated 500 million adults were considered obese (BMI ≥30 kg/m 2 ) in 2008. 2 The trends in France are consistent with this general pattern, with an average relative increase in BMI of almost 6% per year since 1997 and a prevalence of obesity of 15% in 2009. 3 This rapid rise is a major public health concern because of the strong evidence for associations between excess body weight and increased mortality and morbidity. [4][5][6] The relationship between BMI and health-related quality of life (HRQoL) has been investigated in a variety of settings, including health centers for weight loss, general medicine practices, and population-based studies. [7][8][9][10][11][12][13][14][15][16][17][18] Most reports consistently show the following: (1) there is a J-or U-shaped relationship linking physical HRQoL and BMI, with higher risk for poorer HRQoL in the underweight and overweight/ with obesity subjects; (2) findings for psychosocial impairment are inconclusive and detect little or no effect; [7][8][9][10][11]13,19,20 (3) physical, and to a lesser extent psychosocial, impairment is more severe in women than men. 7,8,11,12,[21][22][23] There are few data available to explain the different consequences of obesity between the sexes because most analyses exploring the relationship between BMI and HRQoL account for sex as a confounder to adjust for and do not report stratified results. Among the various explanations that have been proposed, a higher discomfort caused by overweight has been observed in women, 24 and women have been found to develop body image dissatisfaction at higher rates compared with men. 25 Differences in prevalence and impact of obesityrelated medical comorbidities have also been suggested, suchBackground-Negative effects of obesity on health-related quality of life (HRQoL) have been reported, especially in women, but the relative contribution of cardiometabolic and other obesity-related comorbidities to such effects remains unclear. Our objective was to model the association by sex between body mass index and HRQoL and to precisely quantify the indirect effects mediated by obesity-related comorbidities. Methods and Results-Data were drawn from the latest French Decennial Health Survey, a nationwide cross-sectional study conducted in 2003 (21 239 adults aged 25-64 years analyzed). HRQoL was measured by the 36-item short-form health survey questionnaire. A mediation analysis based on the counterfactual framework was performed to quantify the proportion of obesity effects on HRQoL mediated by related comorbidities, including cardiometabolic risk factors (diabetes mellitus, hypertension, dyslipidemia) and diseases (ischemic heart disease, cerebrovascular, and peripheral vascular disease), musculoskelet...

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Section: Sex Differences In Impact Of Excess Weight On Hrqolmentioning

confidence: 87%

Gender-Related Differential Effects of Obesity on Health-Related Quality of Life via Obesity-Related Comorbidities

Audureau

Pouchot

Coste

2016

Circ: Cardiovascular Quality and Outcomes

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“…Methodological weaknesses inherent in these studies raise questions about whether links between maternal pre-pregnancy overweight and obesity and offspring psychopathology are due to a direct prenatal programming effect or confounding variables. Because maternal psychopathology 27 and socioeconomic disadvantage 28 are risk factors for obesity, as well as for the development of externalizing (behavioural) and internalizing (emotional) problems in youth, 29 they must be considered when attempting to isolate the role maternal adiposity in pregnancy plays in the development of emotional and behavioural difficulties in offspring. It is notable that just 8 of the 15 studies completed to date 16,[18][19][20]22,23,26,30 have attempted to adjust for a familial or genetic risk for psychopathology.…”

Section: Limitationsmentioning

confidence: 99%

Maternal Pre-Pregnancy Body Mass Index and Internalizing and Externalizing Problems in Offspring

2013

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Objective: To determine if maternal pre-pregnancy body mass index (BMI) is associated with increased levels of internalizing and externalizing symptomatology in offspring throughout childhood and adolescence, and if these links persist after adjusting for the confounders of these associations. Method:We examined links between maternal pre-pregnancy BMI and internalizing and externalizing symptoms in the offspring of 2785 members of the Western Australian Pregnancy (Raine) Cohort. Mothers rated these problems using the Child Behavior Checklist when their children were 5, 8, 10, 14, and 17 years of age. Growth curves were generated using multilevel linear regression to examine associations and to determine if changes in levels of these symptoms varied over time by maternal BMI.Results: Increased maternal pre-pregnancy BMI was associated with stably elevated levels of externalizing problems, and exhibited a statistically significant interaction with internalizing problems over time, indicating that youth born to mothers with higher maternal pre-pregnancy BMIs had less rapid decreases in internalizing scores as they got older. Significant positive associations between maternal pre-pregnancy BMI and elevated levels of internalizing problems emerged at age 8 and increased through 17. These findings persisted despite adjustment for confounders. Conclusions:Exposure to elevated maternal pre-pregnancy BMI is associated with increased levels of internalizing and externalizing problems throughout childhood and adolescence. Further work is required to establish if these associations are causal. If elevated maternal pre-pregnancy BMI is causally linked to psychopathology in offspring, it could provide a potentially realizable target for the prevention of mental health problems in youth.

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“…1 On average, mentally ill individuals lose 25-30 years of life as a result of obesity-related illnesses, including diabetes and cardiovascular disease (CVD). 2 Higher rates of obesity in this population are, in part, attributable to antipsychotic treatment, which has well-established effects on adiposity and glucose regulation.…”

mentioning

confidence: 99%

Getting to More Effective Weight Management in Antipsychotic-Treated Youth: A Survey of Barriers and Preferences

et al. 2016

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Background: Mentally ill youth are at risk for developing obesity, especially when they require antipsychotic treatment; moreover, they may face unique challenges in adhering to behavioral weight loss interventions. The aims of this project were to characterize the challenges families of youth with psychiatric disorders face when engaging in weight loss treatment and to gather information on attitudes and preferences for weight management interventions in this population.Methods: We devised a telephone survey to evaluate caregiver-perceived barriers/challenges to and preferences for behavioral weight loss treatment in overweight or obese mentally ill youth ages 6-18 treated with an antipsychotic agent in an outpatient setting.Results: A total of 26 parents or primary caregivers completed the survey. The most commonly cited barriers to participation in physical activity (PA) and maintaining a healthy diet were child's dislike of PA and child's preference for energy-dense foods, respectively, which were impacted by psychiatric symptoms. Preferences for weight loss treatment included individualized, prescribed meal plans and shopping lists, and exercise support/demonstration, with a preference for Internet or cell phone applications to help with monitoring food intake and exercise.Conclusions: These results suggest that targets for obesity treatment in this population include individualized, specific support that takes into account the child's motivation, which is effected by psychiatric symptoms. Tools for providing support may include the use of telehealth visits and mobile device applications for self-monitoring.

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Beyond Pharmacotherapy: Understanding the Links between Obesity and Chronic Mental Illness

Cited by 70 publications

References 132 publications

Gender-Related Differential Effects of Obesity on Health-Related Quality of Life via Obesity-Related Comorbidities

Gender-Related Differential Effects of Obesity on Health-Related Quality of Life via Obesity-Related Comorbidities

Maternal Pre-Pregnancy Body Mass Index and Internalizing and Externalizing Problems in Offspring

Getting to More Effective Weight Management in Antipsychotic-Treated Youth: A Survey of Barriers and Preferences

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