Obesity: Treating the Symptom as the Diagnosis

Now that obesity has become a worldwide epidemic, it is more important than ever that we understand the underlying causes for obesity, and how we can further prevention and intervention efforts.  Research demonstrates that most people think the obesity epidemic is due to laziness, lack of effort, and high fat foods.  These stereotypes of obese individuals are harmful, and can lead to hurtful perceptions and further weight gain. To look at causes of obesity only from the strictly physical perspective is to deny the role of the mind entirely.

As Kiecolt-Glaser et al. (2015) highlight, pathologies such as depression and underlying stress can alter the way in which our bodies metabolize food, and thus, can lead to significant weight gain over time. Depression and obesity are highly comorbid, and often fuel the existence of the other. For instance, individuals with depression may feel like engaging in less physical activity, slow their metabolism, and may begin to have erratic eating behaviors (either overeating or lack of appetite). In turn, this may lead to weight gain, and greater intra-abdominal obesity that can put an individual at much greater risk for cardiovascular disease and Type 2 diabetes (Finch & Tomiyama, 2014; Sapolsky, 2004). Common reasons for low esteem and mood in individuals with obesity is due to feeling helpless to alter their situation as they continue to gain weight, and their concern for how others perceive their appearance, which leads back to depressive patterns of thinking.

In order to intervene, it is clear that we cannot simply play the blame game and call out individuals with obesity by saying that they are not trying hard enough. Sometimes their minds, and by extension their bodies, are working against efforts that are made (as in the case of depressed individuals). And yet, media tells the public that it’s all about calories in versus calories out, and that obese individuals need to move more, and go on restrictive diets. Nobody seems to be talking about the mind-body connection, and yet it seems to be an essential component to intervening with the obesity epidemic.

Some research has begun to investigate the role of the mind in commitment to health-related lifestyle changes, and the framing of goals related to physical activity and weight loss. Magnan et al. (2017) discusses previous research that found participants’ self-reported exercise was greater after messages about affective benefits of exercise (reducing anxiety) than cognitive benefits (reducing heart disease). This finding is in direct contrast to the messages we receive from the media. The benefits we hear about in relation to exercise rarely relates to making our mental quality of life better, but rather focuses on the physical aspects. We know that we can reduce heart disease, or that our legs will look better if we run, but do we all know about the research that highlights the mental clarity and work productivity that can come from running on a regular basis?

It seems that it is time to change our tune as a nation, and perhaps worldwide. Americans in particular are known for their intense work ethic and long work hours, but perhaps we can consider what stress, and the pathologies that result in large part from stressors, are doing to our bodies and in particular our waistlines. Is it possible that providing more mental health services, including mental maintenance (such as yoga, meditation, and therapy) could go beyond altering stress levels, but also lead to healthier weight? Furthermore, teaching mental health strategies may even allow for longer-lasting results of weight loss and weight maintenance if we consider making services available for all Americans, regardless of their weight. I feel that this is a potential avenue for research, and that given the connections we already know exist, it is a promising one.

References

Finch, L. E., & Tomiyama, A. J. (2014). Stress-induced eating dampens physiological and behavioral stress responses.

Kiecolt-Glaser, J. K., Habash, D. L., Fagundes, C. P., Andridge, R., Peng, J., Malarkey, W. B., & Belury, M. A. (2015). Daily Stressors, Past Depression, and Metabolic Responses to High-Fat Meals: A Novel Path to Obesity. Biological Psychiatry77(7), 653–660. http://doi.org/10.1016/j.biopsych.2014.05.018

Magnan REShorey Fennell BRBrady JMHealth decision making and behavior: The role of affect-laden constructsSoc Personal Psychol Compass2017;11:e12333. https://doi.org/10.1111/spc3.12333

Sapolsky, R. M. (2004). Why zebras don’t get ulcers. New York: WH Freeman.

One thought on “Obesity: Treating the Symptom as the Diagnosis

  1. Hi Keri, I am glad your post addressed these important points. I agree with you that the media is focused on discussing the benefits in a way that only highlights how good your body will look and does not really highlight the importance of how well we might feel, mentally, after working out. I don’t know if you’ve seen this show, but I am a fan of the 600 lbs life series on TLC. The show follows individuals who are roughly 600 lbs and their weight loss journey. I wonder if having film their weight loss journey is helpful or more hurtful for them in the future? I ask because it does subject these individuals to the various negative comments you brought up, but it also might encourage them by showing these individuals how far they’ve come. This could be one example of how the media could be helpful in helping obese individuals overcome their illness. I think it would be even more helpful however if these shows incorporated more mindfulness/yoga interventions as well because they focus more on surgeries to help individuals lose weight.

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