Obesity and Psychiatric Disorders: Frequently Encountered Clinical Questions

Obesity is a global epidemic and a health priority, and several psychiatric disorders, including major depressive disorder, bipolar disorder, and schizophrenia, are associated with an elevated risk of comorbid obesity. Moreover, persons with psychiatric disorders often have multiple risk factors (e.g., poverty and use of psychotropic medications) for excess weight. Excess weight in turn is associated with serious health consequences, both medical and psychiatric. Mental health care professionals must be familiar with the appropriate screening and treatment strategies for obesity. The authors provide a synthesis of the epidemiology, psychiatric and medical consequences, risk factors, and management strategies for obesity in psychiatric populations, giving particular consideration to management of the psychiatric patient who experiences psychotropic-associated weight gain. To formulate answers to 10 commonly asked questions about obesity and mental health, the authors conducted a MEDLINE search of all English-language articles published between 1966 and June 2005. The search terms were obesity, overweight, body mass index (BMI), metabolism, bariatric treatment, weight-loss treatment, major depressive disorder, bipolar disorder, schizophrenia, binge-eating disorder, eating disorder, and psychotropic medication. The search was supplemented with a manual review of relevant references.