Wednesday, June 9, 2010

Why See a Psychologist for Obesity?

Readers of this blog have no doubt noticed that I tend to highlight research evidence on psychological outcome studies, primarily those testing Cognitive-Behavioural Therapy (CBT), which tends to be very effective for many psychological issues -- often equally and sometimes superior to medication.

Well, I wanted to use this post to address psychology's role in obesity treatment. As most readers know, obesity has become a hot-button issue because the majority of people living in the US and Canada are at least overweight, with significant numbers meeting criteria for obesity (generally defined as a BMI >30). There are various treatment options available for obesity, including diet, medication and even surgery. But how do people know which are effective treatments?

Fortunately, people do not have to be left in the dark on decision-making for treatment options. There are experts in the area who can wade through the vast amounts of research, including outcome studies that examine whether various treatment strategies are effective. In 2007, the Canadian Medical Association published treatment recommendations based on the work of an expert committee. (Side Note: I had the pleasure of working at the same clinic with the lead author of this panel, Dr. David Lau from Calgary).

This expert panel recommended that psychologists be included in the treatment of obesity. Furthermore, they gave comprehensive lifestyle interventions, such as CBT, a grade A rating (this is the highest rating possible in the treatment guidelines).

Why would a psychologist be needed to help treat obesity? An entire book could be written to fully answer this question. But to give you an idea of the association between psychological variables and obesity, I offer the following research findings from recent studies:

(1) According to a recent Canadian study, obesity was associated with the following psychological problems -- depression, mania, panic attacks, social phobia, and agoraphobia without panic disorder. It was also associated with suicidal behaviour.

(2) A similar American study basically replicated most of the findings of the Canadian study.

(3) A recent US study found that 66% of obese patients undergoing bariatric surgery had a lifetime history of a psychological disorder.

Indeed, the link between psychological problems and overeating has been well-demonstrated. If you are someone thinking of making a concerted effort to lose weight, you should consider the advice of health experts and consider consulting a psychologist -- particularly one with experience in health psychology.

Dr. Roger Covin
Montreal Psychologist
www.drcovin.ca

References

Mather et al. (2009). Associations of obesity with psychiatric disorders and suicidal behaviors in
a nationally representative sample. Journal of Psychosomatic Research, 66, 277-285.

Simon et al. (2006). Association Between Obesity and Psychiatric Disorders in the US Adult Population. Archives of General Psychiatry, 63, 824-830.

Kalarkian et al. (2007).Psychiatric Disorders Among Bariatric Surgery Candidates: Relationship to Obesity and Functional Health Status. American Journal of Psychiatry, 164, 328-334.

Lau et al. (2007). 2006 Canadian clinical practice guidelines on the management and prevention of obesity
in adults and children. Canadian Medical Association Journal, 176 (Suppl. 8), Online 1-117
http://www.cmaj.ca/cgi/data/176/8/S1/DC1/1

1 comment:

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