Psychological Challenges


Inconclusive Prior Studies
While the physical health effects of excess weight and obesity are well documented, across all socioeconomic classes, ethnicities and age groups (the exception to the latter being that there is less known about the specific effects on the elderly, see Obesity in the Elderly page in the Obesity Facts section of our website), less is conclusively known about the psychological effects. This is partly due to previous studies that may not have adequately considered income levels, ethnicity, gender, or other peripheral factors that may affect psychology.

For instance, few studies have explicitly examined whether the association between obesity and psychopathology, especially depression, varies by race. This is important because it has been hypothesized that race may moderate the relationship between obesity and psychiatric impact of obesity. For instance, studies suggest that African American women appear, on average, to be more satisfied with their body image, and to have less fear of fat than do Caucasian women.

Much less is known conclusively about the association between obesity and suicidal tendencies. Clinical observations since the turn of the century have suggested a relationship between the two; however, other studies have failed to find a direct association. More recent studies, possibly with better experimental controls, show that a relationship between depression and obesity does exist, but is far more pronounced in women than in men.

Health Issues and Depression
What may be of more significance is a suggestion that, while obesity itself may not be a remarkable factor contributing to psychopathology, there are documented links between an increase in physical health disorders and depression. Since obesity has a clear relation to an increase in health issues, (see Co-Morbid Diseases page of the Obesity Facts section of our website), this may contribute to a relationship between increased obesity and negative psychology.

Negative Psychology and Binge Eating
While most overweight people have no more psychological problems, brought on by obesity, than people of average weight, up to 10% of people who are mildly obese and try to lose weight on their own or through commercial weight loss programs have binge eating disorder. This disorder is even more common in people who are severely obese.

During a binge-eating episode, people eat large amounts of food and feel that they cannot control how much they are eating. Those with the most severe binge eating problems are also likely to have symptoms of depression and low self-esteem. These people may have more difficulty losing weight and keeping it off than people without binge eating problems.

Emotional Consequences of Obesity in America
Emotional suffering may be one of the most obvious psychological pitfalls of obesity. American society emphasizes physical appearance and often equates attractiveness with slimness, especially for women. Such messages may tend to contribute to overweight people feeling unattractive.

Many people think that obese individuals are gluttonous, lazy, or both, even though this is not true. As a result, obese people often face prejudice or discrimination in the job market, at school, and in social situations. Feelings of rejection and shame are common.

Women Suffer More
Some recent studies suggest that severely obese subjects, especially younger women with poor body image, are at high risk for depression. These findings support the hypothesis that severe obesity, while it may not be a causal factor in depression, may aggravate depression.

It seems as though women may suffer even more compounded effects of obesity from a psychosocial standpoint. Studies that followed obese children into adulthood, of those who were persistently obese, obesity was not associated with any major adverse socioeconomic, educational, or social adult outcomes in men, though it was associated among women with a higher risk of never having been gainfully employed and not having a current partner.

Childhood Depression and Adult Obesity
With regard to childhood obesity, depression in late adolescence is associated with later obesity but only in girls.

Obesity and Depression vs. Depression and Obesity
It seems likely that, from studies that examine the relationship between psychology and obesity, there is a clearer understanding of how depression, anxiety, childhood trauma and introversion may lead to factors that cause obesity, less is known about how psychology flows in the opposite direction; that is, how obesity may directly relate to the cause these psychological effects.