Psychological disorders: an emotional link to food

The extreme size of the obese carries a devastating social stigma. Often individuals are ostracized and self-esteem suffers as a result. Long-term depression is a common byproduct of obesity and can worsen the eating problem, with patients seeking satisfaction and comfort through food. Research reported in the July 2006 Archives of General Psychiatry showed a 25% increased risk of major depression, bipolar disorder, panic disorder, and agoraphobia (a fear of being in public places).

This topic becomes more complicated when thinking about the chicken and egg relationship. Typically, people who have a chemical imbalance and are depressed will not take care of their health. Overeating is similar to substance abuse in that it gives a quick but temporary feeling of satisfaction and happiness.

Depression is typically treated using psychotherapy and/or medication. One main obstacle is that many antidepressants on the market do include weight gain.

Osteoarthritis: the joints are suffering from the added strain
With the additional load placed on the joints in the body, it is intuitive that obese patients have a higher risk of facing mobility issues. Osteoarthritis (OA), or degenerative joint disease, is the most common form of arthritis and occurs when cartilage in the joints wears down over time. This wear and tear becomes much more rapid with increased stress and loading. It is easy to understand how being just 10 pounds overweight, which increases the force on the knee by 30-60 pounds with each step, can have a damaging effect on the body’s joints.

A recent study conducted by UNC Chapel Hill analyzed data from over 3,000 men and women in Johnston County, NC. Subgroup analysis showed that obese patients and a notably higher lifetime risk of developing osteoarthritis, at 64.5% relative to 44.1% in overweight individuals and 34.9% in healthy weight individuals.

While it does make sense that healthcare providers are seeing higher incidences of OA in knees and hips, they are also seeing increased osteoarthritis in non-weight-bearing joints such as the hands and wrists. This evidence points to the possibility that there could also be some cross-over systemic effects from the enlargement of fat cells as well. Researchers have found a high correlation between OA and the pro-inflammatory molecule leptin, which is secreted by hypertrophic adipocytes.

At present time, there is no cure for osteoarthritis. Typically, physicians will first recommend therapies to reduce stress on the joint and to relieve pain and stiffness. In very severe cases, patients may be required to undergo surgical intervention.

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