Psychological aspects of obesity☆
Section snippets
Stigma and discrimination
Prejudice and discrimination toward obese individuals persist despite worldwide increases in the prevalence of obesity and the recognition of genetic contributions to body weight. In America, negative attitudes and behaviors are likely exacerbated by our culture's idealization of thinness. Ridicule and disparagement of obese individuals seems to remain a socially acceptable form of prejudice.
The “fat is bad” stereotype begins early in life. Children as young as 3 years old have been found to
Studies of the general population
Early studies of the psychosocial status of obese individuals in the general population yielded inconsistent results.1 Some found that obesity was related to greater emotional distress, whereas others reported that obese people displayed less psychological disturbance. Regardless of the direction of the relationships between obesity and psychopathology, these studies consistently failed to find clinically significant results. The differences between obese and nonobese individuals were not
Potential risk factors
In recent studies, the focus of inquiry has shifted from whether obesity is related to greater psychological distress to which obese people are at increased risk for psychopathology. This new question characterizes the second-generation studies and recognizes the heterogeneity of obese persons. Discovery of risk factors is of great importance given that there is likely greater variability among obese individuals than between obese and nonobese people. In this section we review the
Temporal sequencing of obesity and psychopathology
Researchers have begun to examine the question of whether obesity precedes depression or whether an existing mood disturbance predisposes to increased weight. Three studies have addressed this issue. Goodman and Whittaker24 studied a nationally representative sample of 9374 U.S. adolescents in grades 7–12. Participants reported their height and weight and completed a depression questionnaire in 1995 and again in 1996. The investigators explored the reciprocal relations between obesity and
Clinical implications
The preceding sections have shown that obesity is related to a slight increase in the risk of mood disturbance—but only among women—and that depression appears to precede obesity in adolescence but to follow the onset of obesity in later adulthood. Clinicians are reminded, however, that the vast majority of obese people are not depressed. Careful assessment is needed.
When confronted with an obese patient who is also depressed, the clinician should not assume that the patient's depression is
Conclusions
Contrary to common stereotypes and assumptions, obesity is not strongly associated with depression or any abnormal personality characteristics. Psychological traits are more widely varied within the population of obese persons than between obese and nonobese individuals. As with people of average weight, certain factors appear to increase the risk of psychopathology among obese persons. Obese females, binge eaters, and extremely obese persons are at increased risk for emotional disturbance.
References (31)
- et al.
Thin is good, fat is bad: how early does it begin?
J Appl Dev Psychol
(1998) - et al.
Psychosocial aspects of obesity and obesity surgery
Surg Clin North Am
(2001) - et al.
Psychopathology in subgroups of obese women with and without binge eating disorder
Compr Psychiatry
(1994) Treating depression with selective serotonin reuptake inhibitors: a practical approach
Mayo Clin Proc
(2001)- et al.
Psychological correlates of obesity: moving to the next research generation
Psychol Bull
(1995) - et al.
Body weight and psychological distress in NHANES I
Int J Obes
(1992) - et al.
Relationships between obesity and DSM-IV major depressive disorder, suicide ideation, and suicide attempts: results from a general population study
Am J Public Health
(2000) A study of social stereotype of body image in children
J Pers Soc Psychol
(1967)- et al.
Overweight/obese patients: an overview
Practitioner
(1982) - et al.
Weight bias among health professionals specializing in obesity
Obes Res
(2003)
Prejudice against fat peopleideology and self-interest
J Pers Soc Psychol
The weight of obesity in evaluating others: a mere proximity effect
Pers Soc Psychol Bull
Bias, discrimination, and obesity
Obes Res
Weight-based discrimination in employment: psychological and legal aspects
Pers Psychol
Do parents discriminate against their heavy-weight daughters?
Pers Soc Psychol Bull
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Supported in part by grants (1-U01-DK57135 and K24-DK065018) from the National Institute of Diabetes and Digestive and Kidney Diseases.