Understanding and encouraging the overweight patient.
Objective. To enhance the psychiatrist's understanding of the effect of overweight and obesity on their patients' quality of life and psychological wellbeing and to examine how this can be improved, even in those patients who remain overweight.Design /Setting/Participants/ Measurements. Publications from disciplines, such as medicine, anthropology, finance, pediatrics, dietary, and surgery, are examined for insights into the psychological and societal factors associated with obesity, as well as the effects of different treatments on patients.Results. Being overweight or obese in this society is disparaged, even by young children. A negative body image can lead to psychological distress. This can affect one's wellbeing, even to the extent of affecting one's earning potential. When comparing our culture to a non-Western one, such as Fiji, it can be seen that a large factor in this may be our society's ideals, particularly for its female members. Those who are overweight can receive physical and psychological benefits from learning to accept their weight, even in the absence of weight loss. Also, regardless of the weight attained, an overweight person's quality of life can improve from the state of losing weight.Conclusions. Despite the societal implications and difficulties with being overweight, how one feels about his or her weight can determine how much of an effect it has on one's quality of life. A psychiatrist who is aware of this is in a position to assist their overweight patients in order to mitigate these negative effects.
Dr. Ruelaz is from Cedars-Sinai Medical Center, Department of Psychiatry, and Associate Director, Consultation-Liaison Division Faculty Psychiatrist, Cedars-Sinai Center for Weight Loss, Los Angeles, California.
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Ruelaz