Psychosocial Issues related to obesity

Social Stigmatization

In American and other Westernized societies there are powerful messages that people, especially women, should be thin, and that to be fat is a sign of poor self-control. Negative attitudes about the obese have been reported in children and adults, in health care professionals, and in the overweight themselves.
People's negative attitudes toward the obese often translate into discrimination in employment opportunities, college acceptance, less financial aid from their parents in paying for college, job earnings, rental availabilities, and opportunities for marriage.
Much of the research on the social stigma of obesity has suffered from methodological limitations. There has been a lack of research that has looked at the impact of obesity in the context of other variables, such as physical attractiveness, the situational context, and the degree of obesity. In addition, social stigma toward the obese has primarily been assessed among white individuals.
In addition, the degree of acceptance of obesity among people of lower education and income has not been well studied. Thus, these data are very incomplete with respect to racial and ethnic groups other than whites.

Psychopathology and Obesity
Research relating obesity to psychological disorders and emotional distress is based on community studies and clinical studies of patients seeking treatment. In general, community-based studies in the United States have not found significant differences in psychological status between the obese and non-obese. However, several recent European studies in general populations do suggest a relationship between obesity and emotional problems. Thus, it may be premature to state that there is no association between obesity and psychopathology or emotional distress in the general population. More focused, hypothesis-driven, and long-term studies are needed.
Overweight people seeking weight loss treatment may, in clinic settings, show emotional disturbances. In a review of dieting and depression, there was a high incidence of emotional illness symptoms in outpatients treated for obesity. However, several factors influenced these emotional responses; including childhood onset versus adult onset of obesity (those with childhood onset obesity appear more vulnerable). Another study that compared different eating disorder groups found that obese patients seeking treatment showed considerable psychopathology, most prominently mild to severe depression.

Body Image
Body image is defined as the perception of one's own body size and appearance and the emotional response to this perception. Inaccurate perception of body size or proportion and negative emotional reactions to size perceptions contribute to poor body image. Obese individuals, especially women, tend to overestimate their body size.
People at greater risk for a poor body image are binge eaters, women, those who were obese during adolescence or with early onset of obesity, and those with emotional disturbances. It is no surprise, then, that in some groups of obese persons, these individuals are more dissatisfied and preoccupied with their physical appearance, and avoid more social situations due to their appearance.
Body image dissatisfaction and the desire to improve physical appearance often drive individuals to seek weight loss. However, obese persons seeking weight reduction must come to terms with real limits in their biological and behavioral capacities to lose weight. Otherwise, weight loss attempts may only intensify the sense of failure and struggle that is already present among many obese individuals. For this reason, psychosocial interventions which incorporate strategies to improve body image may be helpful for those who want to lose weight and are very concerned about their physical appearance.

Side effects of slimming pills

Many slimming pills have now been taken off the market because of potential side effects and complications.

Amphetamine-type slimming pills were popular 30 to 40 years ago, but it took some time for doctors to realise they can be addictive and harmful. Few people managed to diet successfully with them and keep weight off, and many became physically hooked.
Even the more recent appetite-suppressant drugs, such as dexfenfluramine, have now been taken off the market in most countries, as research has linked their use to long-term problems such as heart disease.

New slimming drugs

Some new medicines to help people lose weight have been licensed in recent years. One, called sibutramine, alters the chemical messages in the brain that control how the person feels about food. By influencing brain chemicals called noradrenaline and serotonin, sibutramine helps to make a person feel full. Another, called orlistat, changes the way the stomach or intestines function, so that less fat enters the bloodstream. Several other drugs are in the development stage.

But, like any treatment, they have side effects. Sibutramine sometimes increases blood pressure, for example, while orlistat can cause diarrhoea and flatulence.

Anti-obesity drugs are only really suitable for very overweight people. Doctors are advised to only prescribe them in special circumstances. For example, as part of an overall treatment plan for the management of obesity for people aged 18 to 65 years with a body mass index (BMI) of 30 or more. Or where someone has a BMI of 27 or more and has another significant disease, such as type 2 diabetes or high cholesterol. The person must have already made serious attempts to lose weight by dieting, exercise and/or other changes in their behaviour.

See also Article: Asia's Killer Diet Pills @
http://www.time.com/time/magazine/article/0,9171,333902,00.html

Contributed by John Lee

http://www.nhlbi.nih.gov/guidelines/obesity/e_txtbk/ratnl/22112.htm

http://www.bbc.co.uk/health/ask_the_doctor/slimmingpills.shtml