Psychosomatic Aspects of Obesity

Obesity, defined as an excessive accumulation of body fat, presents one of the most prevalent health conditions in the Western world. There are considerable ethical, stigmatic, and health policy implications of obesity. Psychosocial aspects are strongly involved in the causal and maintaining factors of obesity. This includes mental comorbidities such as depression and eating disorders and the still controversial concept of food addiction. Binge eating/binge eating disorder, loss of control eating, grazing, emotional eating, and food addiction are all fairly prevalent among individuals with excess weight. More research is needed on the interplay between impulsivity, reward sensitivity, rash spontaneous behavior, risky decision-making, and reduced inhibition. Obesity already occurs in childhood and early-onset severe obesity presents a significant clinical challenge. Obesity can reach severe forms necessitating bariatric surgery.

Currently available evidence suggests that bariatric surgery is associated with long-term reductions in anxiety and depressive symptoms; however, research has documented a number of different psychosocial concerns that may emerge following surgery including maladaptive eating behavior, substance use disorders, suicide, lack of social support, and problems with excess skin. Maladaptive eating initially declines then increases after bariatric surgery, with a notable number of de-novo cases. Psychosocial interventions have been found effective in improving comorbid psychopathology and there are first promising results with tailored eHealth weight-loss interventions. Psychosocial interventions have also been shown to have a positive impact on post-surgery outcomes, particularly maladaptive eating. Lifestyle changes are difficult to achieve and require new strategies for sustainable habit formation. We would also welcome manuscripts on dietary behavioral habits, such as sugar addiction, both pre and post-surgery.