Overweight and obesity

Obesity and overweight have become a global health problem in recent decades

Some facts according to the WHO

• Obesity has tripled since the 1970s in most parts of the world.
• In 2016, more than 1.9 billion adults were overweight, and more than 650 million were obese.
• In the child and youth population, overweight and obesity rates exceed 340 million, of which 41 million are under 5 years of age.

Obesity and depression are two of the main public health problems, both being highly prevalent.

Both not only have asignificant impact on the health and functionality of individuals, but also greatly affect a country’s healthcare expenditure.

Numerous studies show how obesity is a risk factor for mood disorders, but also vice versa!

Some facts about Mental Health and obesity:

• More than 40% of people with depression are obese.
• Being obese means a 55% higher risk of becoming depressed.
• Furthermore, treatment of one of these two entities (e.g. obesity) has been shown to significantly improve the course of the other (in this example, depression). [Jantaratnotai N, Mosikanon K, Lee Y, McIntyre RS. The inferface of depression and obesity. Obes Res Clin Pract, 2017].
• Being overweight in childhood increases the risk of major depression in adulthood. [Gibson-Smith D et all. Childhood overweight and obesity and the risk of depression across the lifespan. BMC Pediatr, 2020].
• Obese children and adolescents are at increased risk for depressive symptoms, especially women and non-Western populations. [Quek YH1, Tam WWS2, Zhang MWB3, Ho RCM1. Exploring the association between childhood and adolescent obesity and depression: a meta-analysis. Obes Rev, 2017]
• Anxiety is more prevalent in overweight and obese subjects than in the general population [Amiri S, Behnezhad S. Obesity and anxiety symptoms: a systematic review and meta-analysis. Neuropsychiatry, 2019]
• Maternal obesity (more so than paternal obesity) is associated with a higher number of reports of children with attention and hyperactivity problems. [Robinson SL et all. Parental Weight Status and Offspring Behavioral Problems and Psychiatric Symptoms. J Pediatr., 2020]
• It is for these reasons that depression and obesity should be treated jointly, synergistically, and not as two separate entities.

How can we treat obesity?

It is well known that conventional methods (diet and exercise) often fail in these cases.

Until recently, bariatric surgery was the only realistic alternative for patients who failed to lose weight in a significant and healthy way despite multiple attempts to modify their lifestyle, with associated frustration and discomfort.

In recent times, drugs have been developed, the so-called GLP-1 analogues, which were initially marketed for the treatment of type 2 diabetes, and which were found to also produce a satiating or appetite-reducing effect, which was often associated with weight loss in patients.Specific studies were then conducted to find out whether these injectable drugs could also help people with obesity to lose weight, even if they were not diabetic, in a safe way. The results have been positive and, although in other countries such as the United States there are several GLP-1 analogues that have obtained FDA approval for the treatment of obesity, such as liraglutide or semaglutide, in Spain only one of them has been approved for this use.

This has led to a complicated and controversial situation, because there has been an increase in demand and in many cases misuse of this treatment, giving rise to a national stock problem that is affecting both patients with diabetes and patients with obesity, who really have an indication to use liraglutide.

In any case, it is essential to point out that these are prescription drugs and should NEVER be used without a doctor’s prescription and supervision.
Furthermore, it must be accompanied by changes in eating habits and physical exercise, and these healthy routines must be maintained in the long term, otherwise, of course, the weight lost can be regained.