Newsletter

Obesity and Mental Health2025-06-02

Obesity has become a pandemic. With a clear understanding of why this is happening, it is relatively simple to solve.

Obesity occurs when the calories burned by physical activity are exceeded by the calories from food intake. The reduced physical activity is a consequence of our technologically advanced world, where people spend most days sedentary in front of a screen. The increased intake of calories has biological, sociological, and psychological roots. Biologically, some individuals have an evolutionary propensity to eat more than is needed in the present and store as fat for lean times. Over the eons for their ancestors, it was hard to predict when their next meal will be. Now that is not an issue. Moreover, fast food and other ultra-processed industrial food are engineered to be highly addictive. Sociologically, being around people who overeat and are overweight increases your odds of doing the same. Psychologically, the bombardment with advertisements for fast food and junk food and drinks is contributory.

The solution is simple. One hour of exercise a day (including something as simple as walking), cooking and eating a healthy meal at home every evening with your family and friends, and banning advertisement for ultra processed foods and drinks would all go a long way towards solving the problem. They may also be taxed extra, like cigarettes, to further de-incentivize their consumption.

However, an added and underappreciated dimension is that of mental health. Biologically, psychiatric medications can increase appetite. People with mental health issues self-medicate with food (particularly carbs for anxiety), and are more prone to the addictive impact of ultra-processed food. Sociologically, they are more isolative, exercise less. Psychologically, they are not optimistic about the future, so they go for immediate gratification rather than healthier but more delayed gratification, like exercising and cooking a meal for yourself.

The solution there is first to carefully optimize any psychiatric medications, and in most cases de-prescribe, guided by precision psychiatry (such as with the blood testing we have developed). Second, to make exercise a prescription and an organized group activity. And third, to boost their self-esteem and future orientation through therapy and counselling, including nowadays with simple digital tools and apps (such as the one we have developed).

The new GLP1 appetite suppressing medications work, but may have underappreciated adverse effects, and there is a rebound weight gain when they are stopped. A holistic and personalized approach is best and most sustainable. There is no (long term) health without (improved) mental health!