How obesity causes mental depression

Obesity: Exclusion favors mental illness

The prejudice, devaluation, social exclusion, and discrimination people experience because of their obesity act like chronic stressors. The psychological stress caused by this stigma can lead to depression, anxiety disorders and often even further weight gain. The Integrated Research and Treatment Center for Obesity Diseases (IFB) in Leipzig examined the mechanisms behind this on the basis of available studies. The results were recently published in the journal "Obesity".

Strong stigma

The researchers analyzed 46 scientific studies that examined the connection between the stigma of severely overweight people with mental distress. "Many risk factors for mental illness are very pronounced in people with obesity - also because of their stigmatization," says study director Claudia Sikorski.

Above all, the reduced self-esteem described in the studies is considered to be a major risk factor for mental illnesses such as depression and anxiety disorders. Based on an approach taken by Columbia University to explain the effects of stigmatization on homosexual people, Sikorski developed a model for the greater susceptibility of obese patients to mental illness.

Worse self-awareness

Those affected have a reduced self-esteem and a reduced ability to cope with problems (coping). There are also other risk factors such as negative self-perception, increased loneliness and a lack of social support. Morbidly overweight men and women also accept the negative external image that is revealed by stigmatization as a self-image.

Experts speak of an internalized stigma or self-stigma, which can lead to a vicious circle of stigma, more social withdrawal, further weight gain and consequently ever greater stigma. In addition, there is often the experience of disadvantage and discrimination in social and professional life. In the case of weight loss programs in particular, trust in one's own abilities and strength is indispensable, because the therapy of obesity requires commitment and motivation from the patient more than other diseases.

Break the vicious circle

Sikorski is looking for therapeutic approaches to break this vicious circle. "Our work is important for improved obesity therapy because we cannot trust that the social perception of people with obesity will improve in the foreseeable future. We should therefore show those affected ways and means of dealing with stigmatization," says the scientist.

In a follow-up study, Sikorski's team, in cooperation with the forsa opinion research institute, asked around 1,000 adults with obesity about their experiences with stigmatization and how they deal with it. This should help to better understand how stigmatization is experienced, how it unfolds its negative effects and how those affected can deal with it. (red,, 9.1.2015)