Integrating Weight and Depression

How a behavioral health provider would integrate physical and mental health with a patient who is interested in weight management but who is also struggling with depression. What are concerns a behavioral health provider needs to keep in mind for this type of patient?

Weight gain (management) is a serious issue facing millions of people. The statistics for obesity are linked to adverse physical, mental, and spiritual health issues such as depression, anxiety, and diabetes. The world is in a mental health crisis. Countless people are on prescribed medications (psychotropics, opioids) for depression (anxiety) whose side effects include weight gain.

In our digital age, people are working from home and living sedentary lifestyles. Many antidepressants psychotropic medications reduce testosterone and thyroid function linked to loss of energy, motivation, and overeating.  As a behavior health provider (BHP), integrating daily practices (routines) into clients (patients) lifestyle is necessary for long term health outcomes.

A concern for behavioral health providers (BHPs) who have clients that are visibly obese, is influencing (persuading) through motivational interviewing techniques to extract the inner “intrinsic” motivation on why it is important for a patient (client) to address weight management. Weight is a sensitive issue and denial (refusal) to make changes is the challenge for all BHPs (PCs, PCPs) alike.

Integrating information with initiatives (diet, nutrition, physical fitness) need consistency and reinforcement from BHPs and clients. Change happens differently for everyone, sometimes quickly, sometimes slowly. Persistence, encouragement, and access to resources (gyms, neighborhood recreation facilities) are all needed to make changes for people who are willing and open for change. Consistent follow-up meeting on set targets and positive reinforcement are useful methods towards implementing change.

It is important in motivational interviewing to clearly explain the detrimental consequences of poor weight management on physical vitality, mental health, and overall lifestyle (quality of life). When a patient understands that medications can cause weight gain, they can make choices on nutrition, diet, and exercise to help combat the issue.

A healthy body and mind require consistency, discipline, and dedication with short, medium, and long-range targets (goals). Helping a patient understand that their weight gain is not a reflection of poor character, lack of discipline, or motivation, rather a result of medication that needs to be combatted with physical, dietary, and nutritional responsibilities, helps relieve guilt, shame, and rejection.

For adults with overweight and/or obesity, weight management interventions provided by a dietitian are effective for improving several examined cardiometabolic outcomes and quality of life (Morgan-Bathke et al., 2022)

References

Morgan-Bathke, M., Baxter, S. D., Halliday, T. M., Lynch, A., Malik, N., Raynor, H. A., Garay, J. L., & Rozga, M. (2022). Weight management interventions provided by a dietitian for adults with overweight or obesity: An evidence analysis center systematic review and meta-analysis. Journal of the Academy of Nutrition and Dietetics. https://doi.org/10.1016/j.jand.2022.03.014

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