Psychiatr News September 16, 2005
Volume 40, Number 18, page 26
© 2005 American Psychiatric Association
Need for Mental Health Intervention
Up to now, clinical psychiatrists have generally not considered their
patients' obesity their area of responsibility unless weight gain was caused
by psychotropic medications, Gregory Simon, M.D., a psychiatrist and
investigator at the University of Washington Center for Health
Studies–Group Health, observed in a recent interview. But with the
obesity epidemic now occurring in the United States, "that may be
changing," he said.
For instance, he pointed out, "because there is an association
between obesity and depression, psychiatrists will certainly see lots of
people in their practices who are being treated for depression and who are
overweight or obese. And some will say, `I am depressed because I am
overweight, and if I were not overweight, I would no longer be
depressed.'"
Moreover, as more obese patients seek bariatric surgery, an increasing
number of psychiatrists will undoubtedly be called in to evaluate them
psychiatrically and determine whether they are suitable candidates for the
procedure. For example, psychiatrists at Cedars-Sinai Medical Center in Los
Angeles have set up a program with the surgical team there to do psychiatric
evaluations on all patients seeking bariatric surgery. "It is quite a
big program," Jennifer McLain, M.D., a fourth-year psychiatry resident
at the center and one of the program evaluators, said in an interview.
Psychiatrists are likewise being increasingly asked to evaluate obese
children before they receive bariatric surgery, Gagandeep Dhaliwal, M.D., a
Mobile, Ala., psychiatrist reported at APA's 2005 annual meeting in May.
And as David Herzog, M.D., a professor of psychiatry at Harvard Medical
School and an eating disorder authority, told Psychiatric News,
although binge-eating disorder is a provisional eating disorder in
DSM-IV, "it will probably make it into DSM-V as an
actual category." Indeed, he predicted, "all the focus on obesity
may ultimately create this reaction of adding more eating disorders."
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