Obesity and Mental Health

Elective Block
Psychosomatic Medicine
Dept of Psychiatry
Faculty of Medicine
Gadjah Mada University
2015

Metabolism and the

Brain
Individuals with depression have an
approximately 60 percent higher risk
of developing type 2 diabetes.
Conversely, individuals with diabetes
are at an elevated risk of developing
depression. Metabolic disturbances
are also reported to be two to four
times higher in people with
schizophrenia

 neuropsychiatric and metabolic

processes is one mediated by insulin

 insulin plays an important role in

dopamine-mediated reward circuits,
which are involved in the motivating,
rewarding, and reinforcing properties
of food
Insulin and insulin-mediated signaling
pathways also play an important role
in the regulation of normal emotional
and cognitive brain functions
http://www.the-scientist.com/?articles.view/articleNo/33338/title/Metabolism-and-theBrain/

 local inflammation likely causes synaptic

remodeling and neurodegeneration
within the hypothalamus, altering
internal hypothalamic circuitry and
hypothalamic outputs to other brain
regions. The result is disruption to
cognitive function mediated by regions
such as hippocampus, amygdala, and
reward-processing centers

 Food as a coping mechanism is a

very unhealthy relationship

Gmez-Pinilla, Fernando. Brain Foods: The Effects of Nutrients on Brain

Function. Nature reviews. Neuroscience 9.7 (2008): 568578. PMC. Web.
10 Apr. 2015.

Mental Function and Obesity

By Nobuko Yamada-Goto, Goro Katsuura and Kazuwa Nakao

http://howmanyarethere.net/wpcontent/uploads/2012/04/obese1.jpg

OBESITY ??
in 2010 showed 35.7% of American adults have
problem with obesity
17% of all American children are obese
Every year over 400,000 people are dying of
obesity in America. Health problems are also
costing the country over 117 billion dollars every
year

 Obesity is a medical condition in

which excess body fat has
accumulated to the extent that it
may have an adverse effect on
health, leading to reduced life
expectancy and/or increased health
problems
BMI : > 30 kg/m2

A comparison of a mouse unable to produce leptin thus

resulting in obesity (left) and a normal mouse.
En.Wikipedia

 alterations in
cytokine profiles
activation of the
innate immune
system contribute
to a proinflammatory state
inflammatory
mediators

Psychoneuroendocrinology (2009) 34, 181189

Obesity
reduced healthrelated quality-of-life,
Depression
chronic stress

Obesity
Related psychosocial
factors
Poor quality of life
Depression
Social isolation
Poor executive
functioning
Low self-esteem
Peer victimization
Suicidal ideation

Findings
chronic stress has a potential role in
the etiology of obesity
T. De Vriendt in Nutrition, Metabolism &

Cardiovascular Diseases (2009) 19, 511-519

Lifetime stress was associated with

an increased risk of obesity
especially in women
lower social position is associated
with higher stress, poorer diet
quality, and higher body weight

Yue Chen in Preventive Medicine 55 (2012) 464467

Carla J. Moore in

JOURNAL OF THE ACADEMY OF NUTRITION AND DIETETICS April 2012 Volume 112 Number 4

Psychiatric Disorders and

Obesity
major depression

(odds ratio [OR],1.21;

95%confidence interval [CI], 1.09-1.35)

bipolar disorder

(OR, 1.47; 95% CI, 1.12-

1.93)

panic disorder or agoraphobia

(OR,

1.27;95%CI, 1.01-1.60)

lower lifetime risk of substance use

disorder (OR,0.78;95%CI, 0.65-0.93)
Gregory E. Simon et al, Arch Gen Psychiatry. 2006;63:824-830

Stress and Appetite

eating less
Lack of
time
Fear
Tension
Scared
nervous

S. J. Torres and C. A. Nowson / Nutrition 23 (2007) 887894

Stress and appetite

continued..
greater perceived stress was positively
associated with a higher-fat diet
Individuals in situations of greater
perceived workload and perceived
stress reported increases in total
energy and fat intake
high- and low-fat sweet foods after
stress (acute)

ACUTE STRESS

CORTISOL

Neuropeptide Y
elevated secretion

LEPTIN
blunting of the
inhibitory
arm of food intake

APPETITE

http://2.bp.blogspot.com/uR_SBmERItQ/TkUbxZBpzNI/AAAAAAAAMuY/AxDqbce9OLQ/
s1600/leptin-appetite-cycle.jpg

S. J. Torres and C. A. Nowson / Nutrition 23 (2007) 887894

Impact of maternal obesity

Maternal obesity may lead to alterations in
HPA function that persist into postnatal life

Altered ACTH
concentrations

adrenal dysfunction
possibly cause the increase
adiposity, appetite, and
insulin resistance

Neurotransmitters and
obesity

U.N. Das, Nutrition

Volume 17, Issues 11
12, November 2001,
Pages 953966

 Overweight and obese children and

adults have elevated serum levels of
C-reactive protein, interleukin-6,
tumor necrosis factor-, and leptin
Dopamine, serotonin, neuropeptide
Y, leptin, acetylcholine, melaninconcentrating hormone, ghrelin,
nitric oxide, and cytokines and insulin
and insulin receptors food intake
Breast-feeding of more than 12 mo is
associated with decreased incidence
of obesity

Which priority?

STRESS

OBESITY

Management

http://www.dwp.gov.uk/publications/specialist-guides/medical-conditions/a-z-of-medical-conditions/obesity/causes-obesity.shtml

Selesai

Email

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