of obesity to the province’s health-care
system in 2005 was $1.27 billion.
Prevention and treatment strategies
based on the relationship between obesity
and mental health may help alleviate this
health burden, and, more importantly,
help those struggling with obesity.
A common assumption is that obesity
is the fault of those who are obese.
It’s seen as a weakness, a character flaw
or a testament to a lack of willpower.
Along with this goes the belief that the
solution to obesity is the right combination
of diet and exercise. “We tend to think
of weight gain as a simple problem of
taking in more calories than you put out,”
says Dr. Brian Stonehocker, an assistant
clinical professor in the Department of
Psychiatry at the University of Alberta.
“But, in fact, obesity is a complex illness,
with many contributing factors.”
These include a host of environmental,
socio-economic, genetic, medical and
mental-emotional factors such as over-
eating, inactive lifestyles, food insecurity
(the availability of food and one’s access
to it), income, lack of time, poor sleep,
peer pressure, societal norms and
“The 4Ms of Obesity,” an assessment
tool developed by Dr. Arya Sharma, chair
for Obesity Research and Management at
the University of Alberta, puts the many
drivers of obesity and the barriers to
weight management into four categories:
mental (such as depression and eating
disorders), mechanical (for example,
osteoarthritis and sleep apnea), metabolic (including type 2 diabetes and high
blood pressure) and monetary (such as
income, education and employment).
There’s a reason why “mental” is the
first category. “Virtually every mental
health issue, if not controlled and
well-managed, is going to make weight
management challenging,” Sharma says.
He also stresses that not everyone who
is overweight is mentally ill or has a
mental health problem.
Ximena Ramos Salas, the managing
director of the Canadian Obesity Network
(CON), says mental health issues are
factors in approximately 70 per cent of
The interplay between obesity and
mental health is twofold. Mental health
disorders can be the primary cause
of weight gain and they can also be
barriers to making the lifestyle changes
needed to combat obesity and manage
Depression, addictions, acute anxiety,
eating disorders, attention deficit disorder,
post-traumatic stress disorder…all mental
health disorders can affect appetite.
“Emotional eating is a big part of the
obesity issue,” Sharma says, explaining
people often use food as a coping
strategy for depression, stress, anger
or other negative emotions.
The simple truth is people do this
because it works. “From a scientific
perspective, it has been shown that
eating certain types of foods—especially
foods that people tend to crave—can
boost serotonin levels and regulate
emotions, so people are effectively
medicating their mood or anxiety,
but with the side effect of weight gain,”
Many mental health disorders also
is going to make weight