Association between Obesity and Psychiatric Co-morbidities: A Cross-sectional Study

Introduction: Obesity is a global epidemic associated with significant physical, economic and psychological costs. It has a bidirectional relationship with various psychiatric disorders. However, the evidence regarding the strength, direction and moderating factors of this relationship remains inconsistent and inconclusive. Aim: To examine the association between different grades of obesity and psychiatric disorders, as well as, to evaluate their impact on quality of life. Materials and Methods: The present cross-sectional study was conducted in the Departments of Medicine and Endocrinology, PSG Institute of Medical Sciences and Research (a tertiary care centre), Peelamedu, Coimbatore, South India, between January 2019 and June 2020, among stable inpatients. A total of 195 participants with a Body Mass Index (BMI) ≥25 kg/m2 , aged between 18 years and 65 years, of all genders, were included. The participants were initially categorised into two groups: overweight and obese. The obese group was further subdivided into three classes: obese-I, obese-II and obese-III. Participants were required to have the ability to read and write in Tamil or English. The prevalence of various psychiatric disorders and quality of life was assessed using the Mini-International Neuropsychiatric Interview (M.I.N.I.) 5.0 and the World Health Organisation Quality of Life-Brief (WHOQoL-BREF) tools. Statistical analysis was performed using Statistical Package for the Social Sciences (SPSS) software version 21.0. Results: Of the total participants, majority, 114 (58.5%) were aged from 31-45 years. Males comprised 116 (59.5%) and females were 79 (40.5%) of the study participants. Among the 195 participants, depressive episodes were present in 1 (1%) of the overweight group and 7 (8.8%) of the obese-I group. The prevalence of dysthymia was 3 (3%) in the overweight group, 15 (18.8%) in the obese-I group, and 2 (15.4%) in the obese-II group. Panic disorder was observed in 1 (1%) of the overweight group, 3 (3.8%) of the obese-I group, 2 (15.4%) of the obese-II group, and 1 (33.3%) of the obese-III group. Lifetime limited symptoms of panic attacks were reported by 5 (5.1%) participants in the overweight group and 14 (17.5%) in the obese-I group. Pairwise group analysis revealed a significant association with the diagnosis of dysthymia. Quality of life was found to be poor across all four domains: physical health, psychological wellbeing, environmental factors and social relationships. Conclusion: The present study demonstrates a significant association between obesity and psychiatric disorders, particularly dysthymia, anxiety, and substance use disorders. Obesity negatively impacts quality of life across physical, psychological, social, and environmental domains. Further longitudinal studies are needed to explore the causal relationships and underlying mechanisms between obesity and psychiatric co-morbidities.