Obesity Associated Disease in People with Mental Disorders: the Role of Psychotropic Medication and BMI

Obesity-associated diseases, such as type 2 diabetes, metabolic syndrome, and dyslipidemia, are common in individuals with mental disorders. The relative contribution of mental disorders, psychotropic medication, and BMI remains unclear. In this cross-sectional study, individuals aged 18-60 years with a BMI ≥ 30 kg/m² were referred to the University Hospital of Southern Denmark, Esbjerg, and screened for diabetes, prediabetes, metabolic syndrome, hypertension, blood lipid abnormalities, liver disease, and sleep apnea. Individuals with mental disorders were compared to those without using binomial logistic regression adjusted for BMI, age, sex, and use of psychotropic medication. We included 345 participants with and 317 without mental disorders, all with BMI ≥ 30 kg/m². Participants with mental disorders were younger (40.9 ± 10.9 vs. 44.2 ± 10.8 years) and had higher BMI (42.8 ± 7.9 vs. 40.9 ± 6.4 kg/m²). Adjusted analyses showed no increased odds of obesity-related disease except for blood lipid abnormalities and steatosis. BMI significantly influenced most models but not the association with blood lipid abnormalities. Apart from blood lipid abnormalities and steatosis, obesity-related diseases in individuals with mental disorders appears to be largely attributable to obesity. Weight management should be prioritized, with additional focus on blood lipid abnormalities.