The Link Between Obesity Syndrome and Mental Health ConditionsSeptember 28, 2022
When was the last time you stood in front of a mirror and chose self-love over self-criticism? The most important relationship we have is the one we have with ourselves. When we knock ourselves down, we devalue ourselves. We prevent growth and bury our strengths. Many can feel like this during their wellness journeys, especially when they lack support from providers and others. Frustration is common while working towards weight-related and general health goals and mental health conditions. The time and effort we’ve put into caring for our bodies can feel fruitless. People of all sizes may wonder why their bodies can’t resemble the models that society largely advertises, forgetting that the models themselves look nothing like their advertised images in real life.
Surrounded by diet culture, people feel overlooked and unsupported unless we look like the idealized societal standard. When we feel unsupported by providers, our discouragement worsens. As humans, it’s easy to blame ourselves for struggling, when struggling is not our fault. When we neglect to hold ourselves with compassion and see who we are, our struggles grow, and our intuition shrinks. So, how can we help weight loss surgery (WLS) patients be supported and encouraged every step of the way in their journeys?
Anxiety and depression tend to be higher in patients with overweight and obesity syndromes. When the focus is on their weight, the patient, who matters above all else, is ignored. If we treat them from a weight-biased approach, we do harm by disregarding the fact that nobody knows a patient’s body better than the patient. Nobody knows their experience better than they do. Receiving impersonal treatment intensifies their frustrations and struggles. Studies show that nearly half of patients experience depression prior to weight loss surgery (Alabi F). Post-surgery, patients experience less depressive symptoms, but symptoms often return and heighten within the first year, making regular exercise a consideration for long-term success.
Exercise Effects on Anxiety and Depression
Many of us have experienced that post-gym flow of endorphins, especially after choosing the gym over procrastination. When we exercise, we relieve stressors and tension in our bodies, which improves our moods. When you struggle with exercise, these goals are harder to reach. Feeling discouraged is normal, and so is struggling with fitness. We are only human. This is where support comes in because no one is meant to journey alone.
Support can consist of trained professionals, peers, and friends who are on similar journeys. Having a supportive community is essential in helping find the kinds of movement that works best for your body.
When we take a collaborative approach, we make it easier to learn which exercises work, while crossing out what doesn’t. As progress occurs, you may later find yourself enjoying exercise, and when we enjoy what we’re doing, it’s easier for us to show up. Exercise consistently, and we experience improved cognition. We even sleep more soundly at night thanks to a calmer mind (Relojo-Howell D).
If you struggle with ADHD, memory and concentration can improve throughout your wellness journey. Some people choose exercise over medications, while others feel that medication and exercise, together, work best for them. Similar results have been found in people with panic and anxiety disorders, along with PTSD, when they exercise at least three times a week. (Relojo-Howell D). When living an active lifestyle, we support our physical and mental health, while also investing in our long-term quality of life.
Anxiety disorders debilitate our daily abilities to function, and exercise can relieve us of our symptoms and protect against anxiety disorders. (Kandola A). In preventative and treatment purposes, physical activity brings no shortage of benefits. Although further research needs to be conducted, WLS patients with anxiety and other mental health disorders need to know that exercise generally lowers their risk of physical and mental health complications throughout their lifetimes (Kandola A).
In Shape: Physically and Mentally
Consistent exercise is vital. Persevering in your fitness routine represents a commitment to yourself and your wellness journey. You might also go on to lose more weight post-op, and the many benefits of exercise can help in encouraging you as you move forward (Livhits M). The key term here is “consistent.” Patients commonly struggle with being consistent in their fitness programs, and we know how discouraging it can be when it feels as though our struggles are overwhelming.
It might help to consider that studies found that patients who receive counseling before WLS surgery are better prepared for physical activity afterwards. When given mental health support, we provide new approaches to help people work through and overcome exercise hurdles. With assistance, patients and professionals together collectively remove the focus on weight loss.
Another benefit is that when we omit weight from the equation, we combat weight-related stigma, and mental health improves. We feel more motivated to stick with working out when our outlooks are better. The more patients focus on how they feel during their workouts, the less they focus on their weight, and then weight loss isn’t so much a goal as it is a bonus result. Without adequate support, however, we struggle. So, why would we expect anything different in our patients? The better we support people, the more likely they are to shine and thrive.
But what is the correct exercise prescription? Guidelines on how long someone should exercise have yet to be standardized, although many reflect those provided by the American Heart Association, and the American College of Sports Medicine. The guidelines typically suggest up to 30 minutes of moderate-intensity aerobic activity, 5 times a week, or 20 minutes of higher intensity, 3 days a week (Livhits M).
Going for the Gold
A great option is to have a team of trusted professionals who can recommend or refer you to a personal trainer, or group fitness instructor, as well as to mental health professionals. Mental health professionals will be able to address any mental health conditions or concerns you may have while helping you work through challenges you’re facing in your exercise routine. The inclusion of exercise in therapeutic approaches is supported for any of us living with depression, as well as other mental disorders (Schuch FB). Bringing exercise into clinical practices has been gradual, but patients commonly experience levels of relief from mental disorder symptoms when each is combined (Schuch FB). They find that exercise becomes an essential part of their routines, given the wealth of positive effects on their mental and physical health.
Getting to this point in the wellness journey is hard, but each professional you have on your team is here to work with you on your journey. We all experience mental hardships at one or many points in our lives. As hard as it can be for us to push forward, we owe it to ourselves to continue on. We are worth the journey, and we are not on this journey alone.
- Alabi F, Guilbert L, Villalobos G, et al. Depression Before and After Bariatric Surgery in Low-Income Patients: the Utility of the Beck Depression Inventory. Obes Surg. 2018;28(11):3492-3498. doi:10.1007/s11695-018-3371-0
- Kandola A, Stubbs B. Exercise and Anxiety. Adv Exp Med Biol. 2020;1228:345-352. doi:10.1007/978-981-15-1792-1_23
- Livhits M, Mercado C, Yermilov I, et al. Exercise following bariatric surgery: systematic review. Obes Surg. 2010;20(5):657-665. doi:10.1007/s11695-010-0096-0
- Mikkelsen K, Stojanovska L, Polenakovic M, Bosevski M, Apostolopoulos V. Exercise and mental health. Maturitas. 2017;106:48-56. doi:10.1016/j.maturitas.2017.09.003
- Relojo-Howell D. What Are the Mental Health Benefits of Exercising. Psychreg. https://www.psychreg.org/mental-health-benefits-exercising/. Published July 6, 2022. Accessed July 25, 2022.
- Schuch FB, Vancampfort D. Physical activity, exercise, and mental disorders: it is time to move on. Trends Psychiatry Psychother. 2021;43(3):177-184. doi:10.47626/2237-6089-2021-0237
Dezi's Fusion HFX health center offers a supportive environment for her patients.
ABOUT THE AUTHORDezi Zevin is a physician assistant with over 20 years of experience. She is a NASM-certified personal trainer, bariatric fitness specialist, and medical fitness practitioner. She believes in working collaboratively with each patient to create an individualized plan that considers all aspects of their health, from gut health to mental health and fitness. Dezi's Fusion HFX health center offers a supportive environment for her patients. This approach has helped countless people not only reach their goals but empowered them to maintain their results long-term.