Leo Sher, M.D.

A research report, “Obesity as pleiotropic risk state for metabolic and mental health throughout life” has recently been published in Translational Psychiatry (1).

A significant part of the worldwide population is overweight. Obesity is a substantial global health burden. The prevalence rates of obesity have been progressively increasing over the past decades. Obesity is associated with metabolic syndrome, hypertension, and other medical conditions. Obesity is known to increase risk for and severity of psychiatric disorders.

A research group from the Medical University of Vienna examined the Austrian national registry data of inpatient services from 1997 to 2014 to study associations between a diagnosis of obesity and psychiatric disorders. Data covered about 45 million hospital stays of 9 million patients. Data were stratified by age decades and associations between each pair of diagnoses were computed with the Cochran-Mantel-Haenszel method, providing odds ratios (OR) and p values corrected for multiple testing. Directions of the associations were assessed by calculating time-order-ratios.

The authors found that across all age groups, obesity was associated with significantly elevated odds for a large spectrum of psychiatric disorders, including depression, psychosis-spectrum, anxiety, eating, and personality disorders. Researchers observed that for all co-diagnoses except for psychosis-spectrum, obesity was significantly more often the diagnosis received first, i.e., obesity commonly preceded psychiatric conditions. Significant sex differences were observed for most disorders, with women showing elevated risk for all disorders except schizophrenia and nicotine addiction. The authors suggest that among biological pathways linking obesity to mental illnesses, increased neuroinflammation due to cytokine production in adipocytes may be most prominent.

Among medical diagnoses, diabetes mellitus, arterial hypertension and dyslipidemia emerged as the strongest associations with obesity. This is consistent with the role of obesity as a major factor in metabolic dysregulation.

Reference

1. Leutner M, Dervic E, Bellach L, Klimek P, Thurner S, Kautzky A. Obesity as pleiotropic risk state for metabolic and mental health throughout life. Transl Psychiatry. 2023 May 30;13(1):175. doi: 10.1038/s41398-023-02447-w.