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Ask the Mental Health Expert Archives 2001-2004

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Stats on Overweight

Q. Would you happen to know how many people are overweight in USA? Why are so many people overweight and why does it seem like we keep getting larger and larger? Is this related to mental health? Are emotional problems (eating to soothe oneself) and binge eating root causes? Other thoughts?

A. Overweight and obesity are certainly major public health problems in this country. Both terms are defined in terms of a figure called BMI, or Body Mass Index. BMI is basically a measure of weight in relation to height (BMI = weight in kilograms/(height in meters)2). The term overweight is usually defined by scientists as having a BMI of greater than 27 kilograms/m2. Obesity is usually defined as a body mass index above 30 kg/m2 .

To give you an example: a BMI of 30 is about 30 lbs overweight, and is equivalent to 221 lbs. in a 6 foot tall person, or 186 lbs in someone who is 5 foot, six inches. BMI numbers apply to both men and women. Between 1960 and 1994, the prevalence of obesity in the U.S. (in adults) increased from about 13% to about 23% of the population. Some studies suggest that over half of the U.S. population is overweight. Obesity per se is not considered a psychiatric disorder. It probably stems from a combination of genetic, environmental, and social factors. However, binge eating disorder is a proposed eating disorder diagnosis that may be related to psychological factors; e.g., some individuals with this condition say that their binge eating is triggered by depressed or anxious moods, or a general feeling of tension that is relieved by eating. There may be a higher prevalence of depression in individuals with this condition.

Conversely, some depressed patients report binge-eating during their depressed periods, particularly chocolate, sweets, or carbohydrates. Presumably, these are attempts to self-medicate for depression. As far as the increase in obesity prevalence, this may stem from a combination of an increasingly inactive, sedentary life-style for many Americans; the ubiquitous presence of high calorie, fatty foods; and the relentless advertising that promotes this kind of diet. Paradoxically, the prevalence of anorexia nervosa (extreme underweight accompanied by distorted body image) also seems to be increasing. It seems that our culture is sending out two diametrically opposed messages: "Eat, eat, eat!," and "You can never be too thin". No wonder people feel like downing a couple of quarts of ice cream!

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July 2001
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