Mixed Nuts, Part 2

From Fineartamerica.com

I thought I would mix it up a bit.

Change the metaphor.

You know, the "Crazy as a Loon" thing.  Just trying to keep it interesting...

So, part 2 of this salient topic will cover the latter parts of the article I recently reviewed on the psychological profile of the morbidly obese.  Still to get to will be Eating Behavior, Social Integration, and Quality of Life.

Eating Behavior

No stereotypical surprise here.  The reviewed studies did show significant differences in the eating behavior of normal subjects as opposed to the morbidly obese.  More often, morbidly obese subjects exhibited patterns of compulsive eating, binge eating disorder (BED - a rapid ingestion of a large amount of food with a resultant feeling of loss of control and subsequent guilt and self-condemnation), and/or "grazing" (eating smaller amounts of food frequently throughout the day).  'Mindless eating' is also more common, as well as self-reported frequent snacking on high calorie foods.

Going back to the BED, most studies showed that its incidence was closer to 2-5% in the general population, as opposed to the morbidly obese, where it is noted to be present in 30-50% in one study of those seeking medical care for their obesity.

Behaviorally, there was also a notable correlation with emotional eating, that is, overeating in response to emotional distress.

Social Integration

Social discrimination and numerous stigmata are frequently cited in articles. Psychological consequences can lead to low self-esteem,  as patients deal with prejudice and social bias.  The negative social judgements, such as name-calling and labels ("stupid", "ugly", "lazy", "sloppy") reflect negative attitudes that imply that these individuals are responsible for their obesity through lack of control and lack of will power.

That sense is frequently reinforced by their environment, one that can cause embarrassment in regard to fitting in chairs, clothes that don't fit, difficulties with aisles and hallways to name a few, as well as having challenges with personal cleanliness and odor.

Social isolation, as well as employmental isolation often leads the morbidly obese patient to stay at home, which only serves to reinforce the problem.

Quality of Life

Quality of Life refers to the patient's satisfaction with his or her personal life and the overall effects of medical conditions on the physical, mental, and social functioning and well-being of the subject being evaluated.  It is self-reported by the patient.

The article's review of the literature showed those seeking surgical care for their obesity reported a significantly lower Quality of Life.  Often those patients stated that they had little to fear, given they had the perception of little to lose vs. the potential benefit that weight loss surgery could bring.


So, in summary, there were some new discoveries for me, as far as the implication for some of the trends described.  What the article did say was that, all in all, the obese are not a truly homogenous group.  A number of distinct subgroups were noted, but to be fair, not enough to allow for generalities that are an accurate representation.  Many of those generalities persist, even among health care providers.

The NHLBI expert panel from the recent past described obesity as 'a heterogeneous chronic disorder'.  

However, there is no looking past a lot of the similarities that the morbidly obese present with, or "as".  And, as with most other medical disorders that impact patient's lives, those common traits can be used for gain by health care providers in order to make a profound connection with the patient, in order to get them the medical care they need to improve their total health and better their life situation.