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Journal published by the Hellenic
Psychiatric Association


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Anxiety disorders are the most prevalent mental disorders in developed countries. On theother hand, obesity is recognized to be one of the greatest public health problems worldwide.The connection between body weight and mental disorders remains an open issue.Low body weight has been studied enough (anorexia nervosa is a typical example) buthigh body weight has not been addressed sufficiently. It is known that obesity has been relatedwith depression. Although moderate level of evidence exists for a positive association betweenobesity and anxiety disorders, the exact association between these two conditions is not clear yet.The studies about this subject are quite few and they follow different methodology. Furthermore,anxiety disorders share some common elements such as anxiety, avoidance and chronicity, butthey also present a great deal of differences in phenomenology, neurobiology, treatment responseand prognosis. This factor makes general conclusions difficult to be drawn. Obesity has been associatedwith anxiety disorders as following: most of the studies show a positive relationship withpanic disorder, mainly in women, with specific phobia and social phobia. Some authors have founda relationship with generalised anxiety disorder but a negative relationship has been also reported.Only few studies have found association between obesity and agoraphobia, panic attacks and posttraumatic stress disorder. There has not been reported a relationship between obesity and obsessivecompulsive disorder. The causal relationship from obesity to anxiety disorders and vice versais still under investigation. Pharmacological factors used for obesity treatment, such as rimonabant,were associated with depression and anxiety. Questions still remain regarding the role of obesityseverity and subtypes of anxiety disorders. Besides, it is well known that in the morbidly obese patientsbefore undergoing surgical treatment, unusual prevalence of psychopathology, namely depressionand anxiety disorders, is observed. Anxiety is also a common trait in personality disorders.There is no single personality type characteristic of the morbidly obese, they differ from the generalpopulation as their self-esteem and impulse control is lower. Obese patients present with passivedependent and passive aggressive personality traits, as well as a trend for somatization and problemdenial. Their thinking is usually dichotomous and catastrophic. Obese patients also show lowcooperativeness and fail to see the self as autonomous and integrated. When trying to participate insociety roles they are subject to prejudice and discrimination and should be treated with concern tohelp alleviate their feelings of rejection and guilt.

Key words: Anxiety, anxiety disorders, obesity, personality traits

L. Lykouras, J. Michopoulos (page 307) - Full article