The Widening Gap: Weight Gain in Mental Illness: A National Health Priority.
The widening gap between the life expectancy of people with mental illness and Australia’s general population is a problem that requires urgent attention and weight gain in mental illness has become a mental health national priority. Statistics show that the average life expectancy of someone diagnosed with a mental illness is 50 to 59 years, which can be up to 20 years less than the general population. This is due to higher rates of physical illness, higher deaths from cardiometabolic conditions and cancers, and significant under treatment of these conditions. People with mental illness often state that they feel unsupported in their management of weight gain and associated conditions especially those in rural and remote areas. Many say they would consider stopping medications because of their weight gain which was shown in a study about patient’s perspectives and attitudes.
It is well documented that Australia is heading towards an obesity epidemic with 65% of the population overweight or obese. Metabolic syndrome and weight gain in mental illness has become a priority with more than 50% of people with mental illness developing this syndrome. Yet, the physical health of those with mental illness is often neglected.
What is Metabolic Syndrome?
It is defined as three or more of:
- central (abdominal) obesity
- raised blood pressure (hypertension)
- high blood triglycerides
- low levels of high density lipoproteins (HDL)
Many people have discussed the role that psychotropic medication may play in contributing to weight gain in mental illness and we can see from Stephen Stahl‘s graph below that it is the 1st step in the metabolic highway. However, we also have found that people with mental illness, even before starting medication, already show signs of metabolic syndrome concluding that the two conditions are associated.
How can we manage weight gain in mental illness and metabolic syndrome?
Encouraging those with mental illness to stop smoking, reduce alcohol and exercise are the foundations of lifestyle interventions of managing this condition. There is good research showing that mindfulness and cognitive behavioural therapy (CBT) can help with the drug induced hunger and the emotional eating. Being involved in multi-disciplinary lifestyle programs are important for education, motivation and monitoring. A good GP will play an important role in managing and investigating physical illness. More mental health multidisciplinary programs must be set up to tackle weight gain in mental illness. However, will the government throw any money into trying the reduce the worrying trend? Let’s see what they do in the budget.