S06 – Obesity and Mental Health: Understanding the Overlap to Improve Clinical Practice

S06 – Obesity and Mental Health: Understanding the Overlap to Improve Clinical Practice

Saturday, Oct. 29
10:45 – 11:45 (1 hr)
Meeting Room: Willow (Mezzanine)
Sri Mahavir Agarwal*, MBBS, MD, PhD; Margaret Hahn, MD, PhD, FRCPC; Raed Hawa, MSc, MD, FRCPC, DABSM; Sanjeev Sockalingam, MD, MHPE, FRCPC
Supported by the Canadian Academy of Consultation-Liaison Psychiatry

CanMEDS Roles:

  1. Medical Expert
  2. Scholar
  3. Health Advocate

At the end of this session, participants will be able to: 1) Understand the high comorbidity of metabolic dysfunction and sleep disorders in people with mental illness and vice-versa; 2) Understand pharmacological and nonpharmacological treatment approaches addressing these comorbidities; and 3) Understand the efficacy and suitability of bariatric surgery in people with mental illness.

Obesity is a growing public health concern in Canada. As a result of the complex relation between obesity and mental health, psychiatrists are increasingly faced with challenges in treating psychiatric illness, with the complicating effects of obesity. Recent evidence also suggests that treating metabolic comorbidity can lead to improvement in mental health. This symposium brings together presenters from diverse career stages and clinical research focuses to discuss the relation between obesity and mental health and review best practices in addressing this complex problem. Presenter one will review the complex interaction driving the overlap, including contributing effects of illness-associated lifestyle factors, illness biology, and psychotropic treatments; they will then present data from a new meta-analysis, demonstrating how these factors come together to result in obesity in vulnerable people with intellectual and developmental disability. Presenter two will discuss evidence-based approaches to managing obesity in people with severe mental illness, including pharmacological and non-pharmacological approaches. Presenter three will explore the interaction between obesity and sleep disorders, including respiratory-related disorders, such as obstructive apnea and obesity hypoventilation syndrome, and nonrespiratory-related disorders, such as narcolepsy, restless leg syndrome, and night eating syndrome, with an emphasis on treatment options. Presenter four will share new data on the efficacy of bariatric surgery in people with mental illness, focusing on interactions with psychopharmacology and mental and physical health outcomes pre- and postsurgery. Guideline-related resources will be shared, including Obesity Canada toolkits and additional resources developed by the presenters.

References:

  1. Wharton S, Lau DCW, Vallis M, et al. Obesity in adults: a clinical practice guideline. CMAJ 2020;192:E875-E891.
  2. Taylor H, Hensel J. Multimorbidity: a review of the complexity of mental health issues in bariatric surgery candidates informed by Canadian data. Can J Diabetes 2017;41:448-52.