The Psychology of Eating: From Healthy to Disordered Behavior

154 Obesity

BMI and mortality. This therefore suggests that an increased BMI is related
to mortality and that this stands regardless of whether or not obesity itself
causes weight-losing conditions.

Psychological problems

The contemporary cultural obsession with thinness, the aversion to fat found
in both adults and children, and the attribution of blame to the obese may
promote low self-esteem and poor self-image in those individuals who do
not conform to the stereotypically attractive thin image (see chapters 5
and 6). Research has therefore also examined the relationship between
psychological problems and obesity. A number of studies suggest that being
obese can be detrimental and have tended to focus on depression. Some
studies have explored levels of depression in those waiting for surgical treat-
ment for their obesity and consistently show such patients reporting more
depressive symptoms than average-weight individuals (e.g., Bull et al., 1983;
Wadden et al., 2006). In addition, Rand and McGregor (1991) concluded
that individuals who had lost weight following gastric bypass surgery stated
that they would rather be deaf, dyslexic, diabetic, or have heart disease or
acne than return to their former weight. More recently, Simon et al. (2006)
carried out a large survey on over 9,000 adults in the US and concluded that
obesity was associated with increased lifetime diagnosis of a number of

Mortality ratio

300

250

200

150

100

50

0

15 20 25 30 35 40

Low

risk

Moderate

risk

High

risk

Body mass index (kg m
^2 )

Age at issue

20–29

30–39

Figure 8.2 The relationship between BMI and mortality.