WORKSHOP: Obesity and Mental Health - Overview for Psychiatrists
Presenting Author(s): Dr. Atul Khullar, MDD, Dr. Jennifer Swainson, MD, FRCPC
Date and time: 21 Mar 2026 from 14:20 to 15:20
Location: Beehive & Lakeshore
Learning Objectives
- Review the bidirectional relationships between obesity and mental health disorders;
- Consider the importance of appropriate psychiatric treatment for individuals living with obesity who have comorbid mental health disorders, and evaluate current pharmacotherapy options to minimize side effects of weight gain; and
- Discuss current strategies in obesity pharmacotherapy and the potential role of these agents in mitigating side effects of psychiatric medications.
Abstract
Obesity and mental health disorders represent two common intersecting health issues, with a complex and bidirectional relationship. A large-scale Austrian registry study confirmed that a diagnosis of obesity significantly increases the odds for a broad spectrum of severe psychiatric conditions, including depression, anxiety, and psychosis-spectrum disorders. (1) The nature of this bidirectional relationship often creates a challenging "chicken-or-egg" dilemma for clinicians and patients with one of the two often being neglected in treatment.
The underlying mechanisms between obesity and mental health disorders are multifaceted, encompassing biological pathways such as systemic inflammation and HPA-axis dysregulation, as well as psychosocial factors including weight stigma and emotional eating. Notably, specific psychiatric conditions like ADHD and BED are strongly linked to a potent pathway to obesity through the channel of disordered eating behaviours and poor sleep. (2).
This seminar will outline the major mental health co-morbidities with obesity and the deliberate selection of weight-neutral or weight-loss promoting treatments when possible to avoid iatrogenic contribution to obesity. The rapidly expanding field of obesity pharmacotherapy with the GLP-1 and GIP/GLP-1 medications and their impact on mental health will be discussed. Ethical underpinnings of the use of these medications will also be reviewed.
By guiding treatment selection to optimize both metabolic and psychiatric outcomes, clinicians can more effectively break the cycle of comorbidity for this patient population.
Literature References
- Leutner M, Dervic E, Bellach L, Klimek P, Thurner S, Kautzky A. Obesity as pleiotropic risk state for metabolic and mental health throughout life. Transl Psychiatry. 2023 May 30;13(1):175. doi: 10.1038/s41398-023-02447-w. PMID: 37248222; PMCID: PMC10227059.
- Cortese S. The Association between ADHD and Obesity: Intriguing, Progressively More Investigated, but Still Puzzling. Brain Sci. 2019 Sep 27;9(10):256. doi: 10.3390/brainsci9100256. PMID: 31569608; PMCID: PMC6826981
- Pedersen SD, Manjoo P, Dash S, Jain A, Pearce N, Poddar M. Pharmacotherapy for obesity management in adults: 2025 clinical practice guideline update. CMAJ. 2025 Aug 10;197(27):E797-E809. doi:10.1503/cmaj.250502. PMID: 40789597; PMCID: PMC12350384.