As psychiatrists, we should care because these statistics translate potentially into considerable morbidity and mortality for our patients. I would recommend that psychiatrists not only discuss, but
also monitor, their patients' weight as part of every psychiatric evaluation and treatment. Many of our psychotropic medications cause not only weight gain, but also severe metabolic disturbances such as
abdominal fat accumulation, abnormal lipid and glucose levels, insulin resistance, and even overt type 2 diabetes. Patients are less apt to adhere to treatment recommendations when substantial weight
gain occurs with medication. Anxiety and depression are also more common in patients with obesity, though it is not often clear which is cause and which is consequence. Further, the obese may easily
suffer from lowered self-esteem, as they become victims of prejudice and overt discrimination in such areas as marriage, education, and employment compensation. In other words, psychiatrists must be
sensitive to the possibility that their obese patients may experience the potential double stigma of obesity and mental illness.