Waking Up About Weight Loss: Optimizing Psychiatry's Role in the Changing Landscape of Weight Management

Abstract: There has been no time in history in which the conversations around healthy weight and strategies for weight loss have been as contentious as they are now. People are constantly presented with images of the “ideal” body, ads for new exercise programs and apps that will change their lives, and often conflicting information from friends, family, and even healthcare professionals about the “right” things to do to optimize health. With nearly 50% of the US adult population meeting criteria for obesity, it is clear that this is one of the areas of greatest need and potential for intervention on both a personal and population level. In this interactive general session, we will explore ways in which psychiatrists are uniquely qualified to address weight management with our patients, providing evidence-based background, guidance, and practical tips.

We will discuss Ms. A, weaving her case through the three 20 minute presentations and encouraging engagement through guided individual reflection, brief small group discussions with those around you, and the use of polling software.

Dr. Hale will review the research around obesity and weight-related stigma in the healthcare setting, including the effects on physical and mental health outcomes. She will identify strategies that psychiatrists can employ for reducing bias, including emphasizing the social, environmental, and genetic determinants of weight, and avoiding a weight-centric approach to healthcare.

Dr. Valpey will present information on the most popular fad diets of our time, exploring motivations for quick weight loss and the physical and emotional challenges that arise from this approach. She will provide practical tips for psychiatrists to address disordered eating behaviors in the CL setting.

Dr. Chilcote, a diplomate of the American Board of Obesity Medicine, will review the basics of anti-obesity medications (AOMs), highlighting what all psychiatrists should know about the indications and benefits, risks, and hurdles in using medications to help patients who struggle with their weight. This will include the role that psychotropics can play in weight management. She will also highlight the recent conflicting evidence around the potential for GLP-1 agonists to contribute to mood symptoms and suicidality.

The session will end with time for questions and answers.

References:

Thomas JG, Bond DS, Phelan S, Hill JO, Wing RR. Weight-loss maintenance for 10 years in the National Weight Control Registry. Am J Prev Med. 2014;46(1):17-23. doi:10.1016/j.amepre.2013.08.019

“Update on the FDA’s ongoing evaluation of reports of suicidal thoughts or actions in patients taking a certain type of medicines approved for type 2 diabetes and obesity. News Release. US FDA. January 11, 2024. https://www.fda.gov/drugs/drug-safety-and-availability/update-fdas-ongoing-evaluation-reports-suicidal-thoughts-or-actions-patients-taking-certain-type

Content Contributors:

Diversity, Equity, and Inclusion: Dr. Hale will be devoting the entirety of her section of this session to addressing the issue of weight-related stigma, particularly as it negatively impacts patient engagement with healthcare. She will highlight ways in which access to healthcare, overt and implicit bias by providers, and culture-based stigmas disproportionately effect people from racial and ethnic minorities and will provide practical tips for providers to directly address a goal of providing equitable, personalized, and evidence-based care to all.