Assessment of the psychological and behavioral characteristics of obese individuals: Medical observation of depression, low self-esteem, and social adjustment disorders

The modern medical model has shifted from the traditional biomedical model to the biopsychosocial model. The concept of health is no longer limited to the absence of disease, but encompasses a state of complete physical, mental, and social well-being. While biological and genetic factors are closely related to the occurrence of disease, psychological factors and adverse behaviors also play a significant role. Mental state has a significant impact on weight control; a positive attitude and mindset contribute to obesity intervention and the maintenance of weight loss, while a prolonged negative attitude can exacerbate obesity and have a significant impact on the patient's physical and mental health. Therefore, in the process of obesity intervention, in addition to controlling diet and increasing exercise, medical personnel should also grasp the patient's individual characteristics and psychological and behavioral state to conduct positive and effective psychological and behavioral interventions. Obese patients who receive both dietary and psychological interventions often achieve better weight loss results than those who only receive dietary intervention. I. Common Psychological and Behavioral Problems in Obese Patients Obesity has always been a major threat to people's health; it is a pathological condition itself and can cause various metabolic diseases. The factors leading to obesity are diverse, and psychological and behavioral problems are one of the causes. Studies have shown that the psychological state of obese people differs significantly from that of normal people. Obese people are more prone to psychological problems such as loneliness, anxiety, and depression, which can affect weight loss.

Depression: Depression is a group of mood disorders characterized by significant and persistent low mood, slowed thinking, cognitive impairment, reduced volition, and somatic symptoms. The incidence of depression in obese patients is approximately 55%, and the incidence of obesity among patients with depression can reach 58%, indicating a significant bidirectional link between obesity and depression. Obese children and adolescents are more susceptible to depression and more likely to experience severe depressive symptoms. There are also gender differences in the occurrence of depression; obese women are more susceptible to depression than obese men. Racially, obese populations in East Asia are more likely to suffer from depression than obese populations in Western countries. Symptoms of depression in obese patients include anxiety, loss of interest, anhedonia, decreased energy or fatigue, psychomotor retardation, low self-esteem, feelings of self-blame or guilt, and sleep disturbances. In more severe cases, recurrent suicidal thoughts or self-harming behaviors may occur. The development of depression in obese patients is related to dissatisfaction with their body shape. Previous studies have shown that children's dissatisfaction with their body shape is related to their weight; the heavier the child, the higher the dissatisfaction, especially among girls. Overweight and obese children have significantly higher levels of body shape dissatisfaction than children of normal weight, and overweight girls show significantly higher scores on depressive symptoms than girls of normal weight. Childhood depressive symptoms are a risk factor for adult depression. Obese adolescents and college students, due to dissatisfaction with their appearance, concern about others' opinions, and discrimination, often have higher levels of implicit self-esteem and experience greater psychological pressure, leading to various discomforts in their studies and daily lives. They are more prone to somatization, obsessive-compulsive symptoms, anxiety, phobias, psychotic hostility, and paranoia.

Inferiority complex: An inferiority complex refers to the emotional experience arising from underestimating oneself when compared to others. It is a feeling of shame, timidity, timidity, or even discouragement stemming from feeling "inferior." Due to body size, obese individuals often suffer from low self-esteem and cognitive biases, leading them to overlook their strengths and potential, thus easily developing an inferiority complex. Racism, discrimination, and malicious slander from those around them further exacerbate this inferiority complex. An inferiority complex in obese individuals can manifest as hypersensitivity to ordinary things, a tendency to make unfounded assumptions and even distort others' words, and severe internal conflict when faced with negative evaluations. Because of this inferiority complex, obese individuals are often taciturn, poor at communicating, and reluctant to express their thoughts and emotions, resulting in an unmet sense of self-worth and a state of imbalance. Furthermore, obese individuals with an inferiority complex tend to have poor psychological resilience and often choose to avoid difficulties. These traits are even more pronounced in obese adolescents.

Decreased Social Adaptability: Obese individuals, especially obese children, experience a decline in self-awareness and a low self-esteem regarding their physical appearance, which can indirectly affect their daily social skills. Studies show that obese children have lower activity, social, learning, and social adaptability than children of normal weight, and the more severe the obesity, the worse the social adaptability. Obese adolescents also exhibit similar trends. These individuals lack general interaction with classmates, prefer solitude, and are reluctant to make friends, especially severely obese girls. The various psychological problems that obese children and adolescents experience in social situations are mainly social avoidance and social anxiety. Social avoidance refers to behavioral manifestations in social interactions, primarily manifested as a tendency to be alone and a dislike or unwillingness to communicate with others. As obesity worsens and children grow older, their personalities tend to become more introverted and unstable, and behavioral problems and social avoidance phenomena increase accordingly. Due to being ostracized and ridiculed in group activities, obese children are afraid to contact others in social activities, dare not express their opinions or showcase their talents, and gradually develop withdrawal and avoidance psychology, forming an introverted personality and preferring solitude. Social anxiety refers to the tense or even fearful emotional experience an individual experiences when in one or more complex interpersonal situations, such as fear of being observed or commented on by others, or worry about feeling awkward or out of place. It is characterized by a strong and persistent fear of social or behavioral situations. Studies have shown that overweight and obese school-aged children experience varying degrees of social anxiety.

Loneliness: Loneliness is a painful and unpleasant subjective emotional experience caused by a lack of good interpersonal relationships. Obese children and adolescents are prone to loneliness. Studies have shown that children with simple obesity experience loneliness.