Uneasy Obesity

Social anxiety in obese individuals

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) Social anxiety disorder (SAD) is currently defined as having excessive anxiety that's not related to a medical condition. Should researchers change that definition for obese individuals?

Researchers argue that obese individuals who are having social anxiety related only to their weight, may have a form of social anxiety disorder. This conflicts with criteria for diagnosing SAD as laid out in the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV).

"Obesity can cause severe anxiety."

Research led by Kristy Dalrymple, Ph.D. of Rhode Island Hospital evaluated 791 people who were seeking bariatric (gastric by-pass) surgery for weight loss. Study participants were divided into three groups: 135 people meeting the DSM-IV criteria for SAD; 40 who experienced significant social anxiety related to weight only, which researchers called "modified SAD"; and 616 who had no history of psychiatric disorders.

Individuals in both the SAD and modified group were found to have poorer social functioning over the past five years and as adolescents, compared to participants who had no disorder.

Additionally, the study found that the SAD group had more time off work in the past five years due to mental/emotional health issues compared to the other groups. Those in the modified SAD group experienced greater disruption in their social life.

A workgroup proposing changes to the upcoming edition of the mental health diagnostic manual - the DSM-5 - has recommended modifying the criteria for SAD. This would allow individuals with medical conditions such as stuttering, Parkinson’s Disease and obesity to be diagnosed with SAD if the anxiety is excessive or unrelated to the medical condition.

Dalrymple says that obese individuals who experience weight-related social anxiety could potentially benefit from treatment of this disorder. Excluding the diagnosis of SAD may interfere with the full identification of the disorder.

The study is published in the journal Depression and Anxiety.

Reviewed by: 
Review Date: 
June 13, 2011
Last Updated:
June 14, 2011