Weighty Consequences: Diagnostic Challenges and Practice Considerations Associated With Obesity

Wendy Ashley


The impact of obesity is detrimental to health, mental health and well-being.  Despite the significant increase of adiposity in the past two decades, the condition has gained minimal representation in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR and DSM 5), the primary diagnostic classification system used by mental health practitioners. Because the diagnostic classification of obesity is nebulous, obesity related impairments are unacknowledged and treatment is compromised. This article explains why changes in the DSM 5 fail to adequately address the relationship between obesity and mental health, utilizing case study examples to elucidate the psychological impact of obesity in varied clinical settings. Additionally, the author reflects on the challenges of diagnosing and treating obesity with high-risk, marginalized populations.


Obesity; Diagnosis; Practice; DSM 5; Weight stigma

Full Text:



American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington D. C.

American Psychiatric Association. (2010). Eating disorders: Proposed revisions for DSM-5. Retrieved 2011, June 28 from http://dsm5.org/proposedrevisions/pages/eatingdisorders.aspx

American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed.). Washington D. C.

Bean, M. K., Stewart, K., & Olbrisch, M. E. (2008). Obesity in America: Implications for clinical and health psychologists. Journal of Clinical Psychology in Medical Settings, 15, 214-224.

Bomback, A. E. (2014). The contribution of applied social sciences to obesity stigma related public heath approaches. Journal of Obesity, Article ID 267286, 8-15.

Brochu, P. M., & Esses, V. M. (2011). What’s in a name? The effects of labels “fat” versus “overweight” on weight bias. Journal of Applied Social Psychology, 41(8), 1981-2008.

Carels, R. A., & Musher-Eizenman, D. R. (2010). Individual differences and weight bias: Do people with an anti-fat bias have a pro-thin bias? Body Image, 7, 143-148.

Centers for Disease Control and Prevention. (2011). Reteived 2011 October 19 from http://www.cdc.gov/chronicdisease/resourcs/publications/aag/obesity.htm

Centers for Disease Control and Prevention. (2014). Retrieved 2014 October 22 from http://www.cdc.gov/obesity/adult/defining.html

Central Region Eating Disorder Service. (CRED). (2007). Retrieved 2011 June 28 from http://www.eatingdisorders.org.nz/index.php?id=775

Chronic Conditions Team. (2013). Obesity is now considered a disease. Cleveland Clinic News Wire. Retrieved 2014 October 10 from http://health.clevelandclinic.org/2013/06/obesity-is-now-considered-a-disease/

Dave, D. M., Tennant, J., & Colman, G. (2011). Isolating the effects of major depression on obesity: Role of selection bias. Journal of Mental Health Policy and Economics, 14(4), 165-186.

Devlin, M. J., Yanovski, S. Z., & Wilson, G. T. (2000). Obesity: What mental health professionals need to know. American Journal of Psychiatry, 157(6), 854-866.

Foster, G. D., Wadden, T. A., Makris, A. P., Davidson, D., Sanderson, R. S., Allison, D. B., & Kessler, A. (2003). Primary care physicians’ attitudes about obesity and its treatment. Obesity Research, 11, 10, 1168-1177.

García, R. (2013). The George Butler lecture: Social justice and leisure. Journal of Leisure Research, 45(1), 7.

Hadfield, S. C., & Preece, P. M. (2008). Obesity in looked after children: Is foster care protective from the dangers of obesity? Child: Care, Health and Development, 34(6), 710-712. doi: http://dx.doi.org/10.1111/j.1365-2214.2008.00874.x

Haslam, N. (2005). Dimensions of folk psychiatry. Review of General Psychology, 9(1), 35-47.

Karasu, S. R. (2012). Of mind and matter: Psychological dimensions in obesity. American Journal of Psychotherapy, 66(2), 111-128.

Keenan-Devlin, L. (2014). The weight of structural violence: Syndemic stress and obesity among black urban youth in the US. (Order No. 3626766, Northwestern University). ProQuest Dissertations and Theses, 187. Retrieved from http://search.proquest.com/docview/1558126615?accountid=7285. (1558126615)

Luppino, F. S., de Witt, L. M., Bouvy, P. F., Stijnen, T., Cuijpers, P., Penninx, B. W., & Zitman, F. G. (2010). Overweight, obesity and depression: A systematic review and meta-analysis of longitudinal studies. Archives of General Psychiatry, 67(3), 220-229.

Marcus, M. D., & Wildes, J. E. (2009). Obesity: Is it a mental disorder? International Journal of Eating Disorders, 42(8), 739-753.

Medical News Today. (2004). Is obesity a mental health issue? Retrieved 2011, June 11 from http://www.medicalnewstoday.com/releases/14355.php

Megna, J. L., Schwartz, T. L., Siddiqui, U. A., & Herrera Rojas, M. (2011). Obesity in adults with serious and persistent mental illness: A review of postulated mechanisms and current interventions. Annals of Clinical Psychiatry, 23(2), 131-140.

Melcher, J., & Bostwick, Jr, G. J. (1998). The obese client: Myths, facts, assessment, and intervention. Health and Social Work, 23(3), 195-202.

Ogden, C. L., Carroll, M. D., Curtin, L. R., McDowell, M. A., Tabak, C. J., & Flegal, K. M. (2006). Prevalence of overweight and obesity in the United States. The Journal of the American Medical Association, 295(13), 1549-1555.

Puhl, R. M., & Heuer, C. A. (2010). Obesity stigma: Important considerations for public health. American Journal of Public Health, 100(6), 1019-1028.

Puhl, R. M., & Brownell, K. D. (2001). Bias, discrimination and obesity. Obesity Research, 9(12), 788-805.

Puhl, R. M., Schwartz, M. B., & Brownell, K. D. (2005). Impact of perceived consensus on stereotypes about obese people: A new approach for reducing bias. Health Psychology, 24(5), 517-525.

Smith, R. (2012). Obesity costs “significant”. Feedstuffs, 84(37), 9.

Tomiyama, A. J. (2014). Weight stigma is stressful. A review of evidence for the cyclic obesity/weight-based stigma model. Appetite, 82, 8-15.

Wilfley, D. E., Bishop, M. E., Wilson, G. T., & Agras, W. S. (2007). Classification of eating disorders: Toward DSM-V. International Journal of Eating Disorders, 40, S123-S129.

Wilson, G. T. (1993). Relation of dieting voluntary weight loss to psychological functioning and binge eating. Annals of Internal Medicine, 119(7), 727-730.

DOI: http://dx.doi.org/10.3968/%25x


  • There are currently no refbacks.

Copyright (c) 2015 Wendy Ashley

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.

Share us to:   


  • How to do online submission to another Journal?
  • If you have already registered in Journal A, then how can you submit another article to Journal B? It takes two steps to make it happen:

1. Register yourself in Journal B as an Author

  • Find the journal you want to submit to in CATEGORIES, click on “VIEW JOURNAL”, “Online Submissions”, “GO TO LOGIN” and “Edit My Profile”. Check “Author” on the “Edit Profile” page, then “Save”.

2. Submission

Online Submission: http://cscanada.org/index.php/ccc/submission/wizard

  • Go to “User Home”, and click on “Author” under the name of Journal B. You may start a New Submission by clicking on “CLICK HERE”.
  • We only use four mailboxes as follows to deal with issues about paper acceptance, payment and submission of electronic versions of our journals to databases: caooc@hotmail.com; office@cscanada.net; ccc@cscanada.net; ccc@cscanada.org

 Articles published in Cross-Cultural Communication are licensed under Creative Commons Attribution 4.0 (CC-BY).


Address: 1055 Rue Lucien-L'Allier, Unit #772, Montreal, QC H3G 3C4, Canada.
Telephone: 1-514-558 6138 
Website: Http://www.cscanada.net; Http://www.cscanada.org 
E-mail:caooc@hotmail.com; office@cscanada.net

Copyright © Canadian Academy of Oriental and Occidental Culture