Dr. David B. Adams – Psychological Blog

Psychology of Injury, Pain, Anxiety and Depression

"The Obese Masses"

“Many injured workersare obese. This does not help them as far as their back pain goes. Some are depressed. A worthy discussion is whether they are overweight because of back pain, or if their obesity is making their back pain worse.”
The short answer is: both and neither.
The key element here is depression. The presence of a depression is uniformly assoicated with increase in incidence of obesity. There are several reasons for this, among which are the fact that many depressed people have both increased appetite and decreased activity levels. Also the stigma of obesity may lead to depression, and of course, back pain leads to decreased activity as well.
Since depression is a biological condition, it is probable that the same neurochemistry which drives the depressed mood also drives the overeating. Additionally, a depressed individual lacking in pleasure from life may turn to inordinately high calorie foods in a quest for some form of enjoyment.
The obesity rate in the U.S. is between 25% and 30%. The obesity rate among depressed individuals is twice that amount. Obesity is the norm for depressed individuals. So when a back injured patient begins to gain weight, it is important to look for highly probable concurrent symptoms of depression.
Many antidepressants have increased appetite as a side effect, and the choice of an antidepressant for back pain patients must be carefully made.
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#AtlantaMedicalPsychology
#Dr. David B. Adams #Pain
#Depression
#Anxiety

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