The Mental Health Excuse for Discrimination in Obesity Care

Mental health issues seem to be one more excuse for discrimination in obesity care. A new study of people with controlled but complex mental histories examines their outcomes in bariatric surgery. The outcomes, the study finds, can be entirely comparable to outcomes for people with other psychiatric disorders or even no psychiatric disorder. Lauren Thomson and colleagues explain the implications:

Given the significant risk of obesity and its related physical and mental health complications, patients with a history of, or well-managed severe psychiatric illness should not be excluded from consideration for bariatric surgery. Policymakers should work to ensure equitable access to bariatric surgery to those with mental illness, by establishing programs that support psychiatric stability, both preoperatively and postoperatively for those with a history of mental illness.

It seems that people with both complex mental histories and obesity get a double dose of discrimination. In a recent paper published in JAMA, Aaron Dawes and colleagues note that “bariatric candidates with severe mental illness are often screened out prior to referral for bariatric surgery and excluded from published studies.” Despite those exclusions, they were able to determine that “Mental health conditions are common among patients seeking and undergoing bariatric surgery, particularly depression and binge eating disorder.”

A risk of psychiatric complications after bariatric surgery is real and deserves serious consideration. But it’s no excuse for discrimination against people with complex mental histories. Discrimination against people with obesity is already bad enough.

Click here for the study by Thomson et al and here for the study by Dawes et al.

Melancholy, painting by Edvard Munch / WikiArt

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May 4, 2016