The role of apathy in the success of weight loss programs

Obesity is sadly at epidemic proportions. Most of us  are very aware of the devastating health consequences of obesity: diabetes and other metabolic syndromes, heart disease, stroke, even Cancer.  So many are trying to fight the battle of the budge whether it be Weight Watchers, Jenny Craig, Nutrisystem, Atkins and others. There is numerous studies identifying the pros and cons of these programs.
This month I read a very interesting article  in the journal of “Diabetes, Obesity and Metabolism” (December)  This article reported a very intriguing study not normally looked at in weight loss studies. The study looked at how different weight loss programs effected weight loss success. There were three groups. (1) standard nutrition counseling; or (2) the Department of Veterans Affairs (VA) weight loss program called “MOVE” ;, or (3) methylphenidate treatment plus the MOVE program together. The intervention was for 6 months (26 weeks). The last group targeted decreasing apathy. They did this by administering a medication that decreased apathy (Methylphenidate. ) The results showed all groups to lose weight but it was observed that those in the group that targeted the symptom of apathy lost the most weight. This is no surprise to me.
In my practice I see many people who present with the symptom of apathy, a state of being where this a lack of interest or caring in the things around them. Often a patient will have no motivation or energy to eat healthy, to exercise, to address a health problem or do those things that will help them feel better or be in a healthier state. Many of these patients are depressed but others have anxiety, psychotic illness or sometimes ADHD. Interestingly, I will notice after treatment which may include Cognitive Behavivoral Therapy, nutritional supplements, goal setting, and for some, the use of medication that has an added effect in decreasing apathy, that many report  they lose weight.  They notice a higher engagement in healthy habits that wasn’t there before. They may notice less binge behavior.

While I don’t advocate the use of medication for everyone,  for some people with diagnosable mental health conditions medication may be quite helpful in losing or preventing weight gain through the mechnism of decreasing apathy.  Psychotherapy, particularly CBT, is also very useful in helping with weight issues. Anything that will help a person be more mentally healthy I believe will contribute to healthy weight.

Now, I know it is the holiday season, but please do not pass the eggnog!