Joseph Davies, Cardiff Metropolitan University – Psychological Trauma and its Impacts on Forensic Inpatient Obesity

Why are psychiatric inpatients often obese?

Joseph Davies, lecturer in applied psychology at Cardiff Metropolitan University, discusses his findings.

Dr Joseph Davies is a psychologist and lecturer in applied psychology at Cardiff Metropolitan University in South Wales, and member of the International Association for Forensic Mental Health Services. His research focuses on physical health within forensic inpatient populations, particularly underlying psychological mechanisms implicated in obesity.

Psychological Trauma and its Impacts on Forensic Inpatient Obesity

Secure psychiatric inpatient services are hospitals that treat individuals with complex mental illnesses who are considered a danger to themselves or the public. In many cases, these patients have also committed a criminal offence. Secure inpatients usually have a diagnosis of schizophrenia and are often obese. Research suggests up to 80% of secure inpatient populations are obese.

Patients with schizophrenia frequently experience a range of physical comorbidities associated with obesity, which significantly contribute to a 15-year reduced life expectancy, compared to the general population. It is often argued that potent antipsychotic medications are to blame for secure inpatient weight gain. However, recent research shows that these high weight gain risk medications do not predict secure inpatient weight gain upon admission, suggesting there are other factors contributing to weight gain and obesity maintenance in this population.

One explanation considers the role of early psychological trauma. Experiencing trauma in childhood is associated with a greater risk of severe mental illness later in life, as well as self-harm and binge-eating. Literature shows that there is a dose dependent relationship between the amount of trauma experienced in childhood and Body Mass Index in adulthood.

Underlying this association, is the role of the rewarding properties of certain foods. Consuming highly palatable foods is an effective, albeit short-term way of avoiding the intense emotions associated with experiences of early abuse. This is important because energy dense foods are abundant in many secure services. Research is continuing to explore factors underlying secure inpatient obesity, with a view of curating effective weight management interventions.