Winning obesity fight can be weight off the mind

When Tannith Hechter started high school, she noticed something was “amiss” about her weight.

“I started being teased because I wasn’t as small as the other girls... I tried different diets and diet pills but looking back, I wasn’t actually fat or overweight,” the now 33 year old said in retrospect.

Her weakness? Crisps.

“If they are there, I would eat them until the packet was finished. Snackie things were another weakness - cheese and crackers and dips and samoosas and spring rolls - as long as these items are there, I would eat them. I supposed that eating these things until they were finished made me feel ‘complete’. If there was still chips left, I wouldn’t feel right until they were all gone,” she said.

Is there a link between poor mental health and obesity? South Africa has the highest overweight and obesity rate in sub-Saharan Africa, with over 61% of the population overweight or obese, the South African Medical Research Council said.

Dr Ian Westmore, board member of the Psychiatry Management Group, said that as it currently stood, obesity remained a medical condition and, perhaps for this reason, research had neither focused on understanding the psychological impact of living with obesity, nor the influence of mental health on the development of obesity in the first place.

When Hechter was 30, she went on an extreme diet that almost caused her to suffer from anxiety.

“This lasted several months, and I lost a bit more weight. But when my anxiety subsided, because I had stopped the extreme diet, the weight started piling back on,” Hechter said.

“I do feel that when I’m at my thinnest, I am not in a great place, mentally. But when I’m bigger, my head is normally in a good place. When I’m anxious, I can’t eat. So, I lose weight. But when I’m not anxious, I do eat. A lot.”

The Heart and Stroke Foundation said 40% of women in the country are obese, which means they have a body mass index greater than 30kg/m2, prompting Westmore to hypothesise that poor mental health may be a cause and a consequence of obesity.

“What we now know is that obesity is a risk factor for mental health problems and vice versa. For instance, obesity has been found to increase the risk of depression, and depression has been found to be predictive of obesity,” he said.

“It is generally agreed that being overweight or obese occurs when the caloric intake exceeds that which is spent. But when we take a closer look at research, we see that there are many contributing factors to obesity such as traumatic experiences, genetics, certain medications, nutrition, exercise, and the perception of weight (in certain cultures, being overweight is healthy and affluent).”

In many instances, stigma plays a significant role in the way that mental illness is perceived and how patients are able to access the necessary treatment.

“Patients suffering from mental illness and obesity have even more stigma to contend with, and it seems that stigma is a significant driver of population levels of obesity. The myth that people are obese because they lack will power and choose to be overweight certainly drives stigma and associated mental health risk.”

In the US, obesity has been officially declared a medical disease. Westmore said being obese could potentially be classified as a psychiatric illness or as a behavioural disorder whereby the dysfunctional behaviour is eating.

Hechter, who is currently involved in a live weight loss docu-series, Tannith’s Transformation, by the weight loss brand Herbex, is determined to move the scale away from her current 114.3kg.

She said: “I’ve been trying to lose weight for about three years. I keep starting eating plans, but get bored, or demotivated, so I end up picking up a bit more weight than I had lost on the diet.

“My weight has definitely had an effect on my marriage, and I am currently going through a divorce. I am going to be meeting new people, and so need to look better and feel better about myself when doing so.

"I feel that the mental part of this journey is the most important - without being in the right frame of mind, you aren’t going to get very far. And for the last three years, my head has not been in the right space. But finally, it feels like it is now,” she said.