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Psychiatric Illness and Obesity: Recognizing the "Obesogenic" Nature of an Inpatient Psychiatric Setting

Dr. Faulkner and Mr. Gorczynski are affiliated with the Faculty of Physical Education and Health, University of Toronto, 55 Harbord St., Toronto, Ontario, Canada M5S 2W6 (e-mail: guy.faulkner{at}utoronto.ca). Dr. Cohn is affiliated with the Centre for Addiction and Mental Health, Toronto, and the Department of Psychiatry, Faculty of Medicine, University of Toronto.

OBJECTIVE: The prevalence of obesity and obesity-related diseases is higher among individuals with psychiatric illness than in the general population. This study examined environmental factors that contribute to obesity in one psychiatric hospital in Canada. METHODS: Semistructured interviews were conducted with 25 key stakeholders from multiple professional disciplines at the hospital. Transcribed interviews were analyzed through content analysis with the analysis grid for environments linked to obesity (ANGELO) framework as a categorical template. RESULTS: Factors contributing to obesity in this setting were related to increased energy intake, such as easy access to high-calorie snacks and beverages, and reduced energy expenditure, such as lack of access to staircases. CONCLUSIONS: Psychiatric settings may contribute to the high prevalence of obesity among individuals with psychiatric illness. Ecologically framed interventions are required to address obesity in this population.

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