¹Department of Endocrinology and Molecular and Metabolic Research Unit, University of Pretoria, Pretoria, Republic of South Africa

Correspondence: Professor M-T van der Merwe, Netcare Bariatric Centres of Excellence, Suite 21, Lifestyle unit 4, Unitas Hospital, Clifton Avenue, Lyttleton, Pretoria 0157, Republic of South Africa. E-mail: tessavdm@iafrica.com

Abstract

Psychological comorbidity is high in patients with obesity and is associated with a variety of medical and dietary problems as well as demographic, social and cognitive risk factors. Young overweight and obese women are at particular risk for developing sustained depressive mood, which is an important gateway symptom for major depressive disorder. Increased knowledge of behavioural risk factors has enabled patients with obesity to be classified on a psychological basis and this needs to be considered as part of a patient's clinical assessment and treatment strategy. Increased awareness of abnormal eating behaviour, together with profiling of personality traits, could improve treatment selection for obese women and improve the outcome of weight-loss programmes. Individualised antiobesity drug therapy may be required depending on the patient's psychological characteristics.