Saturday, June 10, 2006

Exercise Your Imagination

Alright, since certain people have objected to my frequent posts on correctional topics, here is an entirely non-corrections related psychiatry post.

Given the recent post on atypical antipsychotics in children, I started thinking about our national epidemic of obesity. According to the CDC, here are the top ten states with the highest obesity rates, expressed in percent:

West Virginia24.6

Presently 16% of children and adolescents in the United States are overweight. In addition to the commonly known medical complications of obesity, overweight children have significant psychiatric sequelae: peer and teacher stigmatization, depression, and social withdrawal. If the condition persists to adolescence, weight problems can precipitate eating disorders such as anorexia nervosa or bulimia. While treatment stategies exist, the prognosis is worsened if the condition begins in childhood and the child has at least one obese parent.

So far the evaluation of obesity in children has centered on identification of endogenous (medical) or genetic causes. Given that some atypical antipsychotics have been associated with substantial weight gain in children, drug-induced causes must also be considered.

Of course, all of these risks must be weighed (pardon the pun) against the morbidity and mortality associated with untreated bipolar disorder.

...ironically, in prisoners weight gain is considered a good thing---a healthy sign of returning nutrition after months of drug and alcohol abuse, or an indication that weight-training is paying off.

DOH...almost made it.