The Psychology of Weight Management, With Christine Glenn, D.O.

Mental health and obesity are deeply interconnected conditions, and medical professionals do a disservice to patients when they attempt to treat them in separate boxes.

That is the core message from Christine Glenn, D.O., a clinical assistant professor in the Department of Psychiatry and Behavioral Sciences at the University of Kansas Medical Center. As a physician board-certified in both psychiatry and obesity medicine, Glenn noted that psychiatric complaints and weight management cannot be separated. Depression can cause obesity, and obesity can cause depression, making it remarkably difficult for individuals to lose weight if their mental health is suffering.

Internalized shame and an "all-or-nothing" mentality frequently sabotage long-term lifestyle changes. Many patients mistakenly view obesity as a personal moral failing or a lack of willpower, rather than a complex disease influenced by biology, hormones, trauma and the environment. This self-blame often triggers a vicious cycle: stress increases cortisol production, which drives further weight gain and emotional eating, fueling more self-hatred.

Stigma within the medical community itself actively deters patients from seeking comprehensive health care. Glenn shared a painful adolescent memory of a physician telling her that boys would like her more if she lost weight, an experience that left her feeling dismissed and reluctant to discuss her health. Women especially face clinical bias when their physical symptoms are minimized or blamed entirely on their weight or anxiety. Furthermore, physical barriers in clinics, such as small waiting room chairs and inadequate blood pressure cuffs, leave larger patients feeling ostracized and unwelcome.

The emotional hurdles do not disappear once weight loss is achieved. Reaching the maintenance phase introduces unexpected psychological strain. Patients who have lived with obesity for most of their lives must suddenly navigate an unfamiliar body, manage the uninvited opinions of others, and discover an entirely new version of themselves.

To combat these challenges, Glenn recommends that patients partner with certified obesity medicine specialists who recognize mental health and sleep as essential pillars of treatment alongside nutrition and physical activity. As a doctor of osteopathic medicine, Glenn emphasized that the mind-body connection is fundamental, urging patients to replace negative self-talk with grace, self-compassion and self-love.