Eating disorders in patients with obesity and type 2 diabetes mellitus. Lecture for physicians
Obesity and type 2 diabetes mellitus (DM 2) that result from eating disorders (ED) which lead to weight gain are endocrine diseases provoked (caused) by psychopathology, and are psychosomatic diseases. The clinical features of ED in obesity and diabetes mellitus 2 are that they rarely occur as independent psychopathological units and are mainly represented by syndromic classification in the structure of other mental disorders. Preference of the predominant type of overeating for certain types of ED onset was revealed. Thus, fetal onset is characterized by permanent overeating, pubertal one – by compulsive overeating, psychogenic one – evening overeating and menopausal/age-related hypoandrogenic one – by polysyndromic overeating. Psychopharmacotherapy and psychotherapy combination is used to treat ED in patients with DM 2 and obesity. For prevention of obesity, it is recommended to diagnose early signs of ED which lead to weight gain, and to initiate psychiatric and psychotherapeutic care as soon as possible if ED occurred. Recent 2021 clinical guidelines for the treatment of obesity were updated with recommendation that all obese patients after secondary causes for weight gain were excluded, should be consulted by a psychiatrist-psychotherapist specializing in the general somatic network.