Generalized Anxiety Disorder and Obesity: Overlapping Neuroendocrine, Metabolic, and Behavioral Pathways

Area of Science:

• Psychiatry and Endocrinology
• Metabolic and Anxiety Disorders Research

Background:

• Generalized anxiety disorder (GAD) is a prevalent mental health condition, affecting 3.7% globally.
• The frequent co-occurrence of GAD with obesity presents significant clinical implications for patient care.
• Understanding the link between GAD and obesity is crucial for developing effective screening, prevention, and treatment strategies.

Purpose of the Study:

• To review and identify potential biological mechanisms linking obesity and GAD.
• To summarize the current research landscape on the obesity-GAD association.
• To highlight research gaps and suggest future research directions.

Main Methods:

• A narrative review of literature published between 2015 and 2025.
• Focus on shared biological mechanisms: HPA axis, inflammation, oxidative stress, insulin resistance, gut-brain axis, sleep, and eating behaviors.
• Analysis of studies examining the co-occurrence of GAD and obesity.

Main Results:

• Evidence suggests a significant, though not fully defined, relationship between obesity and GAD.
• Obesity and GAD may form a mutually reinforcing cycle.
• A lack of high-quality prospective and interventional studies specifically on GAD is noted.

Conclusions:

• Integrated, multidisciplinary interventions (psychological, pharmacological, lifestyle) are promising for managing co-occurring GAD and obesity.
• Routine assessment of anxiety in obese patients and metabolic risk in GAD patients is recommended.
• A dual approach targeting both mental and metabolic health domains can improve patient outcomes.