الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
According to WHO criteria, obesity is defined as Body Mass Index (BMI) ≥ 30, and it’s one of the major health problems in Egypt and worldwide. Obesity also increases the risk of developing other medical conditions such as: diabetes mellitus, hypertension, cardiovascular disorders and many psychiatric disorders (especially depressive and anxiety disorders).
The bidirectional association between depression and obesity is well established in literature, and especially, atypical depression (which is characterized by reactive mood, leaden paralysis, hypersomnia, weight gain or hyperphagia), is highly associated with BMI and metabolic dysregulations. Thus, failure of weight loss programs is mostly related to comorbid depressive symptoms or other personality traits.
Alexithymia is a personality trait predisposes to both obesity and depression. It is characterized by a difficulty in identifying, describing emotions and focusing on logic way of thinking rather than feelings (external oriented thinking), and it was first described in psychosomatic disorders in 1973.
Thus, alexithymia is one of the personality traits that exacerbates eating disorders, contributes to the rise in BMI, leads to dyslipidemia and predisposes to depression. Recognizing this trait aids in establishing preventive and therapeutic strategies for obesity and depression.
It’s well-known now that obesity and depression share an inflammatory vicious circle that each condition predisposes to the other. Obesity is associated with low grade inflammation which originates in adipose tissue and disrupts the gut microbiota ratio. This inflammatory process also disrupts the blood brain barrier and leads to neuroinflammation in different brain areas including: the prefrontal cortex, amygdala, hypothalamus and the hippocampus.
Moreover, it leads to modulations in neurotransmitters metabolism and function, especially serotonin, dopamine, and glutamate systems that play a vital role in mood and behaviour. Furthermore, obesity can increase cortisol, leptin and insulin levels leading to insulin resistance and HPA axis disturbances, which leads to can further promote inflammation and exacerbate depression.
Our cross-sectional study aimed at screening for the presence of depressive symptoms in obese persons, assessing the severity of depressive symptoms (mild, moderate, severe) and elaborating on the role of alexithymia in the association between depression and obesity.
The study included Two hundred seventy-five (275) participants were recruited from Neuropsychiatry clinics at Alexandria Main University Hospital (AMUH) and private nutrition clinics. All participants were obese (BMI ≥ 30) and aged 18-60 years old. Those who are bedridden or have independent physical disability, serious mental health problems or severe intellectual disability, any endocrinological, chronic medical illness e.g., diabetes and hypertension, chronic neurological disorder or maintained on chronic medications e.g., corticosteroids were excluded from the study.
All participants who gave the consent were subjected to detailed history taking to collect sociodemographic data, medical, psychiatric and drug history. Body weight, height and waist circumference were measured to calculate Body mass index