The above case is an example of the biopsychosocial approach to severe obesity management when psychiatric comorbidity is present. We know that psychiatric comorbidity and general psychosocial burden is the rule rather than the exception. This book emphasizes the need for an integrated understanding of patients’ physical and mental health issues in order to effectively develop a multifaceted treatment plan that can be personalized to patients. We were deliberate in grounding this book in patients’ experience and the two courageous stories early in this book exemplify the challenges and opportunities to support patient resiliency in the context of severe obesity.

It is clear that there is a growing evidence base for the pathoetiology of the relationship between obesity and mental illness . Moreover, this association is linked to several biological, psychological, and environmental mechanisms that must be considered when assessing patients with severe obesity and comorbid mental health conditions. It is evident from the research that further studies are needed to clearly elucidate risk factors and causal mechanisms linking mental health and obesity. Additional research on the impact on the relationship between bariatric surgery and mental health is needed to more accurately identify risk factors for psychiatric sequalae post-surgery, such as eating disorders and de novo addictive disorders. Longitudinal studies are needed to examine long-term psychiatric trends and opportunities for psychosocial intervention.

Furthermore, we have summarized a range of pharmacological and psychological treatments for mental health and addictions in the context of severe obesity that can be personalized to patients in clinical practice. The next wave of research will need to expand on these initial studies with more rigorous clinical trials and examination of predictors of treatment response. Improving access to these evidence-based treatments will also need to incorporate novel technology in order to address the burden of obesity more broadly.