By Stephen T. Sinatra, M.D., F.A.C.C., F.A.C.N., C.N.S., C.B.T.
In my experience as a doctor, one of the most difficult parts of treating a health problem is figuring out what’s causing it. It’s one of the most invigorating parts of what I do: the study of the symptoms and the hunt for the answers.
Sometimes, there isn’t a clear cut answer. And with the body, one thing can impact another quickly and significantly, so it can be hard to pinpoint which came first, or what is causing what. Take obesity and depression, for example. Which came first: the chicken or the egg? Do people get depressed because they struggle with weight, or are they struggling with weight because they have depression?
It’s an important question, and an issue a lot of people are dealing with. In fact, adult obesity rates now have climbed past 35% in four states, 30% in 25 states and are above 20% in all states. Meanwhile, the National Institute of Mental Health (NIMH) says that 16 million US adults had at least one major depressive episode in 2012; that’s 6.9 percent of the population.
First, What Is Depression and What Is Obesity?
Before I get into the connection between the two, first I want you to understand what all of this means. Obesity is not just being a bit overweight, and it’s not an issue of appearance either. Being obese means a person weighs 20% more than the ideal body weight for their height. This usually means he or she has a Body Mass Index (BMI) of more than 30.
Now, to get into depression: it’s more than just feeling sad, or even feeling sad for a long time. Sadness is a natural, chemical response in your brain to things that legitimately make you upset, and can be either short-term or extended; it’s healthy, normal and usually not something that needs to be treated. Depression, on the other hand, means there’s two large factors at play: the “cognitive” factor (mood) and the “somatic” factor (the body, sleep and appetite). The Beck Depression Inventory (BDI) – a depression assessment tool – lists the following symptoms of depression as either cognitive or somatic:
- Past failures
- Guilty feelings
- Punishment feelings
- Suicidal thoughts or wishes
- Loss of pleasure
- Loss of interest
- Loss of energy
- Change in sleep patterns
- Change in appetite
- Concentration difficulties
- Tiredness and/or fatigue
- Loss of interest in sex
So you see, there are a lot of things coming into play with depression. Throw obesity into the mix, and things only get more complex.
The Connection between Obesity and Depression
In a recent study with teenage girls, researchers determined that depression likely contributes to health problems because of associated weight gain, especially around the abdominal area, over time. Initially, the study was designed to find out whether or not depression causes obesity (or vice-versa). What researchers found was a definite mind-body connection between obesity and depression that sheds light on prevention and treatment possibilities.
To elaborate a bit, you can’t treat obesity as just a physical condition. Not everyone can prevent obesity or lose weight by dieting and exercising. Instead, the root of the problem that needs to be treated is often the psycho-emotional state behind the decisions that eventually make a person obese. For example, don’t just try to keep someone’s hand out of the cookie jar. Instead, dig into why they want into the cookie jar so badly. It’s a proven fact that individuals who are depressed tend to eat more sugary foods in particular, exercise less, and take antidepressants that can cause weight gain. Emotional eating is also likely at play. In addition, depressed people have a harder time sleeping, which also contributes to cravings for unhealthy foods and physical inactivity, which can create a vicious circular link between obesity and depression.
Stress and Weight Gain
As if there weren’t enough to be concerned about, stress is another factor contributing to both obesity and depression: an exhausting trifecta, really. Chronic stress causes many symptoms similar to depression, which in turn can lead to weight gain. Your body releases a hormone called cortisol in response to stress. Many people suffering from depression are known to have elevated cortisol levels. Cortisol and weight gain can walk hand in hand, as cortisol (in excess) signals to your body to store more fat.
Wanting to better understand these three issues in order to better treat them, associate sociology professor Belinda Needham conducted her own study on them. Her study revealed that stress management was one of the most important methods of preventing and treating depression, obesity, and even obesity-related conditions like cardiovascular disease and osteoporosis.
How to Treat Depression, Obesity and Stress
Through her study, Needham found that regular moderate exercise is an essential part of reducing stress, as well as in boosting metabolism and encouraging better sleep. This is because exercise helps balance out the chemicals in your brain, and it also helps you feel a sense of control over at least one aspect of your life. For even greater benefits, add mind-body practices like yoga, tai chi and meditation into the program.
And (no surprise here), but diet plays a huge factor as well. For example, consuming omega-3-rich fish or fish oil can help you fight depressive symptoms, and eating foods with a low-glycemic index can also help prevent storage of abdominal fat.
As the icing on the cake, making regular appointments for massage and acupuncture can also help relieve stress. If you ever needed an excuse to indulge a little, this certainly is it: from my mouth to your ears, it’s just what the doctor ordered.
Here are a few other things you can work on to make the results of your other efforts have an even greater impact on your mind and body:
- Pinpoint sources of anger or unresolved issues, and eliminate or address them.
- Always find at least one positive aspect of a negative situation – I call it the reframe, and focus on it.
- Have a sense of humor. I know that, for me personally, not taking situations as a be-all, end-all and being able to laugh when things go wrong makes things easier… on everybody.
- Find something you like to do, and work on getting better at it. Keep yourself motivated.
- Split the burden: share something that’s bothering you with someone else, and let them carry part of the weight of it for you. It might not make a problem go away, but knowing two people are working on resolving something instead of just one is a good start.
With consistent practice doing these things and a little bit of time, you’ll be on the right track to a happier, healthier you.
- Rabin, Roni C. “Exploring the Links Between Depression and Weight Gain.” New York Times. June 16, 2010.
- Needham BL, Epel ES, et al. Trajectories of Change in Obesity and Symptoms of Depression: the CARDIA study. Am. Jour. of Publ. Health. 2010 June;100;6:1040-46.
- David Engstrom, PhD. “Obesity and Despression.” 2016.
- Stateofobesity.org. Obesity Rates and Trends.
- Pietrangelo A. Depression and Mental Health by the Numbers: Facts, Statistics and You. Accessed Dec. 30, 2016.
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