- The first thing you should do when you’re both overweight and depressed
- Depression overview
- Depression and weight gain
- Role of physical activity, weight loss in depression management
- How to stay motivated to exercise and lose weight with depression
- Diets and depression
- Healthier ways to weight loss
- Accept your genes
- Don’t deprive yourself
- Mindful eating
- Don’t compare
- For Many People, Especially Women — Weight Loss Is Not a Happy Ending
- Dieting can make you feel worse about your body
- Pursuing weight loss can change your brain chemicals
- On weight loss and harassment
- The pressure of weight loss can also affect men
- We have the power to change the cultural narrative around weight loss
- Weight Management Tips for People With Depression
- Why Choose Between Depression or Weight Gain?
- Does depression cause weight gain?
- Obesity, Genetics, Depression and Weight Loss
- Depression and Weight Management: Ten Steps to Successful Weight Loss
The first thing you should do when you’re both overweight and depressed
Foods like ice cream, sweetened yogurt and baked goods made with eggs contain enough protein to block the release of serotonin.
But they do increase blood sugar levels, which can cause emotional highs and lows. “If you’re self-medicating depression with sweets, you may get the momentary sugar rush, but ultimately sugar crashes can end up exacerbating the depression,” Gangwisch said.
While the study only showed an association between high-glycemic foods and depression, and does not prove that they cause it, Gangwisch said it’s likely that altering the type of food you eat, even if you’re not changing the amount or actively trying to lose weight, could improve your mood, which will help when you try to lose weight.
“Make it as painless as possible,” he advises, choosing low-glycemic foods that you enjoy so you won’t feel deprived. This can be as simple as trading corn flakes for bran flakes, or instant oatmeal for steel-cut oats.
The exercise problem
Vigorous, regular exercise improves not just our physical but mental health as well, so much so that some doctors are now prescribing movement instead of medicine. Several studies have shown that aerobic exercise can, in some cases, be even more effective than antidepressants, and lack of exercise has been shown to increase the risk for depression.
But ironically, the easiest way to lift your mood is also the hardest when you’re overweight or obese.
“When people are depressed, they become tired and lethargic. It’s difficult to get people who are depressed to exercise,” Gangwisch said.
Even normal-weight people have trouble motivating themselves to exercise. Fewer than half of Americans get the amount recommended by the CDC.
The overweight and obese may also fear getting hurt physically or being ridiculed when exercising in public even though most manufacturers of exercise clothes — including Nike — have acknowledged that the pursuit of fitness isn’t just for the svelte.
The Mayo Clinic, however, says that it’s movement that betters our mood, and you don’t have to run a 5K to improve your mental state.
“Certainly running, lifting weights, playing basketball and other fitness activities that get your heart pumping can help. But so can physical activity such as gardening, washing your car, walking around the block or engaging in other less intense activities. Any physical activity that gets you off the couch and moving can help improve your mood,” the Mayo Clinic says.
And it doesn’t have to be for an hour. As little as five minutes of movement can have a beneficial effect on your mood, even more so if you’re outdoors and exposed to nature and light, which are among other strategies recommended to improve mood.
Focus on happy
In 18th-century England, a morbidly obese Scotsman named George Cheyne became popular for books he published about how to be healthy. Cheyne, a physician who weighed as much as 450 pounds at one point, suffered from depression, drank heavily and wrote about his struggles in his book called “The English Malady.”
Cheyne’s depression, in part, stemmed from guilt derived from his Anglican faith, said Anita Guerrini, a professor at Oregon State University and the author of “Obesity and Depression in the Enlightenment: The Life and Times of George Cheyne.”
“He felt that being fat was sinful; he felt guilt from living such a lavish lifestyle,” Guerrini said.
Cheyne extrapolated that much of English society was suffering from the same collection of ills that he deemed “The English malady.”
“He thought that the English had been too successful, and were eating themselves to death and living in cities that didn’t make them happy,” Guerrini said. The solution, he decided, involved not just changing his diet but “keeping your mind calm and serene,” and one way he did this was by reading novels and the Bible.
“He thought that having a good spiritual life was important,” Guerrini said.
Cheyne never got svelte, but he eventually lost half of his body weight with a prescription that today would be described as “everything in moderation.”
Three hundred years later, that’s a philosophy that Freedhoff, an assistant professor at the University of Ottawa, embraces.
“If you’re already struggling with depression, and in many cases, there’s guilt associated with that, not succeeding with your planned behavior changes can make matters worse,” Freedhoff said.
Rather than working toward an ideal weight or size, people should set a goal of being happy, said Freedhoff, author of the 2014 book “The Diet Fix.” That doesn’t mean that your weight doesn’t matter — obesity causes disease and shortens life expectancy — but getting to a healthy weight, for most people, involves small, manageable changes.
For example, Freedhoff believes people should cook at home and not succumb to the ills of fast food, but while making the transition, he advises people not to obsess about preparing, say, wild-caught salmon stuffed with garlic and kale, but food that you and your family will like.
“Maybe cutting your cooking teeth on less healthy meals will encourage you to gain the skills and comfort you’ll need to slowly improve your repertoire, and in so doing make the kitchen a room in which you actually enjoy spending time,” Freedhoff wrote on his blog.
“As far as quality of life goes, there’s no doubt in my mind that mental health is far more important than what a person weighs,” Freedhoff said.
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Overweight and obesity are common problems today as rates keep increasing across the globe. Weight loss is possible, but for many people, it’s easier said than done. You see, all people are different and approach to this problem in a different manner. Some people experience difficulties losing weight due to a lack of motivation. Strong willpower is vital for everything we do in our lives, and weight loss is not the exception. Various factors influence our motivation; increase and decrease it. Depression can contribute to a lack of motivation to do something you’d really like to achieve. How to cope with that situation? How to lose weight when you’re depressed and not motivated? Learn more below.
Before we can even begin discussing weight loss and motivation when depressed, it’s important to address depression itself mainly because this mental health problem is largely misunderstood. Depression is defined as a mood disorder indicated by a persistent feeling of sadness and loss of interest.
The disorder affects the way a person feels, acts, behaves, thinks, and it has a negative impact on their relationships, physical health and wellbeing, and overall quality of life. While many believe depression is something a person can easily “snap out of” that’s not the case.
Depression isn’t just a feeling of sadness that comes and goes; symptoms of this disorder are persistent and potentially severe (1).
Numbers show that 300 million people worldwide have depression while 16.2 million American adults suffer from this disorder. In other words, 6.7% of adults in the United States have depression, and it is estimated that about 15% of the adult population will experience depression at some point in their lives (2).
Depression and weight gain
A common misconception is that depression just makes you feel sad and that’s it. This mental and emotional health problem affects your wellbeing in more ways than one. Depression can jeopardize your health in many ways as it’s associated with a higher risk of many diseases and health conditions. But, what about weight gain? It appears that depression and weight gain often go hand in hand. For instance, studies confirm that obesity increases the likelihood of developing depression (3). Vice versa also happens, i.e. depression can enhance the risk of overweight and obesity. For instance, CDC reports that 43% of adults with depression are also obese and both problems were more common among women (4).
Despite the fact that two-way relationship between depression and weight gain has been confirmed by many studies the underlying mechanisms are still unknown. At this point, it would be difficult to pinpoint a certain cause of this relationship with utmost certainty. A combination of different factors could be to blame including stress, overeating to deal with various emotions, lack of physical activity, and many others.
Role of physical activity, weight loss in depression management
Depression is a serious problem. Persons with depression sometimes struggle to get out of bed in the morning, they have no motivation or interest to do anything, and the feeling of sadness is severe to affect their everyday life. Although a severe problem depression is still manageable. There’s a lot of patients can do to feel better and manage the symptoms they experience. If you’re depressed and also overweight or obese, you may want to start increasing activity levels and exercising. A growing body of evidence confirms that physical activity has a significant role in depression management. Regular exercise elevates your mood, improves sleep quality, and increases overall satisfaction (5). Not only does physical activity improve depression management but it also reduces the risk of depression at any age (6).
As you’re already aware, physical activity and exercise are absolutely crucial for weight loss. One reason to get motivated to work out is that slimming down can also contribute to more effective depression management. Research confirms that weight loss is strongly associated with improvements in mood among depressed and obese adults (7). In other words, slimming down can aid depression management and make you feel a lot better mentally, emotionally, and physically.
How to stay motivated to exercise and lose weight with depression
Now that we know more about depression and its relationship with weight gain, exercise, and weight loss it’s time to start discussing different ways to stay motivated. One of the hallmark signs of depression is a loss of interest and motivation in anything. Depressed individuals find it difficult to focus on work, get up in the morning, so it may be particularly difficult to tell them they should exercise more.
If you struggle with depression, you already know how complicated it is to stay motivated although you do want to do something about your weight and physical activity. Below, you can see different ways you can get motivated to slim down.
A common mistake that people make is that they try to do too much at once. While it may seem like a good idea at first, it can cause a counterproductive effect and lead to loss of motivation and desire to continue. The secret is to start slowly. Instead of pushing yourself to do vigorous activities and work out like a professional fitness trainer, you need to start slow and work your way up. At the very beginning, focus on increasing physical activity levels by moving more and doing some exercises. The goal is to be more active than you were. Once you’re used to this new, more active life, you can start exercising more and more.
Do something you find enjoyable
When it comes to weight loss and exercise, options are endless. We have plenty of exercises to do and workouts to try. Don’t do some exercise for the sake of it, do it because you like it. Somehow we’re led to believe that only certain types of exercises or activities can help us lose weight and eventually manage depression. Then, we do things we don’t really like and end up losing our motivation to continue. One way to avoid this scenario is to find exercises, activities, and workouts you find enjoyable. There’s always something you like, exercises and activities you find fun. Focus on those particular activities, and you’ll notice motivation keeps growing. That’s because you’re doing something you like and it’s natural to want to keep doing it.
Exercise when it’s convenient for you
In most cases, people have a strict workout schedule. They exercise at a specific time of day every time. While for many people this type of schedule is practical, it may not be the case for persons with depression. You see, individuals with depression may feel even more stress that leads to loss of motivation if they’re subjected to a strict exercise schedule. That’s why persons with this common mental and emotional health problem should exercise when it’s convenient for them. Don’t pressure yourself to exercise at a specific time of day. Give yourself some liberty to work out when you feel well enough to do so. This is important because some people find their symptoms are worse in the morning while others in the afternoon or night. So, one size fits all rule doesn’t apply here. At the end of the day, it all comes down to how you feel.
The sense of accomplishment does wonders for a person’s mood. When you achieve a goal, you feel better instantly and are motivated to keep going and doing more. That’s why a useful tactic to strengthen willpower to lose weight when depressed is to set small and achievable goals.
Start with something small and easy to achieve, then set the other goal and the next one. The more you work toward achievement of your goals the more motivated you’ll be. Then, start with bigger goals with smaller milestones. Challenge yourself bit by bit, don’t overdo it.
One of the biggest symptoms of depression is social isolation. A person with depression doesn’t want to spend time hanging out with other people due to their persistent feeling of sadness, worthlessness, hopelessness, and other signs. Although hanging out and socializing with someone may be the last thing on your mind right now you should still do it. Spending some time around other people, i.e. in the gym may help you feel more focused on the workout. Plus, socializing is good for your mood too. Therefore, in order to stay motivated to lose weight when you have depression, you may want to spend some time with other people (8), connect with people in the gym, sign up for a class like yoga, options are endless.
Avoid sleeping too much
Sleep is important; we all know that. However, too much sleep is as bad as too little good night’s rest. Getting too much sleep can, in fact, make your depression even worse. This also means it can aggravate symptoms associated with this common mental health problem. Although there comes the time when all you want to do is sleep, you should still strive to do something such as take a walk or go for a jog.
Exercise will also boost your energy, keep you alert, and help you focus more on your work, life, and you name it. As a result, you’ll feel more motivated at the same time. It’s needless to mention sufficient sleep is important for weight management as well.
Inspect your relationship with food
It’s not uncommon for people to use food to alleviate emotional problems. Emotional eating is a common occurrence, especially among persons with depression which could explain the subsequent weight gain. Eating too much is usually followed by an incredible sense of guilt and feeling of worthlessness where a person believes they don’t deserve anything better. As a result, they don’t feel up to exercise or any other type of activity. To improve motivation for successful weight loss when you’re depressed, you need to inspect your relationship with food.
Take a few moments to think about that subject. Do you use food to deal with your emotions? Do you feel guilty after eating? If so, you may want to start changing the way you eat. Avoid binge-eating, late night snacks, and focus on a well-balanced diet. You’ll notice improvements in your mood and motivation too. It’s needless to mention successful weight loss also requires a proper diet.
Millions of people around the globe have depression, and many of them are overweight or obese. Overweight and depression have a two-way relationship. Weight loss and increased physical activity levels are important for diabetes management. Even though it may seem difficult to stay motivated to achieve these goals you can make it happen. Focus on small and achievable goals, analyze your relationship with food, and start small by exercising when you find it most convenient. Step by step, and you’ll get there.
Breaking the cycle of yo-yo dieting is difficult, especially if it’s become a habit. But, shifting your focus from the negative aspect of losing weight to the positive mindset of making healthy food choices in order to fuel your body can make a big improvement to your mental health.
Diets and depression
Dieting really can impact your mental health, especially since it is all about rules and restrictions.
Psychotherapist, Carolyn Karoll, explains that anxiety and depression can increase when we categorise foods as ‘good’ vs ‘bad’.
“Eating the right foods, losing weight, and keeping it off is considered ‘success’, while ‘cheating’ on your diet, not losing weight, and even gaining weight is associated with a lack of willpower,” she reveals.
Karoll says this cycle is a setup, with a guarantee to leave you feeling like a failure. “The core belief that you are not good enough is most often the catalyst for the diet in the first place – failing at the diet simply reinforces this belief.”
She explains there is also a connection between mood instability and malnutrition, and often sees her patients on restrictive diets experience difficulty concentrating, stress, fatigue, and feelings of hopelessness.
“Most if not all diets become binges, rebound weight gain, weight cycling, even eating disorders. And those who are ‘successful’ at weight suppression often suffer even more vicious physical and psychological damages as a result of long-term deprivation,” adds Karoll.
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Healthier ways to weight loss
So, what should you do if your weight is getting you down, but you’re sick and tired of the crash diets which seem to always lead to losing and gaining the same 10, 20, or 30 pounds?
Firstly, you need to embrace the philosophy that good health is really attributed to a lifestyle you can maintain over time. “If a diet plan gets you to a goal, but you can’t maintain it, it will likely make your weight and emotions yo-yo,” suggests nutritionist Amy Goodson.
We also need to remember that as we age, our metabolism slows down and weight gain can be a normal part of the process; that’s why therapist Kimberly Hershenson believes the key to a healthy weight loss is acceptance.
Accept your genes
Karoll says we are all born with a genetic blueprint and while dieting and/or excessive exercise may allow you to manipulate your weight/shape, it is a temporary ‘fix’ with a whole host of negative consequences to both your physical and mental health. Instead, appreciate your body’s natural shape and size – it is unique to you, a kind of legacy passed on from your ancestors.
She recommends focusing your energy on healthy choices that allow your body to return to its natural set point range and spending time learning how to accept your body, appreciate it, reconnect, or in some cases, connect with it for the first time.
“This entails accepting reality for how it is right now, not how you want it to be,” explains Hershenson. For example, “I don’t like my body, but I accept where I’m at today.”
Don’t deprive yourself
Hershenson says restricting food choices as to what you’re ‘allowed’ to eat can actually lead to a binge. It’s important to eat a balanced diet and recognise that all foods can fit into a healthy diet (given food allergies and dislikes).
Telling yourself “I’m not allowed to eat x” will only make you want it more. Instead, look for sustainable realistic changes that fit into your lifestyle, and take some time to learn how to plan meals that will give your body the nutrients it needs. This may be a major mindset shift, especially if you’ve spent years forcing your lifestyle to adapt to whatever diet you were on.
Pay attention, using all of your senses, to choose food that is both satisfying and nourishing to your body. Karoll says this means acknowledging responses to food (likes or dislikes) without judgement (ie good, bad, fattening, loaded with sugar, etc). She advises this also means learning to become attuned to the various stages of physical hunger and satiety (fullness) to enable you to listen to cues that will guide your decisions to plan to eat, eat, and stop eating.
You need to think about fitness as the outcome, not the goal. Karoll recommends finding movement that is fun, meditative, or social and avoid competitive exercise regimens since comparing your abilities to others often leads to despair. Goodson advocates planning three to four days a week on your calendar where you are focusing on ‘bettering your body and energy’. If you are tired, take a yoga class instead of cardio. “Flip your attention to how exercise energises your body and helps you do the things you enjoy.”
Karoll reminds us that health encompasses both physical and emotional wellness and weight is not necessarily a measure of health. “Understanding that health and fulfilment in life come from living in accordance with your values not from reaching a weight goal, is truly freeing.”
Chicago native Erika Schnure, 29, knew she was overweight—and she didn’t want to become like her diabetic mother. “I saw how much she was struggling,” says Erika, “and I didn’t want to go through that as well.” So in November 2011, the 5’6″ Erika decided to start trimming her 230-pound frame.
Initially, she lost about 50 pounds by making simple tweaks to her eating habits—like cooking more meals at home instead of taking trips to Five Guys or Chipotle. Then, when Erika hit a plateau, she incorporated more exercise into her routine, running and participating in races like a 5-K turkey trot. “I liked the runner’s high that I got,” she says. “I liked the competition and challenging myself to constantly do better.” In April 2013, Erika weighed about 140 pounds—and she’s now maintained that weight for more than a year.
But dropping 90 pounds didn’t make Erika feel happy, as she’d expected. In fact, her weight loss spurred a bout of depression that she’s still dealing with today. While the exact connection between weight loss and depression is still unclear, some research does indicate that there may be an association between the two.
Here, Erika opens up about the emotional battle she faced after finally hitting her weight-loss goal.
WH: What do you think occurred after your weight loss that led to your depression?
Erika: One thing I think contributed to this was that , you’re working for something for so long. And then when you’re done, it feels like, “Well, what now?” Losing weight was my life for about 17 months, and I didn’t know what to do
was like a mission for me. I had to set another goal, but I had no idea what that would be. Losing weight was something I did for such a long time that it felt like I lost a friend. This made me really happy—to see myself losing weight—and when it was over, there was nothing else there.
I was still obsessed with weighing myself every day even though I was already at my goal weight. Any time that scale moved, I got upset about it. I had worked so hard to that if I gained two pounds or something, I thought would spiral again.
WH: So how did that affect your day-to-day life?
I stressed over maintaining my weight. Around , I was training for a half-marathon. But I freaked out every time I gained a little bit of weight—which happened because I was eating too much for what I was training for. There’s a delicate balance there that you have to figure out.
At a certain point, I also lost all of my motivation to do anything. I was still eating fine, but I pretty much stopped exercising—which could’ve also been due to the Chicago winter. But I wasn’t interested in exercising. I’d come home and watch TV.
I tried to do some workouts at home—like DVDs—but usually I wanted to just sit around. Exercising was my productive way of de-stressing. If I had a really bad day at work, I would look forward to coming home and running because I could “run” that stress and anger out of me. But then I wasn’t relieving my stress in a productive way—or at all.
WH: You mentioned you’ve cleaned up your diet, but do you still allow yourself to indulge now and then? Is that hard?
I don’t do it often—maybe once a month—but if I do go out to a nice dinner, I’ll order a steak and potatoes. I watch my portions when I do so that I don’t feel completely stuffed or uncomfortable.
There is a little bit of guilt because I think, “This is what got me in the first place.” But when are so sporadic, you have to train yourself to learn that this one meal won’t make you gain five pounds. You have to get over it.
WH: So you definitely have a lingering fear about gaining weight?
Oh, yeah. I’ve gained a little bit back, but there’s a huge fear of going back . I still keep a pair of size 18 jeans that I can’t go back to that weight. I can’t do it.
WH: That must be emotionally taxing to worry about. But what’s so frightening about the idea of going back to your old life exactly?
I was so unhappy and uncomfortable . I didn’t get out much; mainly just stayed inside. I wasn’t living my life. Last year, my mom and I took a vacation to Hawaii. I was climbing all over the volcanic rocks, which I would not have been able to do before because I’d get tired or not be able to lift my legs as high .
WH: What about your new body image? Does that also play a role?
There’s a part to weight loss that people don’t tell you about: It’s that you aren’t going to look like a supermodel afterward. You may have skin issues that you wouldn’t really think about.
MORE: How To Deal With Loose Skin After an Extreme Weight Loss
WH: What do you mean by that exactly?
It’s really all of the excess skin. Of course, it’s different if you lose 20 pounds versus 100 pounds. I have a lot of sagging skin on my stomach that puckers a little bit. It doesn’t look awesome. It’s the same thing with my upper arms. I do love some parts of my new body—like my runner’s legs—but it’s really about my stomach. Someone close to me said that I couldn’t wear a bikini because of it.
WH: How do you cope with hurtful comments like that?
Yes, sometimes I’m self-conscious about . But everyone has their imperfections. People have said, “Oh gross, look at her stomach,” but I don’t care. I earned the right to wear a bikini, so I’m going to do it.
WH: Is there anything else that you’re insecure about?
Definitely my stomach—but my boobs sag a little bit now. That’s generally it. It’s really just the skin that hangs around that you can’t really do much with. It would’ve been really helpful to know that I wasn’t going to look exactly the way that I wanted to.
WH: You’re so brave to admit all of this. What have you done to fight depression from taking over completely?
It’s something I still struggle with. But if I think about how I felt back then, I realize I don’t want to feel like that again, and I know what I have to do to not go back there. I have to stay active. A few weeks ago I started paying for a fitness program because if I pay for something, I’m more likely to stick with it. Plus, my boyfriend , so that helps, too.
MORE: What You Need to Know About Suicide and Depression
Kenny Thapoung Social Media Editor When I’m not stalking future-but-never-going-to-happen husbands on Facebook, you can catch me eating at one of NYC’s B-rated or below dining establishments—A-rated restaurants are for basics.
For Many People, Especially Women — Weight Loss Is Not a Happy Ending
Share on PinterestIllustration by Brittany England
From diet plans, pills, fitness packages, and juice cleanses, Americans spend millions of dollars on weight loss products each year.
Unfortunately, our culture’s pervasive message that a smaller body shape and size can make us happier, more attractive, and more confident causes many of us to romanticize the upsides of weight loss. People often imagine that by losing weight, they’ll magically transform their lives.
But, believe it or not, research suggests there’s a dark side to dieting.
Individuals who lost 5 percent of their body weight over the course of four years were more likely to feel depressed.
One 2013 study, conducted by researchers at North Carolina State University, found that when one partner lost weight, the relationship suffered. The researchers discovered that a partner’s weight loss could make the non-dieting partner feel jealous and more insecure about the partnership.
They also found that when partners’ weight loss goals did not align, the dieting partner became frustrated, feeling like their significant other was not dedicated to shedding the weight.
Other studies caution that weight loss can dampen people’s moods. A study, cited by Business Insider, discovered that individuals who lost 5 percent of their body weight over the course of four years were more likely to feel depressed than those who maintained their weight during that same timeframe.
For years, Selby tried numerous weight loss plans, but as the pounds melted off, she felt worse, not better.
“The pursuit of weight loss is more damaging than high weight itself,” says Linda Bacon, PhD, associate nutritionist at the University of California, Davis, and author of the book, “Health at Every Size.”
According to Bacon, losing weight requires people to stop trusting their bodies, which results in ill health. “We have a great regulatory system that can guide us in how to eat well, and dieting shuts down that system,” she points out.
Dieting can make you feel worse about your body
Years of dieting only worsened how Elijah Selby, 49, a feminist transformational coach in San Francisco, California, felt about her body. Selby tried many diets before she realized that the cause of her unhappiness stemmed from not feeling good enough about herself.
Dieting limits the happy chemicals in our brain, which can affect our mood.
“My journey to love my body has been a struggle,” she reflects. For years, Selby tried numerous weight loss plans, but as the pounds melted off, she felt worse, not better.
“I’d diet, lose weight and then feel terrible about myself, again. It was exhausting.” Like millions of men and women, Selby believed that losing weight would raise her feelings of self-worth: “I placed my value as a human in the world on the size of my body.”
It wasn’t until her son was born that she decided to make a lifestyle change.
Instead of focusing on weight loss, Selby began to concentrate on wellness. “I realized that I had to start accepting my body and learning to love it. I shifted my intention, focusing on eating well to feel good about myself and to have more energy.”
It took several years for Selby learned to how to love and accept herself, and she acknowledges the barriers our culture has, barriers which damage and shame women.
“Society gives us the message that we are not okay as we are. It’s hard to recognize these messages because it’s the cultural water we swim in, which makes us believe it’s the truth,” she says.
“I received lurid stares and sexual comments about my body. Walking down the street, I’d hear men whistling or say, ‘I’d like a piece of that,’ as if I wasn’t a human but some object to be had.”
Pursuing weight loss can change your brain chemicals
Kelsey Latimer, PhD, a clinical psychologist at the Center for Discovery, an inpatient and outpatient treatment program for eating disorders recovery, says that solely focusing on weight loss can damage our well-being.
“On a psychological level, there’s a certain feeling of ‘success’ that our culture sets us up to feel when we see the number on the scale go down. Unfortunately, no one tells us what to do when that stops, which can create a vicious cycle of not feeling good enough,” she says.
Latimer adds that most people aren’t aware that dieting limits the happy chemicals in our brain, which can affect our mood. And for some individuals, losing weight becomes an obsession or an addiction, straining one’s personal relationships and psychological health.
“The pursuit of weight loss is more damaging than high weight itself.” – Linda Bacon, PhD
When Lianda Ludwig, 66 of San Diego, California, was in her 20s, she fell into the trap of reaching for the ‘thin ideal.’
“Seeing images of the thin model Twiggy convinced me that I needed to be thinner in order to feel attractive,” she says.
She began starving herself, eating only yogurt for breakfast and lunch, and increased her daily exercise routine by adding an aerobics class. However, weight loss didn’t make Ludwig feel like a beautiful model; it made her miserable.
“I was caught in a cycle of thinking something was wrong with me,” Ludwig recalls.
Messages of weight loss are so heavily woven into our culture; we often think of the scale as a sign of success.
“The pursuit of thinness hurts our culture because it instills the idea that the size of one’s body is what makes them valuable, which distracts us from finding and pursuing our true potential in life,” says Jenna Doak, a certified personal trainer who promotes body positive fitness on her Instagram page.
This culture can cause us to lavish with praise when a loved one drops a few pounds.
On weight loss and harassment
Cindy’s* weight had always fluctuated, but in college, she unintentionally lost 20 pounds. Friends and family members complimented her on the weight loss, which made it seem like it was an achievement. “It made me feel like my entire worth came down to my waist size,” she says. *Name changed at request of the interviewee to protect her identity.
Her weight loss also brought a lot of unwanted attention from men.
“I experienced street harassment multiple times a day,” she says. The harassment was so awful that Cindy became incredibly anxious and feared going outside or attending social gatherings.
“I received lurid stares and sexual comments about my body. Walking down the street, I’d hear men whistling or say, ‘I’d like a piece of that,’ as if I wasn’t a human but some object to be had.”
To cope with the unwanted attention and the anxiety that came with it, Cindy began dressing in baggier clothes so that she wouldn’t show too much skin. While she confided in friends about the harassment, she never saw a therapist.
“Sometimes, I used food and alcohol as a way to stuff down my fears and anxieties. But eventually, gaining back the weight seemed to be the only trick that worked. It was a way to keep myself ‘safe’ from unwanted sexual attention.”
The pressure of weight loss can also affect men
Despite what many of us believe, dieting isn’t something that only hurts women: it also impacts men. In fact, according to the National Eating Disorders Association at some point in their lives, as many as 10 million American men suffer from an eating disorder.
Studies also show that men have body image insecurities and may feel badly about themselves after viewing images of the “stereotypical” fit and muscular male on television.
Ten years ago, Bill Fish, 40, a certified sleep science coach in Cincinnati, Ohio, struggled with depression. An antidepressant caused him to gain a few pounds.
“The medication hurt my metabolism. Looking at old photos of myself, I knew it was time to make a change,” says Fish.
Like many people who embark on a weight loss plan, he enjoyed the challenge of being able to lose weight and fit into his old clothes.
Fish’s weight had affected his self-confidence and he imagined that by losing weight, he’d feel more confident spending time at the swimming pool and wouldn’t avoid seeing a doctor for his yearly physical. He eventually lost weight, although his experience post-weight loss sheds a light to Selby’s point about the pressure, mistreatment, and expectations society places on women.
For Fish, his weight loss affected his golf game with his sons and took him of the bonding moment.
“With my game struggling, my tendency is to focus on that negative aspect instead of cherishing the time with my sons,” he says. “I’ve learned to absorb more needling from my 12-year-old after a bad shot.”
Supporters of the movement Health at Every Size (HAES) focus on loving and accepting their bodies and exercising for joy, not weight loss.
However, the post-effects of weight loss do still detrimentally affect men.
In 2016, actor Matt McGorry wrote an essay for “Today” opening up about his body insecurities, even during his body-building period.
Matt McGorry on body image
- When I was training for those competitions, I was miserable. One of the big draws for me was that this misery allowed me to test my will and self-determination. And yet, when I stopped competing, I couldn’t help but separate my misery from what I looked like.
- Logically, I understood that in order to look like what I used to look like, I’d have to do things I never wanted to do again. But I couldn’t help but mourn not looking like that.
We have the power to change the cultural narrative around weight loss
Even though dieting has many downsides, there’s a lot society can do to support healthier mindsets around weight loss. In order to flip the script on how we view health, wellness, and body weight, we need to speak out against these damaging beliefs.
To help create a supportive community, Bacon started a movement called Health at Every Size (HAES), with a website where people can sign a pledge declaring their commitment to honoring HAES values of respect, critical awareness, and compassionate self-care. HAES supporters also focus on loving and accepting their bodies and exercising for joy, not weight loss.
Individuals who live by these principles seek to celebrate, not shame, body diversity. They also challenge the “thin ideal” and other inaccurate messages about weight and body image.
“We need to offer cultural support and bonding over how difficult it is to live in a world of judgment,” says Bacon. She adds, “The more we can recognize this cultural problem, the less dependent we become on how those messages define us.”
Juli Fraga is a licensed psychologist based in San Francisco, California. She graduated with a PsyD from University of Northern Colorado and attended a postdoctoral fellowship at UC Berkeley. Passionate about women’s health, she approaches all her sessions with warmth, honesty, and compassion. See what she’s up to on Twitter.
Weight Management Tips for People With Depression
Which comes first, obesity or depression? Just like “the chicken or the egg” scenario, the underlying problem with depression and weight gain (or weight loss) can be hard to tell. Symptoms of depression and weight management issues are linked, and the relationship is a two-way street. In fact, a study done in the Netherlands found that obesity increases the risk for depression in initially non-depressed people by 55 percent, and depression increases the risk for obesity in initially normal-weight people by 58 percent.
Why are depression and weight issues so intertwined? “The part of the brain responsible for emotion — the limbic system — also controls appetite,” explains Joseph Hullett, MD, senior medical director of clinical strategy for OptumHealth Behavioral Solutions in Golden Valley, Minn. “When this emotional part of the brain gets disturbed in someone who is depressed, appetite gets disturbed as well.”
Plus, weight management issues on their own can be depressing. “For some people, being overweight feeds into the self-deprecating ‘I don’t like myself’ thinking pattern, which gets tied into the depression,” says psychiatrist Marketa Wills, MD, MBA, medical director of the women’s behavioral program at St. Joseph Medical Center and an assistant professor in the department of psychiatry and behavioral science at the University of Texas Health Science Center in Houston. You may gain weight, which makes you depressed, and then you may use food to self-soothe. It’s a vicious cycle.
In addition, some of the medications used to treat depression can have weight-related side effects, either causing weight loss or weight gain.
Depression and Weight Gain Versus Weight Loss
When depression sets in, the appetite control center of the brain can get thrown off in either direction. “Some people have a problem with depression and weight gain, and other people have a problem with depression and weight loss,” Dr. Hullett says.
Whether you overeat or undereat has to do with your unique biology and underlying coping strategies, says Dr. Wills. “And it’s possible for depression and weight loss as well as depression and weight gain to happen in the same person in response to two different episodes of depression.”
The type of depression symptoms you experience may also play a role in whether you gain or shed pounds. “People with seasonal affective disorder, for example, may become sluggish and gain weight in the winter and lose weight in the spring, like a bear in hibernation,” Hullett says. “People with depression and anxiety, on the other hand, may wring their hands, pace a lot, and tremble more because their metabolisms are accelerated — as a result, they can lose weight.”
Hullett adds that depression and weight gain is a much more common and serious problem than depression and weight loss. “Generally, depressed people won’t lose so much weight that they are endangering their health, except in severe cases,” he says. “But depression and weight gain can escalate to the point that a person becomes obese and develops heart disease and diabetes, so it needs to be addressed regardless of the severity of depression.”
The Relationship Between Depression and Eating Disorders
Beyond weight gain and weight loss, binge-eating disorder (characterized by bingeing, meaning compulsive overeating used as a way to cope with unwanted emotions) and bulimia nervosa (characterized by bingeing and purging, meaning overeating and then attempting to get rid of it, such as by vomiting) are the two major eating disorders most often tied to depression.
“A high percentage of people with bulimia have depression — at least 50 percent are diagnosed with major depression,” Hullett says. “So treating the depression can often also help to stabilize weight in people with bulimia. Depression treatments are also often effective for binge-eating disorder, when people often eat to compensate for stress and depression, he says.
Anorexia nervosa, on the other hand, is much less likely to be tied to depression, Hullett says.
Tips for Healthy Weight Management
Because depression and weight are so closely linked, tackling both problems is important in order to move forward. “The same tactic to control weight applies if you have depression: You need to decrease calories and increase your physical activity,” Hullett says. “So finding a way to do this despite the effects of depression is critical.”
Here are some helpful weight-management strategies to try:
Examine the relationship between your depression symptoms and food. “Explore the feelings you have about your weight and be mindful of how and when you use food,” Wills says. “Unlike smoking, you can’t quit eating.” So find a new way to look at food — as a source of nutrition instead of a outlet for depression, for example.
Take it slow. “People with depression often feel overwhelmed with life, so having small, incremental weight-management goals is important,” Wills says. “If you drink sugary drinks, for example, make eliminating them your goal for one week. Then move on to cutting out fried foods the next week.”
Turn the TV off and get moving. “Most people with depression and weight gain have reduced their amount of physical activity,” Hullett says. “It may not be obvious, but if you sit for four hours a day watching TV when you’re feeling depressed instead of your usual three hours, your metabolic rate will drop,” he says. Every bit of physical activity helps; start an exercise regimen to boost yourself out of a rut.
Just as with changes to your diet, increase physical activity gradually. “The low energy associated with depression can be debilitating,” Wills says. “Start by stretching for a few minutes in the morning, and make that your goal for four or five days. Then add a walk around the block. If you make small incremental changes, over time you’ll feel more in control, have a more positive outlook, and become more motivated to exercise.”
Ask your doctor if your medications are interfering with your weight-management efforts. “Many of the medications used to treat depression symptoms can cause weight gain over time,” Hullett says. “If weight management is important to you, clearly communicate this to your doctor, because there are alternatives.” Your doctor may change your medication or add a medication to counteract the weight-gain effects.
Consult with a registered dietitian. “This is particularly important if your depression and weight gain or weight loss is significant,” Wills says. To find a qualified dietitian in your area, log on to Eat Right, the Web site of the Academy of Nutrition and Dietetics (formerly the American Dietetic Association).
As you try to make these changes, having a positive attitude is key. “Weight management changes can be challenging for all of us, especially for people with depression,” Wills says. “Stay focused and continue to communicate with your doctor to help reach your healthiest weight.”
Why Choose Between Depression or Weight Gain?
The catch-22 of antidepressant therapy is the depression that comes from gaining weight on a drug used to stop the depression.
Weight gain is, alas, a common side effect of the drugs used to treat depression, fibromyalgia, severe PMS (known as Premenstrual Dysphoric Disorder) and hot flushes. As much as physicians tend to minimize the effects, or protest that patients are gaining weight because they are finally happy and going to restaurants, their patients are protesting. Many are halting their use of these drugs because they cannot stand to live in a body blown up by the overeating generated by the medications.
Anna typifies this problem. She had major depression that was intensified by PMS and was prescribed Lexapro. This drug has been used effectively to treat major depression and to relieve severe premenstrual mood changes. It worked-and left Anna almost 50 pounds heavier after a year. Her psychiatrist claimed that this weight gain was unusual because most patients gain “only”10 to 15 pounds”. Anna claims that she may have gained more weight because not only did her appetite increase; the medication made her lethargic and diminished the time and intensity of her daily workouts. Weight Watchers was tried; she gained a pound over four weeks. Desperate to find her formerly thin body, Anna (with the knowledge of her therapist) stopped the therapy. “I am fearful that my terrible PMS will come back and that I might become really depressed again but I can’t stand myself, ” she told me. “As soon as I stopped the medication, the weight started to come off.”
Weight gain from antidepressants is not a trivial side effect, even though therapists may trivialize the effect of gaining 15 pounds on the patient’s self image (and wardrobe). Given the vast numbers of women who have been medicated with antidepressants, the number of women who may have experienced this side effect is not trivial either. Data collected by the government on the use of antidepressants between 2005 and 2008 show that 12.7% of women were on one or more of these medications during this time period.
The drugs work on relieving symptoms that affect physical and emotional life. But when these treatments deposit extra pounds on bodies that had been a normal size before treatment, patients like Anna may choose to live with the depression or muscle pain rather than accept being fat.
Perhaps her choice could have been avoided if her physician had discussed with her the possibility that weight gain might occur and had suggested interventions to prevent or minimize this occurrence. Physicians do discuss the side effects of the drugs they prescribe. They recommend dosing schedules, the use of food to minimize gastric distress, periodic blood tests to check on organ function affected by the drug, and information about avoiding the sun if the drug may cause photosensitivity. They may even prescribe other drugs to deal with unavoidable side effects like nausea. So why not make a discussion of weight gain part of the side effect conversation?
Anna should have been told to be aware of changes in her appetite and to pay attention to food cravings and an urge to snack even though she wasn’t hungry. If she had been someone who exercised regularly, the possibility of reduced energy and thus decreased ability to exercise should have been mentioned as well. She did not have to be warned to call if her jeans suddenly stopped fitting but weighing herself at least weekly would have been a prudent recommendation. And had Anna been supported in her concern not to gain weight by the offer of dietary and exercise guidelines, then she might not have come to the point of dumping her medications to get back into her jeans. Ideally (although not realistically), she could have been sent to a weight-loss support group run by a department of psychiatry for patients like herself who were struggling with medication-associated obesity.
Unfortunately, there are very few physicians trained, or weight-loss programs designed, to treat antidepressant-associated weight gain even when it is recognized. Conventional weight-loss programs are not designed to treat this side effect and may even recommend diets that could affect the positive mood changes brought about by the drugs. For example, high-protein diets will decrease the synthesis of serotonin, the neurotransmitter on which most antidepressants work. This is because in order for serotonin to be made, an amino acid, tryptophan, has to enter the brain. High-protein diets supply too many other amino acids that compete with tryptophan to enter the brain and very little of this essential amino acid gets in.
As we discovered when we ran a weight management center at a Harvard psychiatric hospital, patients found their food cravings, uncontrolled appetite and weight gain stopped when they followed a food plan that increased serotonin. Even though their medications were increasing the activity of the serotonin involved in mood regulation, for reasons that are still not clear the serotonin involved in controlling their appetite was impaired. The only intervention available then and now was to increase the amount of serotonin in the brain. When this occurred, our patients stopped their snacking and bingeing and began to lose weight.
Fortunately, the dietary intervention to promote serotonin’s control over eating required only a small adjustment to their diets. Since it had been known for decades that serotonin was made when any non-fruit carbohydrate was consumed, we told our patients to consume a small amount of carbohydrate an hour before lunch, late in the afternoon or an hour before dinner and, if needed, about an hour before bedtime. By controlling the amount of carbohydrate in these snacks and limiting fat content, it was easy to insert the snacks into a 1200 to1400-calorie daily diet plan.
We also did not minimize or ignore the tiredness and lethargy that was reported by our patients. Many of them had exercised regularly before they become depressed, but while on their medications they reported feeling too exhausted to continue doing so. It is not easy to force one’s body onto a treadmill or into a pool when lying down seems a much better option. Our clinic had a staff of personal trainers who worked with the patients to develop exercises compatible with their reduced energy levels. As this particular side effect wore off, the amount and intensity of physical activity was increased. Obviously, patients are not going to be given a consultation with a personal trainer by their therapist. However, this side effect should also be recognized and discussed. If, for example, they are told to be content to walk rather than run on a treadmill, or to do something less intense such as yoga rather than kickboxing until this side effect goes away, they will realize that they have more options than lying on a couch and watching their hips grow bigger.
When these dietary and exercise strategies should be implemented is up to the therapist. Obviously, the patient has to be emotionally ready to follow dietary guidelines and engage in an exercise routine. But as Anna points out, therapists should not wait until the patient is getting depressed again because of weight gain. By that time, the choice-stop the medication and endure the depression-may be the wrong one.
Does depression cause weight gain?
Ongoing research shows there may be a biological link between depression and gaining weight.
While researchers still don’t understand fully the complex and tangled relationship between depression and weight gain, they do know “there are specific biological causes that link the weight gain with depression itself,” says Dr. Richard Shelton, vice chair for research at the University of Alabama at Birmingham’s School of Medicine’s Department of Psychiatry and Behavioral Neurobiology and a member of the UAB Nutrition Obesity Research Center. “It’s a reciprocal relationship.”
In other words, the relationship between depression and obesity is interconnected. According to JAMA Psychiatry, a person who is depressed has an increased risk of becoming obese and a person who is obese has an increased risk of becoming depressed.
There are a lot of behavioral reasons why depression could contribute to weight gain — a person who is depressed might not feel motivated to exercise or might seek comfort in foods that are high in fat and sugar. They may take antidepressant medication, which according to research published in JAMA Psychiatry show can cause modest weight gain.
Likewise, social factors and physical problems associated with obesity – such as poor self-esteem, weight-related health problems, or trouble getting out to socialize – can negatively impact a person’s emotional state.
But Dr. Shelton says the connection between obesity and depression appears to be biological, not behavioral. Researchers are still trying to understand exactly which biological mechanisms are to blame. Some people with depression have elevated levels of cortisol, a hormone associated with stress, which may help explain the weight gain, Dr. Shelton says. Or, he says, it could be that the sympathetic nervous system, which is more active in people with depression and which helps regulate metabolism, is to blame.
While more research is needed to understand the role biological mechanisms play, Dr. Shelton says people suffering from depression can take steps to prevent weight gain. He recommends:
- Focus on diet. “If people are really intent on controlling this process they need to focus on their diet,” he says. He recommends avoiding processed foods and eating a whole food diet like the Mediterranean diet, which offers a wide variety of health benefits.
- Exercise. Exercise not only burns calories, it helps people manage their symptoms of depression by releasing “feel good” brain chemicals called endorphins and by providing distraction.
- Talk to your health care provider about adding cognitive behavioral therapy to your treatment plan.
While weight management is important to overall health, Dr. Shelton cautions that individuals who have been prescribed antidepressants should continue to take their medication as directed.
“A lot of the weight gain attributed to medication in the past is likely attributable to biological activity,” he says. Although they might notice an extra pound or two, chances are “it is not an enormous amount so always treat the depression to full remission.”
A new study at the University of Alabama at Birmingham (UAB) confirms the relationship between depression and abdominal obesity, which has been linked to an increased risk for cancer and cardiovascular disease.
“We found that in a sample of young adults during a 15-year period, those who started out reporting high levels of depression gained weight at a faster rate than others in the study, but starting out overweight did not lead to changes in depression,” said UAB Assistant Professor of Sociology Belinda Needham, PhD. The study appears in the June issue of the American Journal of Public Health.
“Our study is important because if you are interested in controlling obesity, and ultimately eliminating the risk of obesity-related diseases, then it makes sense to treat people’s depression,” said Needham, who teaches in the UAB department of sociology and social work. “It’s another reason to take depression seriously and not to think about it just in terms of mental health, but to also think about the physical consequences of mental health problems.”
Needham examined data from the Coronary Artery Risk Development in Young Adults (CARDIA) study, a longitudinal study of 5,115 men and women ages 18-30 that aimed to identify the precursors of cardiovascular disease. Needham studied the data to test whether body mass index (BMI) — weight divided by the square of one’s height — and waist circumference were associated with increases in depression or whether depression was associated with changes in BMI and waist circumference during a period of time.
CARDIA study scientists weighed and measured the waist circumference and BMI of study participants. The waist circumference was measured to the nearest half centimeter. CARDIA researchers also asked study participants in years five, 10, 15 and 20 to rank their own level of depression.
“Looking at the CARDIA sample data, we found that everyone, as a whole, gained weight during the 15-year period of time that we examined,” said Needham. “However, the people who started out reporting high levels of depression increased in abdominal obesity and BMI at a faster rate than those who reported fewer symptoms of depression at year five. In year five, the waist circumference of the high-depression group was about 1.6 centimeters greater than those who reported low depression.”
She added, “By year 20, the waist circumference of the high-depression group was about 2.6 centimeters higher than those who reported lower levels of depression. In contrast, a high initial BMI and waist circumference did not influence the rate of change in symptoms of depression over time”.
Needham said there have been reports showing that cortisol, a stress hormone, is related to depression and abdominal obesity. “So, there is reason to suspect that people who are depressed would have higher levels of abdominal obesity versus other parts of the body because of elevated cortisol,” she said.
More studies are needed to determine the underlying causes for weight gain among those who reported being depressed, Needham said.
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Obesity, Genetics, Depression and Weight Loss
There are a lot of different opinions and strong emotions when it comes to the topic of obesity and weight loss. This article is simply another opinion about obesity in America. By writing this article, I am not trying to convince anyone of anything; I’m just trying to give you something to think about — perhaps a new idea.
The statistics regarding obesity in America are alarming. Currently, 35 percent of American adults are obese (CDC, 2012), and that number is projected to rise to over 50 percent in most states by 2030 (Henry, 2011). We’ve been fighting the so-called “war against obesity” since the 1980s, and yet despite all of our efforts, the problem has only gotten worse. Clearly, what we’ve been doing to try to solve this problem isn’t working and is possibly making it even worse. In my opinion, the reason for this is that the psychological piece hasn’t been addressed yet and until it is, we will have an increasing problem on our hands.
Years ago I was seeing a client who we’ll call Sarah. Sarah was very obese and desperate to lose weight. Her doctor had recently told her that if she didn’t lose a significant amount of weight she would lose her mobility as well as have a host of other medical consequences. Sarah tried numerous diets and exercise programs but nothing worked. She even enrolled in a weight loss clinic but had no success. She actually ended up gaining even more weight during this time. Not knowing what else to do, Sarah’s doctor told her that she needed to talk to a therapist.
When I met Sarah she was quite desperate to lose the weight and very depressed. Much to her surprise, I told her that I didn’t want us to work on her losing weight, but rather I wanted to work on her depression and teach her to accept and love herself unconditionally. This seemed the opposite of what she needed in order to lose weight, but Sarah decided to trust me anyway. You see, like a lot of people, Sarah thought that if she could just hate herself enough, that would motivate her to do whatever it took to lose the weight. As a therapist, I know that that is simply not going to work. We therapists follow something called the “Rogerian hypothesis,” which states that people tend to move in a positive direction only when given unconditional love and acceptance. Well, I’m happy to say that after we had alleviated Sarah’s depression and she had learned to love and accept herself, the weight came right off.
The current methods for helping people lose weight seem to be the opposite of love and acceptance. Much of the efforts seem to involve trying to shame and scare people into losing weight. This simply doesn’t work. The worst thing you can do is give someone more anxiety and depression regarding their weight, and I’m going to explain why that is later on. Also, the ways we go about teaching people to lose weight are much more complicated than they need to be. One should not have to read a book, go to a clinic, or take a class to learn how to lose weight. There is a very successful diet that has been around for thousands of years and all of the big celebrities do it. Can you guess what it is? It’s called “Moving more and eating less.” How you go about accomplishing this is up to you. I believe that losing weight is not complicated and that people intuitively know how best to do it when it comes to themselves. They simply need to stop feeling so anxious and depressed about it.
Obesity and Genetics
Before I talk more about how obesity is linked to depression and anxiety, I first want to briefly address the popular belief that obesity is purely a problem of bad genes. This is the popular belief and I can see why it is so popular. In a society where people are constantly trying to shame you about your weight, it can feel good to be able to say “Hey, you have no right to shame me about my weight! It’s not something I can control! It’s because of these bad genes I have!” But in order for this to be true, it means that our genes would have had to somehow change since the 1960s. Scientists agree that genetics is not responsible for the obesity epidemic, although they do agree it is a factor. Depending on which study you look at, genes only account for between 1 percent and 5 percent of a person’s body mass index (Li et al., 2010). I think that most people would agree that 5 percent of bad genes doesn’t excuse the 95 percent of it that scientists claim is due to bad habits.
When confronted with these facts, people often cite that most of the people in their family are also obese, so it must be genetics. However, the more likely possibility is that families tend to eat the same foods and have similar habits. Genetics also doesn’t explain why obese people also tend to have obese pets (Bounds, 2011). Obviously the dog doesn’t share the same genes as the owner, but they do share the same environment. Of course, we can’t mention genetics without looking at twin studies. Since identical twins have identical genes, researchers often compare twins to examine the effects of genetics and the environment on a person.
Obesity and Depression
Researchers aren’t quite sure if obesity causes depression or if depression causes obesity, but the two are definitely linked. In fact, the two conditions are so intertwined that some are calling obesity and depression a double epidemic. Studies have found that 66 percent of those seeking bariatric, (weight loss) surgery have had a history of at least one mental health disorder. And of course, it doesn’t help that the medications people take for depression and other mental health issues can cause dramatic weight gain.
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Consider this: According to the CDC, half of Americans will suffer from some sort of mental illness, and most of them will not receive any treatment for it. 63 percent of Americans are also overweight or obese. There are almost as many Americans taking diet pills as there are taking antidepressants (8 percent and 10 percent). People with mental health issues are twice as likely as those without them to be obese, and that’s even before they start taking psychiatric medication (McElroy, 2009).
So why are people with mental health issues so much more likely than those without them to be obese? We know that depression and bipolar depression slows down your metabolism (Lutter & Elmquist, 2009). Depression also depletes our willpower, making us less likely to avoid eating unhealthy foods. Depression also causes us to crave high-fat foods and sugar. This is where emotional eating comes in. When we’re feeling down, fatty and sugary foods make us feel better, at least temporarily. Of course, you don’t need to have depression or a mental illness in order to engage in emotional eating. It’s something we learn at a very young age. Eating something unhealthy is much easier than fixing the problem or dealing with what’s causing us to feel unhappy. Teaching people how to deal with unpleasant moods other than by eating would certainly cut down on emotional eating and would certainly lead to significant weight loss.
So if depression causes weight gain and antidepressants cause weight gain, then what is the solution? Well, research has shown that talk therapy is just as effective at relieving depression as antidepressant medication (Doheny, 2010), and talk therapy doesn’t have the negative side effects that medication does. Another option is exercise. In a 2005 study on the effects of exercise vs. Zoloft (anti-depressant medication) on the treatment of depression, participants were randomly placed into two groups. On group received 150 mg of Zoloft while the other group engaged in 20 minutes of cardiovascular exercise three to four times a week. After eight weeks, they found that the exercise was just as effective at reducing depression as the Zoloft! Another thing to consider is that Zoloft has negative side effects such as weight gain, sleep problems, and sexual dysfunction. As you can imagine, the side effects of exercising are the opposite of that.
Obesity, Genetics, Depression and Weight Loss
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Marina Williams, LMHC
Marina Williams, LMHC, is a Provider Quality Manager at Massachusetts Behavioral Health Partnership, She received a Master’s degree in Clinical Psychology from Bridgewater State University. She also holds an adjunct faculty position at at Grand Canyon University, teaching a variety of counseling and psychology courses.
Williams, M. (2018). Obesity, Genetics, Depression and Weight Loss. Psych Central. Retrieved on February 2, 2020, from https://psychcentral.com/lib/obesity-genetics-depression-and-weight-loss/Last updated: 8 Oct 2018 (Originally: 17 May 2016)
Last reviewed: By a member of our scientific advisory board on 8 Oct 2018
Indiana mom Kari Eads watched her weight go up and down over the years and was becoming frustrated with the process. It took being diagnosed and treated for severe depression to finally break that cycle.
Eads recently shared before and after photos of her progress on Instagram and opened up about her experience in the caption. “While I can’t tell you when my self-love journey first began, I can tell you when I got serious about becoming my own best friend. March 2016,” she wrote. “After decades of taking my self-hate, lack of confidence, and emotional pain out on my body, standing over my washer weighing in at 240 lbs with tears streaming down my face, I decided that since I wasn’t brave enough to take my life, I was going to have to be brave enough to save it.”
She made an appointment with her doctor, who said she was “severely depressed” and gave her a prescription for antidepressants. “I would be lying if I told you I didn’t think those little white pills were going to save my life,” Eads wrote. “Over the past 1.5 years, I have learned there are no magic pills. While those little white pills calmed the endless negative chatter racing in my head, they didn’t fix what needed the greatest healing…My soul.”
Eads tells SELF that her physical and emotional changes began in 2009 after two close deaths in her family.
“I had always had support from my family and everyone was gone,” she says. “It was like me against the world, trying to carry all this and process the grief.” At that point, Eads says she would try to self-medicate with alcohol, shopping, and food, but she still felt worse.
“I would go through bouts where I would find a glimpse of light, and it was always based around my weight,” she says. She trained for a half marathon and lost weight in the process but, after the race was over, she gained it all back. She did a weight-loss challenge at work and went to extreme measures to lose weight, including a juice fast and two hours a day of cardio. “After I weighed in, I was so proud of myself but I immediately went back to food because I had starved myself,” she says.
In addition to struggling with her weight, Eads was struggling mentally. After quitting a job that wasn’t validating or fulfilling for her, she felt good for a few months, until winter hit and she experienced seasonal affective disorder. Eads says she would often sleep on the couch during the day while her son played on his iPad, and she had difficulty doing basic chores like laundry and the dishes. “I was just miserable,” Eads says.
After the appointment with her doctor, Eads started the antidepressants, which she says “took the edge off.” Still, it wasn’t a magic fix.
“It finally hit me: ‘Kari, you’re going to have to do some work,’” Eads says. So, she started following people on social media that she found to be motivational, journaling, and reading the self-help book, Adventures for Your Soul. “I just kept digging deep into myself and trying to heal those little things I had continued to carry with me that allowed me to feel unworthy and unaccepted,” she says.
You might think that dropping pounds and getting healthier would go hand-in-hand with becoming happier—but a new study turns this assumption on its head: Believe it or not, losing weight might actually put you at a higher risk for depression—at least, that’s according to a new study from the online journal PLOS ONE.
And while this isn’t the first study to make a connection between weight loss and depression, it’s important to dig a bit deeper into these findings before you decide to ditch your weight-loss plans altogether.
MORE: 8 Tips That Make it Easier to Stop Eating When You’re Full
For the study, researchers looked at almost 2,000 overweight and obese adults and found that those who slimmed down were 80 percent more likely to be depressed—and even after controlling for major life factors such as losing a loved one, those who lost weight were still more likely to be depressed than the people who didn’t drop a pound. Strange, right?
The study authors attribute this to the fact that many dieters slim down by depriving themselves—or the possibility that even though participants had dropped pounds, they not have reached their goal weights yet. Weight-loss expert Keri Glassman, R.D., a Women’s Health advisory board member, says this isn’t a reason to abandon any weight-loss plans you may have, though.
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For starters, says Glassman, this study doesn’t take into account how people were losing weight—it only looks at the fact that they lost it. This missing detail makes it impossible to distinguish whether a restrictive diet had anything to do with their elevated risk for depression—or if depression may have even caused their weight loss, says Glassman. (Study authors also acknowledged this limitation.) What’s more, the researchers didn’t look into why people reported being depressed, which makes it hard to understand what issues made successful dieters more likely to be depressed, says Glassman. Lastly, the study might not have gone on long enough for the people who were losing weight to be happy with the amount they lost—an idea that the study authors also noted.
There are valid reasons why a person losing weight could become depressed, says Glassman. “The people who lost weight might have been successful at losing it but became negative because they were doing it wrong,” she says. Glassman also notes that some of her clients feel defeated when they don’t lose weight as fast as they had hoped to. While those reasons are certainly legitimate, more research needs to be done to prove that an increased risk of depression does actually exist in those who lose weight. “The results of this study aren’t a reason to not try to lose weight, but they show that we do need to better understand the implications of weight loss on your psychological wellbeing.”
The bottom line: It’s still uncertain if there’s a strong connection between losing weight and becoming depressed and, if so, why that relationship may exist. That said, it follows that using extreme measures to drop pounds would bring anyone down. For a more sustainable—and happier—way to lose weight, approach it as a lifestyle change; swap out unhealthy calorie-dense foods for healthier ones you love, and start incorporating regular exercises you enjoy into your routine. Using this tactic may not provide the fastest results, but you’ll certainly be more upbeat along the way—and probably find that the pounds you drop are more likely to stay off for good.
MORE: 5 Weight-Loss Strategies You Should Absolutely Avoid
Ashley Oerman Deputy Lifestyle Director Ashley Oerman is the deputy lifestyle director at Cosmopolitan, covering fitness, health, food, cocktails, home, and entertainment.
Depression and Weight Management: Ten Steps to Successful Weight Loss
In the page of this web site called “My Story: How I Was Healed From Depression,” I describe how I emerged from a one year, suicidal depression. I experienced many blessings as a result of this episode, such as a deepening of my compassion and a renewed faith. There was, however, a downside—I now weighed 250 pounds. This was a far cry from the 180 pounds I had weighed a decade ago.
I didn’t consciously plan on this happening. I didn’t wake up one day and say. “I think I will gain seventy pounds today.” Growing up, I was a skinny kid. I could eat whatever I wanted and not gain weight. But when I entered my forties, my metabolism began to slow down. As I became less active, the extra pounds gradually snuck up on me. And when I experienced a major depressive episode at age forty-seven, I ingested all sorts of antidepressants, some of which were said to cause weight gain. I am sure that these drugs played a part in the expansion of my girth.
At first I was so happy to be free of depression that I didn’t mind the excess weight. But then I learned of that people who suffered from depression, like those who are overweight, were at a greater risk for heart disease, diabetes and dementia. Thus, a person who is both depressed and obese receives a double whammy.
All of this was percolating in my mind as I entered the new millennium. Over the next ten years, I made three attempts to lose weight. Each time I met with modest success, only to put the weight back on. According to the body mass index (BMI), I was borderline obese. I decided I had to something.
Then, in late July of 2010, I bumped into a former member of my depression support group who also struggled with his weight. He recommended that I join Weight Watchers because he knew, as with recovering from depression, that people need social support to successfully manage their weight. Thus, I made a vow to go to a meeting as soon as I returned from a trip to the East Coast to attend my godson’s wedding.
A week later, on August 2, 2010, I attended my first meeting of Weight Watchers. I weighed in at 232.8 pounds. Weight Watchers jump-started my recovery in two ways. First they introduced me to the idea of keeping a food diary to track my calorie intake. Second, they helped me to set my first short-term goal of losing five pounds. As I worked the program, the obvious dawned upon me. Just as I had created a new lifestyle to heal from depression, now I needed to implement significant lifestyle changes to manage my weight. Moreover, unlike my previous three attempts, this regimen needed to be sustainable and enjoyable.
To make this happen I took elements of my 12-week body-mind-spirit depression recovery program and combined them with the principles I had learned in weight watchers to form a ten-step weight loss plan. The results of this program have been stunning. By making incremental changes in my patterns of eating and physical activity, I have been able to gradually and responsibly lose forty-five pounds over an 18-month period. Today, as I write this blog, I celebrate my 63rd birthday with a weight of 185 pounds. My friends tell me I look ten years younger. The payoff in terms of health, vitality and increased longevity is priceless.
Now I would like to share my ten-step program with you so that you can have the same success that I did.