Depression and weight changes often coexist. Most often mental disorders like depression and anxiety affect not just your mood but can result in changes in your body weight.
Some people experience weight gain (and even obesity) while some people with depression suffer an unhealthy weight loss.
Both these conditions, weight loss and weight gain, can have serious health complications when they coexist with depression. But, it is for the treating doctor to decide how and which condition should be given preference for the cure – the weight issue or the depression.
Depression and weight gain/obesity
Studies do indicate that people with mental disorders like depression have a higher tendency to become obese than people without this mood disorder.
Similarly, obese people are more likely to become depressed. Though the link connecting depression and obesity is strong, the association of direction, however, still remains unclear.
According to a Netherlands’ study, obesity increases the depression risk in mentally healthy people by 55 percent, and depression increases the risk for obesity in normal-weight people by 58 percent.
This link between depression (or anxiety) and obesity is seen stronger in:
- White people
- Teenage girls
- And among the affluent class, which includes people with more education and income.
What causes weight gain (or obesity) in depression?
Which comes first – the depression or obesity?
There are clear causes, which link depression to weight gain. At times, there may be extreme weight gain, which could result in obesity.
Similarly, there are reasons as to why obesity could result in depression. So, the cause and the effect can vary in different people.
It is necessary to take this issue seriously because you are then exposed to the risks of complications of both depression and obesity, both of which can cause serious diseases such as cardiovascular diseases, cancer and a tendency to commit suicide.
Increased appetite and physical inactivity
Increased appetite and physical inactivity are two depression symptoms, which can lead to obesity.
A depressed person in his effort to seek diversion from his mental state does indulge in binge drinking and binge eating.
He is unable to control his food intake and loses interest in any physical exercise, which could be the reason for gaining weight.
Most of these individuals who do not maintain a normal weight could be prone to daily, monthly or seasonal disturbances in mood.
This can lead to an excessive ingestion of carbohydrate-rich foods and loss of interest to do any type of physical activity.
Depression after weight gain
Similarly, obese people are more likely to become depressed due to the social stigma and social criticism that obese people face.
Some antidepressants taken over long-term (six months and more) to treat depression can cause changes in weight.
About 25 percent of people who take certain antidepressant drugs gain weight, sometimes as much as 100 pounds.
Why antidepressants cause weight gain is not clearly known, but if a certain drug is causing you to gain weight, switching drugs might make a difference.
One theory suggests that possibly, these weight gaining antidepressants trigger your craving for carbohydrate foods, which can add pounds to your body.
Another theory suggests that these drugs alter your metabolism. A third suggestion is that antidepressants improve your mood and depression, which increases your appetite.
One antidepressant that is most likely to cause weight gain is Paxil, an SSRI (selective serotonin reuptake inhibitor).
It is commonly believed that the tricyclic type of antidepressants (TCAs) increase appetite, therefore perhaps causing weight gain
There are other SSRIs, such as Prozac, Lexapro and Celexa, Zoloft that may be used because they do not cause weight gain.
Other antidepressants such as Effexor (venlafaxine) and Serzone (nafazodone) usually do not cause weight gain while Wellbutrin (bupropion) tends to cause weight loss.
A third factor, which is also being held for this cause and effect relationship could be the chronic stress levels that accompany depression. There is extra secretion of cortisol (the stress hormone) during the mental stress that depressed people constantly face.
Cortisol stimulates and promotes the storage of fat in the abdomen. This is done to make provision for additional energy, which may be required during times of stress.
Chronic stress as seen during depression does result in chronic secretion of cortisol leading to deposits of extra abdominal fat causing central obesity.
Studies have shown that the prevalence of obesity in the US population is 25% to 30% while the prevalence of obesity among people with depression is about 50%.
Depression, weight gain and the serotonin connection
Serotonin is a chemical produced by the nerve cells of the brain, which is a neurotransmitter carrying signals between the nerves and responsible for maintaining a good mood and well being.
Its low level appears to be responsible for mood and appetite disturbances. Studies indicate that medical interventions, which increase the serotonin activity, help in normalizing food intake and mood disturbances.
To prevent weight gain, it is necessary to maintain the mood and normalize food intake. This will avoid binge intake by the depressed individual. This can be achieved by a sustained or periodic intervention that will keep serotonin activity at its optimum.
These reasons and statistics show a clear indication that treating obesity for obesity alone may not be enough. There could be an underlying cause of depression, which has to be treated.
Depression and Weight Loss
As explained above, depression and anxiety can be associated with weight loss in some individuals. People with these mental disorders develop anorexia, which is seen in depressed men and women.
Some people with a depression disorder develop loss of appetite and eating disorders, such as anorexia nervosa, which explains why weight loss is seen in these depressed people. At times, the depression precedes the eating disorders.
Loss of pleasure in anything is the hallmark symptom of depression. This is especially seen in women.
Depression deprives the person of enjoying the pleasures of life, which he or she once enjoyed.
The depressed person loses interest in things including living life. This includes loss of interest and pleasure in eating, which leads to weight loss.
Another cause of weight loss in spite of eating a lot could be bulimia nervosa. This is an eating disorder characterized by binge-eating followed by a purging of the body.
Purging may occur due to induced vomiting, laxative overuse or over-exercising the body. It is a well-known fact that depression is commonly associated with bulimia.
Dealing with depression and weight changes
Treating depression and the weight problem is a time-consuming affair and treatment has to be considered as a long journey rather than a short affair.
Treatment of depression consists of medications and some natural remedies, both of which play an important role, and importance vis-à-vis cure is given to both the problems, with depression given the preference over the weight problem.
A lot of obese people trying to lose weight do not succeed in spite of dietary control, regular exercise and attending weight loss clinic.
At such times, one positive option would be to rule out anxiety and depression. Consulting a doctor with this expertise will in all probability help.
The possibility remains that even will full effort, if an obese person does not lose weight, it is very likely that he or she has slipped into depression.