Depression

Obesity and depression are the global health issues and mostly come hand-in-hand. Many studies have demonstrated that depression causes obesity and vice-a-versa.

We all are aware of the fact that obesity causes several health problems; amongst them, depression is on the top. This association is mostly higher in women than in men. According to studies, women with high BMI (>30 kg/m²) have a 21% high risk of depression, whereas men with the same BMI have only 8% of the risk.

Emotional impact of obesity

Obesity is the condition, in which one health problem leads to the development of several others. Obese people are self-conscious about their appearance, which has a greater impact on their emotional health. Some of the emotional health hazards associated with obesity include:

• Anxiety
• Depression
• Attention-deficit hyperactivity disorder (ADHD)

Low self-esteem, social isolation, and behavioral issues are also common in obese individuals. Additionally, obesity affects other organs and may cause shortness of breath, sleep disturbances, chest pain, and digestive problems, which triggers the feeling of sadness and worsens depression.

Association between obesity and depression

The exact reason for how obesity leads to depression is not yet known. But, certain studies have demonstrated the following mechanisms associated with obesity and depression:

• Genes: According to recent studies, the genes associated with higher BMI have a strong and direct association with depression, either with or without any medical condition, especially in women. Additionally, the risk get doubled if coupled with sedentary and unhealthy lifestyle.
• Hormones: Obese individuals have high levels of cortisol (stress hormone) in blood. These high cortisol levels interfere with the serotonin (brain chemical) levels and influence the mood, appetite, and sleep, thereby leading to depression. However, further research is required for a better understanding of this correlation.

Many studies have also suggested that individuals with high cortisol levels do not respond properly to psychotherapy, thus resulting in failure of treatment in depression patients.

Complications

Having either depression or obesity can trigger the occurrence of other medical conditions. Being overweight and ignoring it may lead to several obesity-related conditions, such as heart attack and stroke. Whereas ignoring the depressive symptoms may cause you to overeat and become less active, ultimately resulting in obesity.

If these conditions are ignored and left untreated for long-duration they may result in:

• Heart disease, such as hypertension, heart attack
• Diabetes
• Hypothyroidism
• Chronic pain syndrome
• Fatigue
• Anxiety
• Asthma
• Sleep apnea

Additionally, untreated obesity in depression patients results in suicidal thoughts, which may cause death.

What can be done to manage these risks?

The medical team should work with the individual to build an appropriate therapy for managing obesity and depression. Unlike other conditions, the treatment option for obesity and depression focuses on the physical and emotional aspects of the person. Changes in weight, appetite, and self-esteem are addressed first. In most cases, behavioral modifications sometimes referred to as behavioral therapy, could be of great help.

Behavioral therapy: This therapy includes counseling and the involvement of the support group.

• Counseling: It involves the help of a mental health professional who addresses the emotional and behavioral issues of an individual related to overeating. This therapy is done to:
  1. Know the reason behind overeating.
  2. Learn healthy ways to cope with obesity and depression.
  3. Monitor diet and physical activity.
• Support groups: These groups provide help to individuals in several ways who are facing similar challenges in life. We at AIG Hospitals regularly organize support group meeting to interact with others and share success stories.

Medication therapy: Medication therapy, along with lifestyle modifications, is very effective in managing obesity and diabetes. It includes weight loss medications to reduce or control body weight. In some cases, anti-depressants are also given if the depressive symptoms are not improving in the patient.

Lifestyle modifications

Medications alone do not help to deal with obesity in a depressed patient. Even the medications to work effectively, the patients should focus on their lifestyle. These lifestyle modifications include:

• Healthy diet: Have a diet rich in fruits, vegetables, and low-fat dairy products. Avoid intake of high-fat and high-calorie foods, such as cakes, cookies, and fried foods.
• Stay hydrated: Drink plenty of water. However, avoid drinking high calorie or sugar-added drinks, such as sodas, sports drinks, and alcoholic beverages.
• Exercise: Burn calories by including physical activities, such as walking, jogging, or cycling. Doing so regularly increases the metabolic rate, reduces body fat, and improves heart and lung function. This helps in reducing and maintaining a healthy body weight.
• Stress: Studies have demonstrated stress as a major contributor of obesity. It also increases the cortisol levels in the blood. So, manage stress by doing yoga, meditating, and performing any relaxing therapies.

Other habits, such as having meals while watching television or while driving a car, may distract you from thinking about how much food you are consuming. So, avoid these activities while having a meal. Additionally, taking adequate rest, exposing to sunlight, and cutting the intake of caffeine helps in boosting the mood and reducing the symptoms of depression.