Understanding obesity and depression
Learn how these two conditions work together and how to treat them both.
Will I fit? When going to a restaurant, most people do not give a second thought about where they are going to sit, but simply having a hostess show you to a table can strike fear in a person who is obese. It also happens on airplanes, amusement park rides and other situations.
This fear can lead to isolation and add to the ongoing depression that people with obesity face on a daily basis. Several studies show that up to 80 percent of obese individuals suffer from some level of depression.
Obesity & depression
Defined as having a body mass index (BMI) of 30 or over, obesity has been on the rise — not only in the United States, but around the world — since the 1980s. The World Health Organization estimates that by 2020, obesity will be the single biggest killer on the planet. As a person’s BMI increases, their feelings of depression often grow as well. Obese individuals sometimes feel discriminated against in the workplace, at the doctor’s office and in public. Many avoid the doctor’s office entirely for fear of hearing the doctor say, “I can’t help you if you don’t lose weight.”
Obesity is often caused by poor diet and exercise habits. Obesity rates are on the rise in developing countries now being exposed to Western lifestyles of fast food, refined sugars and saturated fats. Adding to the epidemic, our urban lifestyle and electronics have decreased daily movement.
However, many mental health issues can also lead to obesity. We are seeing an increase in depression that triggers emotional or “binge” eating. Complicating things further, many medications used to treat psychiatric illnesses have side effects of weight gain. Medicating a depressed patient may actually lead to an increased BMI, which then leads back to more psychiatric symptoms. This cycle is not going away anytime soon.
What can be done?
Obesity can be treated in various ways, including medically supervised diets and bariatric surgery. And the good news is that studies have shown that treating obesity often helps alleviate depression. A recent Swedish study showed that people’s mental health improved over the span of two years after surgery; but the reality is that change is difficult when people are depressed or feeling just plain bad about themselves. Obesity and depression (or other mental health issues), therefore, must be addressed together. Medical professionals often overlook the mental health aspect of diseases.
The battle must be fought on both sides: by physicians and patients. As a patient, you have to make sure that you find a medical doctor who is not only sensitive to your medical issues, but is also willing to treat you as a whole person. At the same time, health care professionals need better training in handling medical conditions that involve obesity and depression as side effects.
How to start your recovery
- Make small changes. Like a New Year’s resolution, dramatic changes rarely last, so don’t attempt to make huge changes all at once. Pick one habit to change at a time, like increasing the servings of vegetables that you eat in a day. Then move on to another goal you can achieve. Small successes will add up, and they’ll give you confidence that you can overcome this disease.
- Be an informed patient. Patients today have a choice of professionals. If your current physician is not addressing your needs, it might be time to find someone new. When you do see your doctor, make sure you have a list of questions or points that you want to cover.
- Be direct. Tell your doctor that you want help dealing with both obesity and depression. Both are on the rise, and you are not the first person your doctor has seen with these issues. Realizing that you’re not alone may help you speak up during office visits.
- Make yourself your priority. Too often, people who are obese talk about how stressed they are, and that they don’t have time to eat properly or manage their health. Maintaining both physical and mental health does require some planning and work. You would not send your children off for the day without knowing what they are going to eat for lunch. How many times do you leave the house without a plan for your own meals and activities? Plan for the day. What are you going to eat for lunch? When can you take breaks to walk around your building or just take a break from the stress of the day?
- Ask for support. Multiple studies indicate that when making any changes in your life, having a support system can make all the difference. Support can come from many places including family, friends, your medical team or even virtual support like online forums, chat rooms or emails. You are not alone and do not need to deal with this on your own.
Finally, remember that this is a marathon, not a sprint. Take it one step, one day at a time.
BMI By the Numbers
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Melissa Bailey is a licensed clinical psychologist, owner of the Bailey Psychology Group (drmelissabailey. com) and the Director of Allied Health for the National Obesity Foundation (NOF) — a nonprofit organization dedicated to helping individuals who are struggling with obesity and its related diseases (nofusa.org). She is also the best-selling author of Pink Hell: Breast Cancer Sucks, a memoir that sheds some humor on an otherwise dark period of life.