Obesity and depression: What's the connection?

The bidirectional relationship between obesity and depression drives a vicious cycle that requires lifestyle and healthcare-based treatments.

November 11, 2022
Obesity and depression: What's the connection?

The prevalence of obesity continues to rise in the U.S., standing at a staggering 41.9% as of March 2020. The buildup of excess fat in your body — whether contributed by genetics, lifestyle choices, or medications — is not just a body characteristic, but rather a disease state that is fast becoming a leading cause of death. For one, obese patients face an increased risk of diverse diseases including type 2 diabetes (T2D), cardiovascular diseases (CVD), and cancer. On top of that, the obese population can experience lower self-esteem and worsened body image, contributing to deteriorating mental health. In this article, we will take a closer look at what depression is, how obesity and depression are linked, and explore the physiological connection between the two conditions.

What is depression?

Depression induces feelings of sadness, anxiety, and hopelessness that last for at least two weeks. Depression covers a wide range of disorders such as bipolar disorder and postpartum depression, but we will focus on major depressive disorder (MDD). In MDD, the following symptoms can arise:

  • Angry outbursts and increased irritability or frustration
  • Sleep disturbances (sleeping too much or too little)
  • Fatigue and/or lack of energy
  • Slowed thinking, speaking, or body movements
  • Brain fog (trouble thinking, concentrating, making decisions, remembering things)
  • Suicidal thoughts
  • Physical symptoms not easily explained, such as headaches or muscle aches

What is the relationship between obesity and depression?

Much research discusses obesity and MDD as participating in a bidirectional relationship. This means that having either obesity or MDD increases the risk of getting the other. 

On the one hand, the literature provides support for obesity being a risk factor for MDD:

On the other hand, patients with depression are more likely to be obese. In these cases, the symptoms associated with MDD increase the risk of weight gain through various behavioral mechanisms.

  • A cross-sectional, retrospective chart review of 102 adolescent patients showed that patients diagnosed with depression were 3.5 more times likely to experience severe obesity than those without depression. Interestingly, the study also noted that this link was not mediated by emotional eating. Another systematic review of 13 longitudinal studies determined that adolescents who were depressed had a 70% increased risk of being obese
  • Similar results have been observed in adult patients. A meta-analysis of 16 studies showed that adults diagnosed with depression were at a significantly higher risk for developing obesity. Worryingly, the study also notes that the risk was particularly high for adolescent females.
  • While some studies do not attribute emotional eating to depression-driven obesity, other research suggests that higher emotional eating, combined with shorter sleep durations, leaves people with depression more vulnerable to substantial weight gain.

Physiological contributions to the obesity-depression connection

The scientific literature provides a strong argument for the intricate link between depression and obesity. These mechanisms generate a vicious cycle with biochemical links. But what are the mechanisms that mediate this relationship?

Bodily inflammation may provide some answers to this question: 

Changes in mood driven by the endocrine system provide an additional mechanism through which obesity and depression link together:

Ways to improve mental health through dietary changes

Many of the mechanisms mentioned previously are driven by excess nutrient intake, driving physiological changes that augment inflammation and magnify the vicious cycle. With that in mind, here are some dietary suggestions that can help reduce your weight and, in turn, improve your mental health:

Key takeaways

Obesity and depression are two of the more challenging disorders to treat. Part of this difficulty stems from the fact that the two disorders are closely linked with each other. The research among adults and adolescents demonstrates a bidirectional relationship between the two conditions, both of which are heightened in females. The two conditions are linked together by diverse metabolic mechanisms that drive bodily inflammation and nervous system modifications. While changes to one’s diet can help mitigate obesity, which could in turn help alleviate depressive symptoms, treating depression may require more extensive psychiatric help. Talk to your doctor and psychiatrist if you are experiencing worsened mental or suicidal thoughts. There is help available for you and depression is treatable.

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