Obesity, weight gain, and depression: What's the connection?

If you are one of the over 100 million US adults living with obesity, or one of over 20 million Americans experiencing symptoms of depression, it may be no surprise to hear there is significant overlap between these two conditions. Our mental and physical health go hand in hand, and the scientific literature supports the two-way street that is depression and obesity. In this article, we will cover the connection between depression, weight gain and obesity, as well as some tips to manage the depression-obesity cycle, including getting help from a medical professional. 

The connection between depression and weight gain

It can be hard to commit to a healthy lifestyle when you are depressed, but can depression cause weight gain? Feelings of hopelessness, worthlessness, and anhedonia - or having difficulty deriving pleasure from previously enjoyable activities such as exercise - are hallmark symptoms of depression, and are associated with poor body image. MRI studies show that untreated mood disorders can lead to changes in the brain such as shrinkage of the prefrontal cortex, which is responsible for executive functioning and self-control, which can result in increased impulsivity and an uncontrolled response to food cues, whereby an individual is less responsive to internal signals of hunger and fullness.

Experiencing abnormal eating behaviors is one of the nine classic symptoms of a major depressive episode, and while overeating in response to low mood was once labeled “atypical depression” because it was thought that most patients with depression decreased their food intake, increased appetite and subsequent weight gain are now increasingly recognized as “typical” features of major depressive disorder. An overactive appetite is often coupled with emotional eating, whereby individuals turn to food - particularly “comfort foods” high in sugar and unhealthy fats - to alleviate negative emotions. Unhealthy eating behaviors and a lack of motivation to exercise are some of the ways in which depression can increase the future odds of obesity by as much as 58%. 

The connection between depression and obesity

At the same time, many with obesity find it difficult to feel good about themselves; they often suffer stigmatization, discrimination, and poor self-esteem, which can exacerbate or even cause a depressive episode. Making matters worse, some antidepressant medications are associated with weight gain, and patients with obesity may not respond as well to antidepressant therapy as those with a healthy weight.

Finally, chronic stress - and the corresponding mild increase in cortisol, poor sleep, and systemic inflammation, which are all linked to both depression and obesity, can reinforce the depression-obesity feedback loop. 

In other words, obesity and depression - and their impacts on our biology and behaviors - are both upstream causes and downstream consequences of each other. If you are suffering from both obesity and depression, treating one condition may help alleviate the other. One study found that depressive symptoms were significantly and sustainably improved after weight loss surgery, with the largest reductions in depression symptoms seen in those who lost the most excess body weight. Another study showed that a weight loss strategy prioritizing the treatment of depression through the use of cognitive behavioral therapy and as-needed antidepressant medication led to more weight loss than weight loss strategies that did not include a behavioral health component.

For these reasons, we cannot treat either of these conditions in a vacuum. Promoting healthy lifestyle changes is at the core of a successful weight loss strategy, and so is recognizing and treating conditions like ​​depression that reduce our motivation and impair our decision making. We cannot expect behaviors to improve if we don’t integrate elements of behavioral health into our treatment plans.

Possible treatments and tips for managing weight gain, obesity, and depression

Here are some steps you can take to improve your mood and your weight, to break the obesity - depression cycle:

1. Develop a balanced diet: Work with a Registered Dietitian to create well-balanced meal plans that promote weight loss while addressing your nutritional needs. Minimize processed foods and sugary snacks and beverages, and focus on consuming whole foods such as lean proteins, whole grains, fruits, and vegetables. There is even evidence to show that a healthy Mediterranean-style diet can improve symptoms of depression.
2. Practice mindful eating: Mindful eating applies the principles of mindfulness (awareness of the present) to eating behaviors. It helps you recognize the difference between emotional and physical hunger, and encourages you to slow down and savor each sip or bite you take so that you can better follow your fullness cues.
3. Increase physical activity: Regular exercise not only helps with weight loss but also boosts mood through the release of endorphins. Engage in activities that are enjoyable and set goals that are achievable.
4. Manage stress levels: Chronic stress can exacerbate both depression and obesity. Seek out healthy ways to reduce stress, such as exercise, meditation, deep breathing exercises, or engaging hobbies. Practice self compassion and gratitude to reframe negative thinking into more balanced thoughts. Counseling and therapy are other proven ways to deal with a specific stressful issue or better manage stress in general.
5. Seek professional help: Consult a healthcare professional who understands the link between depression and obesity, and who can help you develop a personalized treatment strategy to address both conditions simultaneously. Obesity and mental health specialists can offer therapy or medication options and monitor your progress.

How to address weight gain, obesity, and depression

If emotional eating, chronic stress, and low mood have gotten in the way of your weight loss goals, Form Health may be able to help! Form Health’s board certified health care professionals have a deep understanding of how our mental and physical health are interrelated, and will help you see the connection between your eating habits and mood to finally break the depression-obesity cycle. Using science-backed tools like behavioral support, nutrition, physical activity, and FDA-approved medication, we help you form a comprehensive weight loss program that will improve your overall health. Take our quiz to see if you’re a candidate to see if our medical weight loss program could be right for you.