The Link Between Depression and Being Overweight

Which comes first: being overweight or having depression? It turns out it’s a bi-directional path, with each part being both the cause and the effect.

Dr. Michael Kullman diagnoses and treats patients with all forms of depression, including treatment-resistant depression, major depressive disorder (MDD), postpartum depression, and postmenopausal depression, at our offices in White Plains and Pleasant Valley, New York.

And understanding the relationship between weight and depression, he and the staff also provide weight loss services, so you get help with both ends of the problem. Here’s what the team wants you to know about the interrelated problems and what we can do to help.

The magnitude of the problems

According to data from the CDC’s National Health and Nutrition Examination Surveys, 2005–2010, 43% of adults who had depression were obese as compared with 33% of adults without depression.

Obesity was measured by the body mass index (BMI), which must be 30 or higher to be considered obese and 25-29.9 to be considered overweight. Depression was measured using the Patient Health Questionnaire (PHQ–9), which is commonly used in clinical studies measuring depression.

The study found that women with depression were more likely to be obese than those who didn’t have depression, and that relationship held across all age groups. It was also observed in men aged 60 and over.

Moderate-to-severe depressive symptoms were associated with an increased rate of obesity both in those taking antidepressant medication and those who weren’t, and those taking an antidepressant had a higher rate of obesity with moderate-to-severe depressive symptoms than those who took low doses of antidepressants or none, indicating a potential side effect of the medication.

The study couldn’t clearly determine if depression or obesity occurred first because they were both measured at the same time. Other studies, though, have shown a bi-directional relationship.

Understanding the link

Weight gain and depression both stem from social, environmental, and biological causes. As a social example, people who live with financial insecurity or who’ve had difficult childhoods are at a higher risk for both obesity and depression.

There’s also the environment, like living in a food swamp or food desert. When you’re living among mostly fast food and convenience stores and don’t have access to stores with fresh produce, it becomes more difficult to eat healthy, and you gain weight. That gain may make you unhappy with your body, leading to depression.

And people who are depressed may eat to relieve themselves of dark thoughts.

Scientists are still trying to tease out all the contributing factors to both problems. A classic symptom of depression is the loss of interest and pleasure in activities. Rooted in the brain’s reward system, it can make enjoyable activities suddenly seem mundane.

Food is an excellent example. Your mouth revels in sweetness and satisfying umami tastes, but the pleasure you feel is processed by your brain. If your reward system (the pleasure of eating) doesn’t work properly, you may seek more food to make up for the dull or absent pleasure.

This can lead to food addiction, giving you uncontrollable cravings. You eat, and you gain weight, but you still don’t get the reward, so you eat more.

Depression may also interfere with impulse control. If you’re depressed, you’re more likely to develop cognitive impairments that can result in eating disorders like binge eating and bulimia.

Stress is a factor, too. The hormone cortisol plays a role because it’s linked to insulin resistance and obesity. Initially, stress dampens your appetite, but long-term stress leads to higher insulin levels; blood sugar plummets and causes cravings for sugary and fatty foods.

We still deal with stigma surrounding both weight and mental health conditions, making people caught in the cycle of overeating and being depressed about their life less likely to seek out professional help, when that’s exactly what they need.

Dr. Kullman provides treatment for both depression and weight loss, making the office a one-stop solution to help address your problems.

If you find yourself obese and/or depressed, call our office at 914-465-2882 to get help, or visit our website for more options.