Weight Loss Blog

Obesity and depression often go hand-in-hand in middle-aged women, a new U.S. study found.

The research collected information on the height, weight, dietary and exercise habits, and body image of 4,641 women, ages 40 to 65, enrolled in a health plan. The women also completed a questionnaire used to measure depression symptoms.

Women with clinical depression were more than twice as likely to be obese (a body mass index of 30 or more), and obese women were more than twice as likely to be depressed, the study found.

It also found that women with BMIs of 30 or higher exercised the least, had the poorest body image, and consumed 20 percent more calories than women with lower BMIs.

The link between obesity and depression remained intact even when the researchers factored in marital status, education, tobacco use and antidepressant use.

The study was published in the January/February issue of the journal General Hospital Psychiatry.

It’s likely that depression and obesity fuel one another, said lead author Dr. Gregory Simon, a psychiatrist and researcher at Group Health Cooperative in Seattle.

“When people gain weight, they’re more likely to become depressed, and when they get depressed, they have more trouble losing weight,” he said in a prepared statement.

The stigma of being overweight can damage self-esteem and efforts to lose weight.

“It’s not that these women are clueless. It’s that they’re hopeless,” said Simon, who suggested that if obese women focus on rebuilding their self esteem, it may help them lose weight.

According to the National Institute of Mental Health, more than 19 million people in the United States — 1 in 10 adults — experience depression each year. Women are twice as likely as men to experience depression. In fact, more than 6 million women experience depression each year.

Study finds a clear link between obesity and mood disorders

There is a clear link between obesity and depression, anxiety and other mood disorders, according to a new Group Health Center for Health Studies report.

“People who are overweight or obese are more likely to have anxiety or depression problems. They’re really stigmatized,” said Dr. Gregory Simon, a psychiatrist and researcher at Group Health.

“There had been previous research saying there appeared to be a link between obesity and depression — the results weren’t surprising — but this study made it clearer,” Simon said.

Kathleen Tate once embodied that. A year ago, her body mass index, or BMI, indicated she was on the verge of obesity. She also had a history of depression. But after participating in the Weight Management Program at Swedish Medical Center and making lifestyle changes, she’s now in the normal range. She also feels much better.

“There are so many factors that contribute to why someone might have depression. Weight loss might help, but it’s part of a process,” Tate said. “I think it’s possible to be thin and terribly depressed.”

The findings weren’t surprising to Carol Birch, a nurse practitioner in the Center for Medical Weight Management at Swedish Medical Center. Working with weight management patients for the past three years, she’s learned that obesity and mood disorders are “definitely linked.”

But it’s not always easy to see.

“Patients might not even recognize they’re depressed,” Birch said. “They may be in denial. They might do a lot of work, or mask it. But when tested on a depression scale, it becomes evident. A score of 10-15 (of a possible 63 points) raises a red flag. If the score is in the 30s, they’d better be in counseling.”

Simon was leader of the Group Health study, published in the July Archives of General Psychiatry. He said the team used data from a large national survey of mental disorders conducted by Harvard University between 2001 and 2003.

Simon, who specializes in research on depression and mood disorders, said the survey gave his team information on 9,125 participants to analyze. Average age was 44.8. By applying standard definitions of depression, they could use a participant’s responses to determine anxiety, depression and mood disorders.

Obesity was measured by BMI. His research also found that well-educated obese caucasians were even more likely to be depressed, a likelihood that could be as high as 44 percent.

Do people who are depressed become overweight, or do they become overweight and then depressed? Simon said he’s studying this.

If people lose weight, does depression improve? “We don’t have the answer to that. But it does go both ways, at least if you talk to people — people say they’d be less depressed if they were able to lose weight, for example.”

Birch said one reason white, educated obese people may be more prone to depression is that they set a high standard for achievement. If obesity impinges on their abilities to achieve, it could lead to depression.

She’s also learned that some people aren’t willing to give up their lifestyles, to set aside time to take care of themselves. Only when their health starts to fail will they seek help.

To obese adults already at higher risk for diabetes, heart disease and other life-altering conditions, this study isn’t good news.

“What we believe is that people who are depressed have much more trouble losing weight, changing diet and increasing activity level,” Simon said.

“Since there’s an overlap between obesity and depression, what kind of special programs do we need to develop to help them? That’s a question we’re working on. I can’t say I have the answer.”

But there is a bright note. Simon’s study found that obese people had a lower prevalence of substance abuse disorders.

What are the symptoms of depression?

Doctors continue to learn about how women are affected by depression, but there are some common symptoms. If you’re depressed, you may have some of these symptoms nearly every day, all day, for 2 weeks or longer:

• Feeling sad or crying a lot
• Losing interest or pleasure in things you used to enjoy (including sex)
• Feeling guilty, hopeless or worthless
• Thinking about death or suicide
• Sleeping too much, or not being able to go to sleep or stay asleep
• Losing your appetite and losing weight (or eating too much and gaining weight)
• Feeling very tired or slowed down
• Having trouble paying attention and making decisions
• Having aches and pains that don’t get better with treatment

What causes depression?
Depression seems to be related to a chemical imbalance in the brain that makes it hard for the cells to communicate with one another. Stressful life events, such as the death of a loved one, a divorce or moving (such as leaving home to go to college), may lead to depression. Taking certain medicines, abusing drugs or alcohol, or having other illnesses can also cause depression.

Women with premenstrual syndrome (PMS) are more likely to become depressed. Depression is more common a week before a woman’s period and in the weeks after a woman gives birth (this is called postpartum depression). In some women, taking birth control pills may cause symptoms of depression.