Weight and Depression: 9 Must-Know Facts

Click here 

The Food-Mood Connection

Changes in mood can have unpredictable effects onyour diet. When feeling down, you might lose your appetite -- or become ravenous and overeat. The same is true for bouts of happiness: Not thinking about food or “happy eating” both can occur. Why? Brain biology and behavioral cues control both mood regulation and hunger signals. And because the same brain signaling that moderates mood also regulates hunger and fullness signals, people often notice that changes in mood also result in changes in food intake -- either eating more or less.

Depression and Weight Gain

Daily life is filled with ups and downs that can trigger short-term bouts of the blues. But sustained feelings of sadness, hopelessness or anxiety that do not go away and interfere with daily activities are a red flag to seek help. Depression can lead to changes in appetite, sleep patterns and sexual interest, and many people find they’re overeating and sleeping more -- leading to significant weight gain. However, many other depressed people lose their appetite and can’t sleep, leading to significant weight loss.

Loss of Appetite and Insomnia

Significant changes in eating and sleep patterns are symptoms of major depression, and are often linked. This is not surprising, since a common brain circuitry regulates both. The most commonly seen symptom of clinical depression is loss of appetite, resulting in weight loss. Depressed people often report a loss of appetite and interest in food, along with diminished enjoyment in eating. This is paired with insomnia, the inability to fall asleep. Some people can fall asleep but can’t remain asleep, awakening throughout the night with fitful sleep, or rising after only a few hours.

Eaters and Sleepers
Although most people who are depressed report loss of appetite and insomnia, an increasing number suffer from overeating (and weight gain), accompanied by excessive amounts of sleep. During depression, hunger signals can also be enhanced, and people often choose unhealthy “comfort foods,” like cookies, chips and pizza, to feel better. These high-calorie foods usually replace fruits and vegetables, and can pack on the pounds. Depressed people can also experience overwhelming fatigue, leading to extra hours of sleep at night, but without a sense of feeling rested, refreshed and alert.

Getting Help: Biology and Behavior Treatments
Depression is a medical illness with a two-pronged approach to treatment: talk therapy, medications or a combination of the two. This approach can bring about changes in brain chemistry, which lead to changes in mood. Getting your depression in check can help you focus on making lifestyle changes in eating, activity and stress management that will allow you to control your weight.

Medications That Promote Weight Gain
One of the major barriers to successful treatment of depression with medication is the well-known side effect of weight gain -- in fact, it’s the main reason people stop taking their meds. Many of the older medications that effectively resolve depression promote significant weight gain by both stimulating appetite and reducing metabolic rate, but newer generations of medications have a more focused effect on the brain and can stabilize mood without causing notable changes in appetite and metabolism for the vast majority of people. Being a mindful eater and staying physically active can help you offset any potential weight-related side effects. It’s important to discuss this aspect of treatment with your doctor -- before your medication trial begins.

Weight Loss During Medication Treatment
There is good news about weight loss during medication treatment: It’s not any harder to drop those pounds while on antidepressants. And if you’ve gained weight during your depressive episode, those pounds aren’t any more resistant to removal than those gained before. If feeling better during treatment restores your appetite, remember the foundation of weight control: Focus on lean protein and fruits and vegetables, and be active for at least 30 minutes daily. As with all weight-loss plans, it’s important to set realistic short- and long-term goals. The bonus is that the boost in mood supports your mental focus and determination, helping to keep you on track.

When to Switch Meds
Individual responses to different antidepressants can vary greatly. When starting a new antidepressant, it’s important to pay attention to both your change in mood and any effects on appetite. Even a medicine that’s not routinely associated with weight gain might stimulate your hunger. If you do notice a change, don’t stop the medication, but call your doctor to make a change. There are many categories of medication that resolve depression without unwanted weight gain. Medication that’s going to cause a change in weight will do so when it’s new to your body, so if you start gaining weight months (or years) after starting an antidepressant, it’s likely not that drug. Start with an honest talk with your doctor to discuss the best medical and lifestyle plan.

Long-Term Weight Issues and Depression
Depression is an illness that is managed over a lifetime, and for most people is episodic and recurrent. Because depression is a multifaceted disease, it’s important to know yourself and the way your body responds to external stressors, as well as cues that another episode may be occurring. This includes mood, eating and sleep patterns and weight change over time. With or without medication, you can effectively manage weight changes over time with consistent effort. Be mindful of your response to stress, and if it triggers overeating, take action. Small daily changes, including weighing yourself at least weekly, win the weight-loss race. And remember that not gaining weight -- remaining weight stable -- is also a health plus.