South Asian culture, being influenced by Western images of beauty, has shifted to value thinness in recent years. With this transition, and newfound pressures to maintain unreasonable thinness, comes the belief that being overweight or obese results in feeling depressed.
This can be true. People who are overweight or obese tend to eat less healthy food, exercise less and consume more calories as well. Poor eating habits as well as a lack of exercise is closely tied to developing low mood, low self-esteem and eventually, depression.
However, the connection we often miss is how depression can also make you gain weight. A study published in 2010 found that people who reported feeling symptoms of depression (such as sadness, hopelessness, anxiety, etc.) gained weight more quickly over 15 years and accrued more abdominal fat than those who did not experience depression.
So how is weight and depression connected? It seems that they are related through the process of chronic stress. People who are depressed have a nervous system that is always turned on, just like people who are always stressed. It seems our bodies react similarly to depression as they do to elevated stress levels. When cortisol (the stress hormone) levels are chronically high during when we are anxious or depressed, our bodies are designed to collect fat.
The connection between depression and obesity is seen as early as the age of 12. Teenagers in middle school and high school who were depressed were significantly more likely to gain weight and possibly become obese one year later. Interestingly, being overweight did not seem to increase any preexisting depressive symptoms.
Perhaps these studies can shed some light on the obesity epidemic, especially in children, that has taken over the United States. Poor nutrition can be one explanation for the higher rates of overweight and obese children in the country; however, a factor we have not yet fully considered is, could these children be depressed? If children are left alone too often, have trouble making friends, lack parental support etc., it can create feelings of isolation, low self-esteem and depression, thus affecting their bodies as they grow.
People who are underweight are not immune from the weight and depression connection. Research has shown underweight people to have higher levels of depression than those of average weight. This could be because some people who are depressed tend to lose appetite and thus consume less calories than is healthy for their age, height and weight. Poor nutrition can result from eating less and can exacerbate depressive symptoms. In addition, some severely underweight individuals may have eating disorders which are closely connected with depression.
South Asians, who are genetically at a higher risk for cardiovascular disease and diabetes, have to be particularly mindful of any factors that increase that increase their chance of a cardiac event including weight gain. Depression is associated with high levels of stress which also is a significant factor in developing cardiovascular disease and diabetes.
If you find yourself exercising regularly and eating a nutritious diet but still having trouble losing weight, emotional health care is crucial to consider as the missing link in your weight management plan. Excluding mental health care from the treatment plan of serious physical ailments such as obesity, cardiovascular disease and diabetes is like forgetting 1/3 of a building's foundation and wondering why the building is still tilted. Physical and mental health are much more intricately connected that we think and addressing both aspects guarantees a much better chance at living a truly healthy life.
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