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Which comes first, depression or weight gain?

We may never know whether it's the chicken or the egg that came first, but new research has shed some light on another vexing question: Are people who are overweight at increased risk of become depressed, or are depressed people at higher risk of becoming overweight?

Researchers have long seen a link between depression and overweight, but it's been difficult to pin down which causes which.

In a study in the June issue of the American Journal of Public Health, Belinda Needham of the University of Alabama at Birmingham looked at data for more than 4,600 young adults in the Coronary Artery Risk Development in Young Adults study. Needham focused on information collected about participants' BMI, waist circumference and symptoms of depression at five-year intervals over 20 years.

In short, the study found that:

Respondents who started out with higher levels of depressive symptoms experienced a faster rate of increase in BMI (for whites only) and waist circumference (for blacks and whites) over time than did those who reported fewer symptoms of depression in year five. Initial BMI and waist circumference did not influence the rate of change in symptoms of depression over time.

That suggests that depression comes first. But Needham is careful to point out that her study does not establish a cause-and-effect relationship, only a temporal one. She also notes that perhaps there's some circumstance that underlies both depression and obesity. If that were the case, then neither of those two conditions could be said to cause the other.

As Needham observes, cracking this case could lead to more effective treatments or preventive interventions for both obesity and depression.

Do you have any insight into the relationship between obesity and depression? Share, please!

By Jennifer LaRue Huget  |  June 15, 2010; 7:00 AM ET
Categories:  Mental Health , Nutrition and Fitness , Obesity  
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I know, for myself, the depression came first, then the weight gain. There, of course, are also issues with certain medications (both anti-depressants and others) causing weight gain which just exacerbates the situation.

Posted by: dgb123 | June 15, 2010 8:23 AM | Report abuse

I don't mean to throw a cherry bomb here, I know there are overweight people that are happy, passionate, and very active in their lives. They just have unhealthy eating habits, and that's the end of the story. In my family however I've noticed that being passive and being overwieght seem to go hand in hand. Consumption can take the place of doing something you are excited about, and that consumption can mean excessive food, drink, drugs, or shopping. When you get busy doing and and accomplishing things (and I'm not just talking about what you do to bring home a paycheck, I'm talking about what you do to lead an interesting and assertive life) you just don't feel the need to use as much stuff. You get comfort from thinking about your future rather than eating another doughnut. I'd argue that time spent in front of the tube trains people to be more passive, which leads to mild depression and resulting wieght gain. It's not the nanny state we need to be worrying about here in the US, it's cable TV that's been our undoing.

Posted by: tiggertime1 | June 15, 2010 10:37 AM | Report abuse

I agree with dgb123. The fact that antidepressants often cause weight gain is problematic. What if a person who didn't previously have a weight problem develops one as part of his or her treatment for depression?

Posted by: capta1nk1rk | June 15, 2010 1:42 PM | Report abuse

One way to fight depression is to exercise at least three times a week, and walking is a right method of exercise. Once you gain weight because of depression it becomes more difficult to exercise on regular basis. Maintaining a healthy diet also helps with reducing or eliminating depression. The thing is to be able to do those things, which often is difficult because of the symptoms.

Posted by: transltdpolish | June 15, 2010 1:49 PM | Report abuse

I put my money on depression.

It's a little simplistic to characterize overeating as a substitute for something more exciting. That implies either ignorance (i.e., can't you find something better to do?), laziness (i.e., you could get your butt off the couch if you weren't such a big fat slob), or some sort of psychiatric displacement (I eat because food is the only thing that won't reject me).

Some or all of that may be true for some people. But depression is actually much more insidious than that. It's not about being "sad." It's not about "choosing" to wallow instead of doing something more productive. It's not even about not having the energy to do X or Y or Z.

For me, it was this: I could not think of a single thing in the world that was interesting or exciting enough to justify the effort involved in doing it. That's it. The entire world was grey. Every single thing in my life -- every single idea -- seemed completely pointless. Why bother? Sitting on the couch becomes the default when there's nothing else.

Then, of course, you can add in the fact that something that tastes good can provide a little teensy spark in the middle of all that grey -- a shock of feeling, of being alive, of something that almost feels close to pleasure, even if just for a fleeting moment. The end result is a foregone conclusion.

I was lucky: turns out my depression was due to a thyroid problem. As soon as I got on replacement hormone, the sun came out behind the clouds, and the world was full of interesting things that I couldn't wait to do. But it sure gave me a whole new appreciation for the struggles faced by people who have to live with and manage depression on a daily basis.

Posted by: laura33 | June 15, 2010 3:03 PM | Report abuse

oops meant leads to poor diet

Posted by: alterego3 | June 15, 2010 3:23 PM | Report abuse

alterego3, it's time for you to lead by example.

Here's a gun.

Now go out back and do the right thing.

Posted by: angelos_peter | June 15, 2010 4:35 PM | Report abuse

The US population has among the highest rates of both depression and obesity and it seems that nearly everyone recognizes some type of link between the two.
The US also eats an enormous amount of beef and dairy products - meat and dairy that are fed and raised in a way that is unique to this country.
I'm not a science expert, but I have done a lot of research and I know that the chemical makeup of the meat and dairy products that come from our animals, which are raised on feed, is very different than that of an animal who is grazed/grass fed. There are significantly higher ratio of Omega-6 to omega-3 fatty acids in our meat and dairy, versus a higher level of omega-3 acids in grass-raised cattle. Excessive omega-6 fatty acids have been shown to cause high cholesterol, obesity, and ... depression.
Not one causing the other here, but all symptoms of the unhealthy, inhumane, and unsustainable way we raise our animals.

Posted by: aneer1 | June 15, 2010 5:41 PM | Report abuse

angelos_peter please send gun I will happily do the right thing
bet you don;t have one

Posted by: alterego3 | June 15, 2010 6:10 PM | Report abuse

aneer1, by that logic vegetarians and vegans should have a lower rate of depression than meat eaters. Do you have any statistics on that?

Posted by: theGelf | June 15, 2010 6:40 PM | Report abuse

Obviously, many common anti-depressants have a side effect of weight gain. So, in order to find a correlation between depression and weight gain that is not a pharmacological side effect, one would have to study people diagnosed as depressed who are not taking any of the medications that have the side effect of weight gain.

It is very surprising that the authors of the column do not even mention the connection between anti-depression medications and weight gain.

Posted by: AnonymousBE1 | June 16, 2010 5:52 AM | Report abuse

I know my depression comes first. Then I eat because I'm depressed, and my depression also translates into not wanting to exercise. End result: weight gain. After using different medications for years, I've found that the only thing that really works for me is to be strict about my exercise. I walk at a good clip for at least half an hour a day, rain, shine, sleet, or snow. It keeps the depression at bay, and also keeps the weight off. And I know that if I slack off, it's a slippery slope back into that depression spiral.

Posted by: dcn8v | June 16, 2010 7:48 AM | Report abuse

What a chicken & egg question. There is a very suggestive genetic link to the depression I have been suffering from for 25+ years. Add to that, obesity, joint problems, poor coordination & assorted issues not caused by obesity (allergies, dysfunctional family dynamics, etc.) and stir in antidepressants & the hectic life of the DC area. The resultant recipe is for the same set of problems but it is almost impossible to find the beginning.

Posted by: Arggg | June 16, 2010 8:30 AM | Report abuse

I was on Zoloft for several years and gained nearly 70 pounds. If I had know I would gain weight on that med I wouldn't have taken it. My doctor switched me to another, saying people do tend to gain weight on Zoloft. I don't think it was the amount of food I ate, but it made me feel very sluggish, wanted to sleep all the time. It screws up your metabolism. I'm on Celexa now, but losing the weight has to be with my own effort.

Posted by: Baltimore11 | June 16, 2010 10:04 AM | Report abuse

Alterego3 -- Just in case you are being serious, please call 1-800-273-TALK (8255). Angelos_peter: You've obviously never lost someone you love to suicide or you won't be so blase. For those of us left behind, it never stops hurting. Thanks for the reminder, as if I needed it. Also, I think you misunderstood the original comment.

Posted by: walkeraza | June 16, 2010 10:34 AM | Report abuse

Well, I've been overweight ever since I was a kid, and it certainly is *depressing* when I think back over my lifetime of being rejected by society because I don't meet a certain standard of appearance.

Not to say that there isn't also a biological component to depression, because I am absolutely certain that there is. But spending your whole life being told that you are morally bad because of the shape of your body certainly doesn't help.

Posted by: mccxxiii | June 16, 2010 11:11 AM | Report abuse

Now that I know how depression feels, I'm sure I've had it since puberty. I've always been a little overweight. After two pregnancies, I'm really having a hard time losing. But I don't blame drugs or depression. I've just always self-medicated with food, primarily sweets, and, in adulthood, beer. What's keeping me fat is my habit of eating and drinking to feel better.

Posted by: jenniegeisler | June 16, 2010 11:54 AM | Report abuse

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