I often hear weight gain among the list of troubles of patients who are depressed.  Sometimes it’s just a few pounds, sometimes it is more.  Often, it is too many.  It makes sense that depression could lead to weight gain; being depressed makes it more difficult to get out of bed and be active.  Being depressed can make it harder to pay attention to what you are eating.  People who are depressed often turn to food to make them feel good or for more energy.  On top of this, gaining weight can lead to poor body image and self-esteem, which can leave people feeling more depressed.  

Research shows: Depressed people tend to gain more weight than those who aren’t depressed. Over 5,000 young people were followed for 20 years. Everyone-whether depressed or not – put on at least a few pounds.  BUT those who were depressed gained the most weight (particularly around the waistline). The study also showed that being overweight, does not necessarily lead to depression.*   

Weight gain and depression are complicated and can be influenced by a number of factors: 

Sleep Disturbances: Depression often causes a disruption of sleep and insufficient sleep can lead to depressive symptoms.  When tired, people turn to food for energy or can take in calories from late-night snacking. Insufficient sleep causes the excretion of ghrelin and leptin, which disrupt the sensations of hunger and feeling full so people might tend to eat more, and feel less full.  Not getting enough sleep also can cause increased fat storage. 

Stress: Stress moves us forward and helps cope with life's demands, but it also affects our mood and emotions.  When under stress our bodies store fuel, slow down metabolism and excrete cortisol and other hormones which are more likely to cause     obesity in the abdominal region.  Elevated cortisol levels also   increase appetite to help the body refuel after stressful times, so people with depression may eat more food – particularly high carbohydrate foods.  

Antidepressants: Unfortunately, weight gain is a side-effect of some anti-depressants; 25% of those on antidepressants gain weight.  Some people report they gain weight on anti-depressants because they start to eat and enjoy food more.  If a medication is effective but causes weight gain, the pressing need to getting depression under control may take precedence. There are antidepressants that are less likely to affect weight.  A conversation with your health care provider is recommended before you make any medication changes and to determine the best course of care.  Carbohydrate control can be a key component in weight control for those using psychotropic (i.e., mood altering) medications.   

Getting help:  

Losing weight is hard, and depression can make everything feel harder. Fighting depression while trying to lose weight can seem insurmountable.  Starting and making change is especially hard when depressed and therapy can be helpful with this.  If you are overweight, depressed or both, you can get help now.  Getting exercise is a prescription for depression and can allow you to sleep better.  A 20-minute walk not only helps to reduce levels of the “stress hormone” and lift the spirits, it burns extra calories. Bodywork, guided imagery, naturopathic work and hypnosis can all be helpful too.

In my practice at Partners in Healing, I incorporate psychological, behavioral and experiential tools and therapies into my work to address the complex interplay between depression and weight management challenges. 

By Alana Riss Fine, PhD