Is Depression Wrecking Your Weight?
Depression and weight problems often go together. Here are tips for handling both.
Weight Loss and Depression
Although weight gain is commonly associated with depression, weight loss can also be a problem.
“With severe depression, you might lose weight because you’ve lost your interest in food, which comes from losing in interest in pleasure,” Gordon says. Loss of pleasure is a hallmark of depression.
Depression may also accompany an eating disorder. In Heinberg’s practice at the Cleveland Clinic, patients with anorexia nervosa are often depressed.
“In patients with low body weight, the brain becomes starved and they develop symptoms that meet the criteria for depression,” she says. “Often, once you feed them, the depression goes away. It’s resolved, and it’s generally resolved quickly.”
If You Move, You Lose - Pounds and Depression
Treating depression often takes a multipronged approach that may include talk therapy and medication, as well as exercise, a healthy diet, and other lifestyle measures.
It's important to know that weight gain is a common side effect of some of many prescribed antidepressants.
Fortunately, patients who are both overweight and depressed can help themselves with the same prescription: exercise, which can help counterbalance drug-related weight gain.
“I won’t necessarily tell them to watch what they are eating at first,” says Abramson, “but I will work with them to get them to move.”
At the beginning of therapy, that usually means walking. Abramson recommends picking up a pedometer before hitting the sidewalk. By measuring the number of steps they take each time they walk, they can monitor their progress. And, says Abramson, “small victories equal positive thoughts.”
Heinberg often prescribes walking as well. She likes to focus on her patients’ depression for the first six to eight weeks of therapy, introducing low-key exercise only to keep weight steady rather than bring it down. Once the depression is under control, she says, it becomes easier to address weight problems.
Be Active, Make Choices, Feel Better
Exercise is a key part of treating overweight and depression, in part because it allows patients to play an active role in caring for themselves. In fact, Gordon maintains that exercise is the best prescription for treating mild to moderate depression, as well as being helpful for severe depression.
“People feel good about doing things for themselves - that, in itself, is therapeutic,” Gordon says.
Gordon also recommends taking a break from fast food and other unhealthy eating habits; instead, he says, make time to cook a meal for yourself.
“It goes beyond just preparing something healthier to eat than fast food,” says Gordon. “People get engaged in their own care, and that’s crucial to dealing with weight.”
Gordon, who is the founder and director of the Center for Mind Body Medicine in Washington, D.C., includes alternative and complementary treatments in his practice. Key among them is meditation.