Episode 5: Depression and Obesity

Depression and Obesity

The NHANES 2005-2010 survey showed that 43% of adults with depression were suffering from obesity, and adults with depression were more likely to have obesity than adults without depression. Learning this, we know that depression and obesity could be so closely interlinked.

In today’s episode, join us as we discuss the complexities of this with Dr. Anuneet Sabharwal. He is one of India’s leading psychiatrists and also one of the most followed psychiatrists on social media in India.

Key Takeaways:

Listen to this episode and learn:

• Different studies on the reciprocal relationship between obesity and depression
• The two basic pathways that cause this reciprocal relationship
• The importance of family and social support in caring for patients with obesity
• The impact of having a family member who is also a patient with obesity
• The weight loss or weight gain effects of anti-depressant medications
• How multistep CBT (Cognitive Behavioral Therapy) helps patients with obesity
• What People First Language means and why it is important

The Right Approach to Patients with Obesity according to Dr. Anuneet Sabharwal:

1. Rule out which came first: obesity or depression.
2. Treatment with medications known to reduce appetite and weight loss is ideal.
3. Refer the patient to a counselor for intensive multistep Cognitive Behavioral Therapy.
4. Involve the family. Educate them about healthy eating habits.

The Two Basic Pathways that Causes Obesity and Depression to Affect Each Other:

1. Biological
   1. Obesity can be seen as an inflammatory stage because weight gain is shown to activate inflammatory pathways.
   2. Obesity causes HPA access dysregulation (highly involved in depression).
   3. Obesity increases the risk of diabetes and increased insulin resistance.
   4. Obesity induces alterations in the brain particularly the blood-brain barrier structure.

1. Psychological
   1. The perception of being overweight causes psychological distress.
   2. Obesity may increase body dissatisfaction and decrease self-esteem, which are risk factors for depression.
   3. Disturbed eating patterns, eating disorders, and experiencing physical pain as a direct consequence of obesity are known also to increase the risk of depression.
   4. Depression exacerbates the possibility of the individual developing obesity and increases obesity to long-term activation of the HPA access.
   5. The cortisol, in the presence of insulin, inhibits lipid-mobilizing enzymes and this leads to an increase in abdominal fat.
   6. Because of depression, people adapt to unhealthy lifestyles. They become exercise-deficient and develop unhealthy dietary preferences which lead to obesity.

The 6 Modules Included in the Multistep CBT Treatment Program for Management of Obesity:

1. Managing food intake, physical activity, body weight
2. Change in eating patterns
3. Developing an active lifestyle
4. Obstacles to weight loss
5. Weight loss and its primary goals; and
6. Obstacles to weight maintenance

Quotes:

“Obesity was found to increase the risk of depression, and depression was found to be predictive of developing obesity.”

“Describe what a person has, rather than a certain what a person is.”

“If one changes, the entire family changes.”

“Both obesity and depression are very closely linked.” –Dr. Avishkar Sabharwal

Links:

Obesity Action Coalition – www.obesityaction.org

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• https://decodingobesity.com/