Obesity and the mind: how your mental health can affect your weight

Obesity is a medical condition in which someone has a high body weight compared to their height (excessively high amount of body fat). A person is classified as 'obese' if they have a BMI (body mass index) of 30 or more. A person is 'overweight' if their BMI is between 25 and 29.9, and 'normal' if their BMI is between 18 and 25.

Being overweight can also increase your risk of developing other health problems, such as cardiovascular disease, type 2 diabetes, and joint pain. Obesity can also come with psychosocial issues, as many with a high BMI struggle with low self-esteem and body image issues.

There are many factors that can contribute to weight gain, and in turn lead to obesity. Mood disorders are just one of them.

Other factors that can influence weight gain include:

• lifestyle and dietary factors (i.e smoking or drinking alcohol)
• certain medical conditions (e.g chronic pain, arthritis and Cushing’s syndrome)
• taking certain medicines (e.g high blood pressure, epilepsy or diabetes medications)
• genetics
• socioeconomic status
• ethnicity

It is important to remember that weight gain is not necessarily a bad thing. In fact, people of all sizes can be healthy. However, if you are carrying around extra weight that you are not comfortable with, it can be helpful to understand the potential causes.

Studies have shown that people who suffer from mental health conditions such as anxiety, depression, and bipolar disorder are at a higher risk of obesity than those who do not have a mental illness.

One study investigated the rates of comorbidity (co-occurrence) of obesity and psychiatric disorders. They found that 70% of obese patients had depression (major depressive disorder) and 27% had an anxiety disorder or panic disorder. They also found a significant incidence of personality disorders and eating disorders in those with a high BMI.

It should be noted that not all mental health conditions are associated with weight gain, and nobody experiences one mental health condition the same. Depression, for instance, can significantly reduce appetite and lead to extreme weight loss.

Can stress cause weight gain?

Whilst stress isn’t a psychiatric diagnosis in the same sense that depression and bipolar are, it can still have a significant impact on the body. In particular, research has found that it is the stress hormone cortisol that has a strong influence on obesity as it can affect your food intake in response to stress. People with a lot of weight around their middle, also have higher levels of cortisol. For that similar reason, stress can also cause weight loss.

Mental health affects everyone differently and can affect people’s weight differently. There are several possible explanations for why there is such a strong correlation between mental illness and weight gain, from disordered eating to the medication that treats mental health disorders.

Relationship with food

People with mental health problems are more likely to turn to food for comfort. This is because our brain treats food like a reward, and this creates a pleasurable feeling when we eat it. In fact, one study found that when people are overeating, it activates the same parts of their brain as drug addicts when they indulge in their habit. This is known as emotional eating, and this increased food intake can lead to weight gain over time, where the calories consumed exceeds the calories metabolised.

There are also several eating disorders that cause people to overeat such as binge eating disorder, which has a higher prevalence in those with severe obesity. People who have this disorder eat large quantities of food in short amounts of time, and is usually caused by a comorbid mental health disorder or from past psychological trauma.

Sedentary lifestyle

People with mental health issues are more likely to lead a sedentary lifestyle. For instance, one of the main depression symptoms is a lack of desire to go out or do the activities they previously enjoyed.

This means many with mood disorders will do little physical activity. For most, this means they’re not burning off the calories they consume and can lead to weight gain.

Medication

Some medications used to treat mental illness can cause weight gain as a side effect. Research suggests that this is due to how they affect brain chemicals such as serotonin. Fluctuations in these neurotransmitters can increase appetite and carbohydrate craving which can lead to weight gain. In some cases, this is a positive side effect as many who struggle with mental illness have low BMIs.

Many antidepressants have been linked to weight gain. One systematic review found that tricyclic antidepressants (e.g amitriptyline) had the biggest impact on weight. In fact, one later study found that most patients gained between 1 - 7kg after 6 months on tricyclics.

The most commonly prescribed antidepressants are known as SSRIs (selective serotonin reuptake inhibitors). They were previously believed to be weight neutral antidepressants, however more recent findings have indicated this is not the case. One 12-month longitudinal study found that most patients taking the SSRI citalopram experienced at least a 5kg weight gain. However, the amount of weight gain experienced will depend on the drug and the individual.

This is also true of antipsychotic medications, most commonly used to treat schizophrenia, are also known to cause weight gain. Research suggests it is most likely due to their effects on the levels of dopamine and serotonin in the brain, as well as their tendency to increase appetite.

There is some evidence that suggests that obesity can cause mental health problems. One 2017 meta-analysis found that people who are obese were over 30% more likely to develop depression. Other statistics suggest it’s much higher, and that overweight people are over 55% more likely to develop a mental disorder compared to those who do not struggle with their weight.

Obesity can also result in body dysmorphia, where people are unhappy in how they look to a point of subconsciously distorting their own perception of their body image, and this can result in depression and anxiety.

The physical side effects of obesity can also affect your mental health. Many obese people are less mobile and therefore not able to see people, go out or require specialist care. This can leave many obese people feeling isolated and can cause a mental health disorder.

If you are struggling with your weight or your mental health problems, there are a number of things that you can do to address the issue.

Mental health support

Seeking help for your mental illness will considerably improve your overall health, especially if it is underpinning your weight management.

There are talk-therapies with mental health professionals available on the NHS. However, those with a serious mental illness or an eating disorder may benefit from psychiatry. There is likely to be a psychiatrist who specialises in eating behaviours.

If you’re worried about the side effects of the medications you already take, then you should speak to your GP or your primary care provider. They can decide whether another medication would be more appropriate and help you with your weight management.

Weight loss treatment

Weight loss can benefit your overall well being in many different ways, but research has found it can also improve your mental health and your health-related quality of life. Many feel more confident, have a better self-esteem and have more positive feelings about themselves and their body image.

Healthy eating and a regular exercise regime is the main way to lose weight. However, for many people it’s not that simple and can be difficult to get back down to a healthy, normal weight. Whilst bariatric surgery is a popular option for those who are struggling to lose weight and are more at risk of fatal conditions, it is not ideal for everyone. That’s why prescription weight loss medication could be the right option for you.

At euroClinix, we offer licensed prescription weight loss medication that gets you significant results in a short space of time. Our service is safe, secure and completely online. All you have to do is fill out an online questionnaire with your medical details, and then it is reviewed by one of our registered doctors. Once approved, your treatment is shipped to your door the very next day.