Diets & Depression

Being on a diet is so common that we take it as a simple choice to lose weight. Occasionally it is, but in fact it usually involves much more. If we scratch the surface, we find out that for those who have been on and off many diets throughout their life, the decision to try to lose weight again is usually part of a much larger life transition and improvement agenda.

"I am going through menopause and don't want to go into the next part of my life as a heavy person."

"I want to start having fun in life."

"I'm going through a divorce."

"I have lost someone dear to me and it's time to take care of myself."

These are all common reasons people give for wanting to lose weight. If we take a second to think about these statements, dieting obviously involves much more than simply a desire to slim down.

What Dieters Have In Common
Last year we did an internet survey of 7500 people who were seeking diet information. We asked them about the stress in their life and how they felt about their life. The survey results, along with what I've seen in my work with thousands of dieters, has convinced me that there is definitely a strong relationship between being overweight and depression and that going on a diet for roughly two thirds of the serious dieters is part of their attempt to do something positive about their life, and their depression.

Sixty-nine percent of the dieters we surveyed said they were not having enough day-to-day fun in their lives and an equal number felt they were not taking care of their own interests. And roughly the same percent said they were rarely free from doubts and fears. This is quite an astounding set of facts. It shows quite clearly that dieters are seeking more in their life than to just lose a few pounds. They are on a mission to make some changes in their life so they can make themselves feel better. About two thirds of the dieters we surveyed also said they felt stuck in their life, that they weren't satisfied with their friends and that they didn't like the way they spent their leisure time. Dieting for these people is part of doing something about their life.

Around fifty percent of the dieting population we surveyed thought they were going through a major life transition and did not think that their future looked bright. One of the keys to being happy is to be able to look forward to a good future. When the future looks dark or gloomy or uncertain, a depressed feeling always comes into play and colors everything, including a downgrading of one's accomplishment or past joys. In fact when you look at these survey results, it's easy to conclude that there is some degree of depression at work and that dieting is tied to an effort to relieve that depression.

This impression was clearly strengthened when we asked another question of our survey population. We asked them when they most frequently broke their diet and turned to food for relief of stress. Two thirds said it was when they were most critical of themselves and one half said it is when they were depressed. As a psychiatrist, when a patient tells me they are too critical of themselves, I instinctively understand that I am talking to someone who is depressed. I know very well from my own work with patients who are overweight that people have learned how to silence the internal critic temporarily with food, so overeating becomes the medication of choice.

What I Mean By "Depression"
The word depression has come to mean so many things lately that I want to clarify what I mean by it before I go any further. The kind of depression I'm talking about here is not the clinical depression called major depressive disorder that has been diagnosed in up to 10% of the adult population. Instead I'm talking about the depressed moods that come and go, take their toll, but do not incapacitate the person. The depressed mood is tied to a perception that one's life is not going as well as hoped for or as expected. This has been called a sub-clinical depression and at any one point in time we believe that about a third of the adult population is in this state of mind.

The Vicious Cycle
In doctors' offices it is estimated that 70% of all outpatients have some degree of sub-clinical depression. In Britain, because of this high percentage, they have asked their doctors to stop giving antidepressant medication to this large group of people who are distressed, but not clinically depressed.

Although antidepressants are frequently prescribed for sub-clinical depression in this country, it is probably not the best choice for people who are overweight or sensitive to weight gain. Many of the most popular antidepressants cause significant weight gain in one out of every four patients. The average weight gain is 7 per cent of their body weight, and for some it is up to 20% of their body weight. There are an estimated 28 million people in this country taking antidepressant medication so undoubtedly for some the cause of being overweight is a combination of two factors, the depression and the medication for the depression.

And of course there is a self-perpetuating cycle at work. If you are depressed and then eat to comfort yourself and gain weight, that weight makes you more unhappy, so of course you have to eat more to comfort yourself.

This cycle goes on and on until one day you wake up and say no more and decide you are going to do something about the cycle. You either decide to see a therapist, or ask your doctor for an antidepressant, or go on a diet, or start rearranging your life to get unstuck, or you start doing all of the above.

That's exactly why I said at the beginning of this article that dieting is part of some larger agenda in the lives of most dieters. On the surface a diet's purpose is to help you lose a few pounds, but it's probably also an attempt to break the cycle of sub-clinical depression, and to regain the momentum in your life, and with that, to recapture your own self-esteem.

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