Will Losing Weight Make You Less Depressed?Friday, February 25, 2011
Regular readers will appreciate the importance of mood as a driver of ingestive behaviour. While typically depression is associated with a loss of appetite, atypical depression can lead to increased cravings for “comfort” foods, especially those high in sugar and fat.
Depression is also well recognized as a major barrier to weight loss in that individuals with depression will appear less motivated, report lower energy levels, and have poor sleep patterns, all of which can in turn affect diet and physical activity.
So while depression can clearly drive weight gain and make weight management more challenging, a question often asked is whether weight loss will actually improve mood.
This question was now addressed by Anthony Fabricatore and colleagues from the University of Pennsylvania in a paper just published in the International Journal of Obesity.
The authors conducted a comprehensive meta-analyses of over 5971 articles, including 394 randomized controlled trials, regarding the relationship between weight loss and depression.
Thirty-one studies, in almost 8000 participants were included in the final analysis.
Comprehensive lifestyle modification was found to be superior for reducing symptoms of depression than control and non-dieting interventions.
Lifestyle modification was also marginally better in improving mood than dietary counseling or exercise-alone programs.
Of particular note (given my recent post on the nutritive benefits of exercise), exercise-alone programs were superior to control interventsions in reducing symptoms of depression.
Nearly all active interventions improved depression but there was no relationship between the amount of weight lost and the reduction in depression symptoms.
Health at every size (HAES) enthusiasts will likely argue that the improvement in mood has more to do with the active interventions (which include eating healthier and increasing physical activity) than with the actual weight lost – something that would be hard to argue with given that the amount of weight lost appears to have little impact on the actual improvement in mood.
Thus, rather than concluding that weight loss leads to an improvement in mood, it would perhaps be more accurate to conclude that lifestyle modifications AIMED at weight loss ALSO, on average, tend to improve mood.
This of course would not be hard to believe given the evidence that both dietary intake of certain (unhealthy) nutrients as well as increased physical activity can significantly decrease symptoms of depression.
Certainly, this study does not change my opinion that in many patients mood disorders need to be identified and addressed as a “root cause” of weight gain and that weight loss, without lifestyle change, is unlikely to improve mood.
Clearly the notion held by many of my patients, that they would be so much less depressed if only they could lose some weight, is not borne out by this data – rather I would suggest to them that a healthier lifestyle will probably improve their mood irrespective of whether or not they actually lose weight.
But of course, as always, I defer the last word on this to my readers…
Fabricatore AN, Wadden TA, Higginbotham AJ, Faulconbridge LF, Nguyen AM, Heymsfield SB, & Faith MS (2011). Intentional weight loss and changes in symptoms of depression: a systematic review and meta-analysis. International journal of obesity (2005) PMID: 21343903