Why does depression make you fat? Is the reverse true?

• Burnout occurs in the professional sphere while depression affects all aspects of a person’s life.
• Burnout is a process of degradation linked to the relationship to work. The effects of depression lead to a characteristic depressive state: mood disturbances, low self-esteem and loss of interest in activities that are usually pleasant.

It is important to note that burnout can evolve into depression, which we will then call: depressionexhaustion.

“More than a link between the effect of depression on weight gain, there is above all a link between obesity and depression” indicates Dr. Gérard Apfeldorfer, psychiatrist. And for good reason: these two pathologies are linked: “We know that obese people are victims of stigma and that this necessarily affects their mental health. They begin to be ashamed of being “fat” and this shame leads them to a loss of self-esteem and even a collapse of their entire definition of self with statements such as: “I am something bad, worthless….”.

In response to this feeling of shame, they may then seek solace through food by eating foods high in calories, high in sugars and fats. It’s a simple way to comfort yourself” illustrates Dr. Gérard Apfeldorfer. A vicious circle…

“It is important to remember that situations of acute stress and especially chronic stress, in which the individual can no longer adapt to the demands of his environment, lead to various hormonal changes that facilitate overweight, the onset of diabetes and depression. Repeated and chronic stress makes you fat. And it has also been observed that obesity goes hand in hand with a drop in serotonin, which results in depression” specifies Dr. Gérard Apfeldorfer. Some studies have also shown that individuals going through a depressive period will tend to gain fat around the waist due to a higher rate of cortisol (hormone produced in response to stress) (source 1). In addition to metabolic reactions, this hormone also serves to regulate blood pressure by keeping it constant, to keep concentrations of glucose in the blood and also to regulate the immune system. Too much stress, and therefore cortisol, will not be good for general health.

There are indeed drug treatments that can promote overweight. These include, for example, so-called “imipramine” (amitriptyline, doxepin, imipramine, etc.) and “tetracyclic” antidepressants such as mianserin or mirtazapine. It will therefore be important to know their effects on weight in order to talk about them with your doctor (psychiatrist, etc.) and to be able to adapt the treatment, thus limiting the undesirable effects on weight. “It should be noted that there are other treatments, in particular to fight against severe and resistant depression, for example those observed in bipolar disorders. A new antidepressant drug, Spravato, a ketamine derivative (intranasal treatment), which does not seem to have an effect on weight can in some cases avoid having to resort to electrotherapy” adds Dr Gérard Apfeldorfer.

It will be hard to imagine achieving lasting weight loss through dietary measures as long as depression is present. As a result, it will most often be better to start with the combination of antidepressant drug treatment coupled with psychotherapeutic treatment of depression, and only consider cognitive-behavioral therapy for eating disorders in a second step, in particular to achieve lasting weight loss” insists Dr. Gérard Apfeldorfer.

“The stage of depression can easily be assessed using psychological tests,” explains psychiatrist Gérard Apfeldorfer. And if these are freely available on the internet, it will however be recommended to carry them out with your follow-up doctor who will be qualified to interpret the results and medically judge the patient’s stage of depression.

“Once the state of depression is sufficiently reduced, while continuing to work on this depressive state, with or without medication, we can propose to work on eating behavior (diet, etc.) as well as on what is called emotional eating, when eating to erase life’s problems” explains Dr Gérard Apfeldorfer. Mindfulness meditation will also find its usefulness there as well as other methods, in order to distance oneself from one’s emotional experiences, to “unmerge” from one’s anxiety-provoking or depressogenic inner discourse.

“Even if certain experiments tend to answer in the affirmative, there are still many variables depending on the individual and overweight would concern more people with “small” or “medium” depression “, of what is usually called reaction depression, concludes Dr. Gérard Apfeldorfer. Those in a situation of “intense” depression seem to be more likely to lose weight because of their inability to feel pleasure in anything, and who are disinterested in eating like anything else. The effect of depression on weight gain should therefore be qualified. Not to mention that other medical reasons such as diabetes, hypothyroidism…can have effects on weight gain.