Overeating And Depression
Margaret E. Woltjer, Ph.D. | November 2004

Almost everyone is now aware that obesity in America has reached epidemic proportions. Between the years 1991 and 2001, the percentage of obese Americans rose from 12 percent to 21 percent, affecting over 44 million people. If we combine those who are overweight with those who are obese, the percentage rises to almost 65 percent according to the latest government estimates. The United Health Foundation has recently reported that approximately 300,000 adult deaths in the U.S. each year are related to obesity. Concurrently, it is estimated that 9.5 percent of the population, or about 18.8 million American adults, suffer from a depression disorder.(1) When we look at the additional problems often associated with depression and obesity, we soon become aware of the great personal and financial expense these illnesses bring to those who are affected.

The Relationship between Depression and Being Overweight
Obviously, the terms "overweight" and "depressed" span a great deal of associated feelings and behaviors. An “overweight” person could be carrying a few extra pounds, have an eating disorder, and/or be morbidly obese. A depressed person can function fairly well in most areas of his life, although one who has a depressive disorder probably cannot. The relationship between depression and overeating is difficult to assess for a number of reasons. One explanation is that most people with a depressive illness do not seek treatment. Another is that both depression and obesity can be the result of biochemical imbalances which are resistant to efforts by the individual to work through the problem without some medical intervention. Yet another reason is that being depressed and being overweight do not always coexist. However, we also know that most people who are overweight develop additional medical problems if their obesity is left untreated, with this further decreasing satisfaction with life.

Results of the Nutritional Health Assessment
In the past few years, information has been gathered from over 40,000 people who completed the Nutritional Health Assessment. Of particular interest were those who responded: “I am overweight”. Within that group, about 65 percent were female and 35 percent were male. Altogether, over 20 percent of all overweight people indicated that they were depressed.

Table 1 presents the percentage of people in mid-life who said they were overweight, while Table 2 shows the distribution of individuals who said they were depressed. Our research indicated that people are not only more likely to be depressed if they are overweight, but that depressed people are more likely to be overweight. For example, among the 50 to 54-year-old group, 15.7% of men and 27.2% of women were depressed. But when we looked at the same age range among only those who were overweight, we found that 18.6% of the men and 31.2% of the women were depressed.

Table 1. Percentages of participants who said they were overweight

Age Groups
50-54 55-59 60-64 65-69
Men 53.5% 51.1% 48.7% 45.3%
Women 62.9% 62.5% 63.0% 55.4%


Table 2. Percentages of participants who said they were depressed

Age Groups
50-54 55-59 60-64 65-69
Men 15.7% 16.5% 14.5% 16.8%
Women 27.2% 23.4% 19.3% 19.5%


According to information gathered from the Nutritional Health Assessment, we see in more detail the relationship between depression and being overweight. Table 3 shows the percentage of depressed people who are overweight. Out of the entire depressed group, less than 10 percent said that they were on an antidepressant. This would suggest that the majority of depressed people are trying to cope through other means.

Table 3. Percentages of depressed people who were overweight

Age Groups
50-54 55-59 60-64 65-69
Men 64.1% 55.1% 60.2% 52.6%
Women 70.7% 72.2% 73.5% 57.7%


The information in Table 4 provides us with a glimpse of how overweight people differ from those who are not overweight in several important ways.

Table 4. Comparison between Overweight and Non-Overweight Groups

Overweight Non-overweight
Eat too much food 65.2% 16.4%
Eat when not hungry 66.3% 27.7%
Exercise less than 3 times/week 75.2% 60.3%
Eat when nervous 52.6% 17.9%


As a group, 65 percent of all overweight people said that they ate too much food and 66 percent said they ate even when they weren’t hungry. This is significant when we see that of those who are not overweight, only 16 percent said that they eat too much food and 28 percent said that they eat even if not hungry. There were also major differences between groups as to exercise frequency and how they coped with anxiety.

Further comparisons revealed that overweight participants reported a greater incidence of nearly every physical problem listed, a greater use of medications, and a feeling of ineffectiveness in dealing with food in general. Their self-perception also seemed lower. For example, they reported more problems with short-term memory, having difficulty working under pressure, not having much initiative, and feeling more uncomfortable in crowds.

Our data lends some support for research seeking a neurochemical connection between obesity and depression. Among our participants, the incidence of depression was lower for those who were not overweight compared with those who were. While 9% of overweight men said they were depressed, only 7% of non-overweight men said the same. The difference was more pronounced among women. While 20% of overweight women were depressed, just 12% of non-overweight women were. In their InteliHealth website, the Harvard Medical School reports that about two-thirds of all obese people are carbohydrate cravers, and that these individuals often score high on tests for depression. They also tend to snack more in the afternoon and evening, increasing their caloric intake by as much as 50%.(2) There was some evidence on the Nutritional Health Assessment that supports this research. Compared with non-overweight participants, the overweight group indicated that they craved sweets or coffee in the afternoon (53% vs. 38%), craved chocolate (43% vs. 30%), and get very hungry between meals (40% vs. 23%).

In view of the association between obesity and depression, dietary programs must address the likelihood that people have these conditions for different reasons and will quite possibly respond to dieting in different ways. Those diets that fail to take into account the need for balanced nutrition will quite likely fail to produce the long-term results that most individuals who diet are looking for. But those who are dieting must also become aware that changing eating patterns has the potential to cause fluctuations in mood and food cravings. As mentioned above, if only 10% of the depressed participants were taking antidepressants, the majority were probably trying to cope in other ways, including the way they used food.

References:
  1. Robins LN, Regier DA (Eds). Psychiatric Disorders in America, The Epidemiologic Catchment Area Study, 1990; New York: The Free Press.
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