Kaiser Health News recently published an article, detailing a medical breakthrough: depression and obesity are intertwined.
This is probably not news to you if you are, like me, fat and depressed. It shocked me to hear that this has not already been explored by the medical community. And then, the biggest shock — “Scientists don’t know why.”
Really? Scientists don’t know why? Did they ask any of their fat and depressed patients? Sure, I might not know the biological reasons why, but I can detail several reasons why my fatness and depression are linked.
Depression says “What’s the point?”
My weight has many causes: some genetic, some medical, some my decisions. Generally, I try to eat pretty healthily, as I tend to get heartburn and gastrointestinal distress pretty easily. I feel my best when I don’t eat meat or dairy. It’s not about weight, it’s about not spending the next day feeling nauseated and in pain. I do a pretty good job sticking to meals that I know are “safe” for me to eat. However, when I have a lousy day and my depression is really bad, it’s so easy to go “Ugh, what’s the point?” and grab fast food on the way home. I am weak to the siren call of the double quarter pounder with cheese. And I buy it anyway sometimes, because I know it will make me feel better in the short term. Depression says, “What’s the point in eating healthy, you already feel terrible, do something you know will feel good.” It’s a very short term reward, a hit of dopamine, to eat that burger I know I’ll regret.
Fat people are treated poorly by society
Constant messages that your body is unacceptable are depressing. Mentally healthy people struggle with their body image in the face of the media’s obsession with thinness and health. People already predisposed to depression take the criticism even harder. Facing the insidious idea that you are wrong and bad and should feel bad about it, it’s hard to feel good about yourself. Even going to the doctor for help with a mental illness can be a trial. Often, no matter what you see your doctor for, they’ll start the consultation by telling you to lose weight. Have a sore throat? Lose weight. Ingrown toenail? Lose weight. So depressed you can barely make it to work every day? Try getting some exercise! Knowing that your concerns will be brushed off and you’ll be chastised for your body make it much easier to avoid seeing a doctor at all.
Antidepressants often cause weight gain
The side effects of the most common antidepressants almost all list weight gain. Seeking treatment for depression while fat can cause you to get fatter. Even if you remove morality from weight, gaining weight can be difficult to handle just in a day-to-day-life kind of way. Your clothes stop fitting, and it gets expensive to buy more. If you start to feel better mentally, the pressure to lose weight creeps back in. Trying to find the right prescription is difficult enough, but if your doctor won’t prescribe you one known to cause weight gain, the list of options gets smaller and smaller. What if the pill most likely to help is also the one most likely to cause weight gain? Depending on your current weight, your doctor may not even prescribe it to you.
At 23, I was diagnosed with Major Depressive Disorder, the most severe form of depression
My depression seemed to cycle. I would be okay for long stretches of time, sometimes even years, and then I would suddenly sink for months. The first time I took an antidepressant, I was 14. I gained weight, but I was able to do my school work and participate in activities again. After a little over a year, I went off it on doctor’s orders. I went back on a different one at 17. And 19. And again at 21. And 23. When I was last prescribed an antidepressant, the doctor told me to take it for at least two years straight, hoping that it would permanently change my brain chemistry. So far, it seems to have worked. But having depression is like being an addict, in that you’re always in recovery. I’ll always have depression, even if I’m not currently depressed. I’m not as high-functioning as I could be, but I’m at a point of feeling “good enough” that I don’t want to try any new medications and upset this balance.
My depression and weight are absolutely linked. I’m curious to see if the medical community can get past their bias against fat people to find out the biological reasons why. I’ll be waiting, fat and depressed, to see if they can improve my quality of life.