Some new research suggests that obesity is linked to poor mental health, particularly feeling depressed. A report appeared on Oct. 23, 2023 in the Philosophical Transactions of the Royal Society B looked at a group of large studies that found a link between being overweight and feeling depressed.
The idea that being overweight is good for mental health, also known as “jolly fat”, has been proven wrong. According to Andrew Steptoe, PhD, of University College London, there is a lot of evidence that being overweight is actually linked to more distress and depressive symptoms in rich countries.
While the reasons are complex, the research points to two primary factors linking obesity and mental health issues:
- The stigma, discrimination and bullying those with obesity frequently face
- Biological mechanisms like inflammation and hypothalamic-pituitary-adrenal (HPA) axis dysregulation
Experiencing Weight Stigma Takes a Psychological Toll
In the review, it is noted that 40% of people with severe obesity face weight-related stigma or discrimination, such as bullying, teasing, media stereotyping, and discrimination in employment and health care.
Steptoe mentioned how these negative societal attitudes can really mess with our heads, making us feel bad about our bodies and ourselves. Surprisingly, rather than motivating people to lose weight, stigma may actually lead to weight gain because it can lead to overeating.
Inflammation and Cortisol Also Play a Role
On the biological side, the review highlighted two key mechanisms that can drive the obesity-depression link:
- Chronic low-grade inflammation, which is commonly elevated in obesity
- HPA axis dysfunction, which can lead to elevated cortisol levels
Co-author Philip Frank noted that the association between obesity and psychological distress may be due to issues with the innate immune system and HPA axis regulation.
Frank says that so far it seems that about 15-20% of the relationship between obesity and depression may be due to inflammation in the body.
Do Obese People Develop Depression or Vice Versa?
It was also looked at whether the chance of depression goes up or down: does being depressed make people more likely to become overweight?
“The majority of findings are consistent with obesity leading to increased distress,” explained Steptoe. “Although distress from obesity may subsequently help maintain greater body weight.”
The authors looked at several long-term studies and found that being overweight at the start consistently predicted a higher risk of getting depression later on. The opposite wasn’t true: being sad didn’t mean someone would become overweight later on.
Specific Depression Symptoms Linked to Obesity
The research also revealed connections between obesity and certain clusters of depressive symptoms:
- Lack of energy
- Loss of interest/joy
- Feeling inadequate
- Feeling depressed
These associations remained even after accounting for overall depression diagnoses.
“Individuals with obesity were two times more likely to experience these somatic and emotional symptoms than to have general depression,” explained Steptoe.
Reducing Weight Stigma is an Important First Step
In the end, the study stressed how important it is to fight the social stigma attached to weight and push for more compassionate and moral policies regarding obesity.
“Changing negative attitudes would improve wellbeing for obese individuals, and promote more effective, weight-inclusive approaches in healthcare,” stated Frank.
The authors say that all healthcare workers should first get anti-stigma training so that bias doesn’t get in the way of treatment. Being understanding and not judging others can help improve mental health.
Instead of being “jolly fat,” the evidence we have today shows that being overweight can cause mental distress, depression, and an increased chance of health problems. To help change these trends, both in society and in individuals, we need a lot more compassion and understanding.