Wednesday, July 05, 2006

Which came first?

An article in the journal Archives of General Psychiatry this month has concluded that mood and anxiety disorders, including depression, are about 25 percent more common in the obese than in those of normal weight. The abstract is here [if you are a member of the AMA, you can access the full text]; news stories about the study are here and here.

This, of course, completely busts the myth of the jolly fat person.

And it also, of course, makes you wonder if obesity precedes depression, or if mood disorders cause some people to eat more.

It's both, of course, and it's also neither. The conclusion, according to the abstract, states [in part]:
"Variation across demographic groups suggests that social or cultural factors may moderate or mediate the association between obesity and mood disorder."
Well, duh.

One of the news stories suggested that doctors should be more aware of the incidence of depression in their obese patients, and quotes Dr. Susan McElroy, a psychiatry professor at the University of Cincinnati, as saying:

“This is a state-of-the-art psychiatric epidemiology study that really confirms that there is, in fact, a relationship [between obesity and mental disorders]."
I don't know about you, but they could have asked a dozen fat people on a street corner and probably learned the same thing. Or maybe I'm the only one whose eyes glaze over at the sight of a plate of fudge – or bag of chips, platter of ribs, insert-your-crazy-food-here.

Interestingly, the study showed that the incidence of substance abuse in the obese is 25 percent less than in the normal-weight population. My own experience is that the consequences of alcohol abuse were much worse than those of food abuse. When I stopped drinking, I started eating. One takes one's comfort where one can. I've been both fat and thin during my sobriety, and it's been far easier to stay fat.

Which means I'd better continue to work on all the angles of this weight-loss odyssey, doesn't it? For me, it's not just a problem of too much food and too little activity. Crawling into the bottle or hiding in a fat shell takes me out of myself, out of the world, out of reality. I've been in a bit of denial about this, and I initially scoffed at the study. [I've already deleted a couple sarcastic paragraphs from this post.] While I don't feel the need to enter therapy [or throwuppy, as one of the angryfatgirlz called it] at this time, I'd better pay closer attention to the whys, and not just the whats, of my food consumption.


stretchy said...

When I feel depressed, I do want to overeat.
When I quit smoking I saw the difference in my life, and when I stopped drinking, I really really saw the difference in my life--hello, energy, nice to meet you!

The depressing part: Am I really more FUN to my pals with booze and a platter of fries attached? I was always the shy observer in bars, never thought about it much.
I laugh more now, but am not as much fun? what gives? I'm depressed by this. Maybe the mopey me was amusing somehow.

Jonathan said...

I used food as an anti-depressant for about, say, twenty years. It only works if you eat lots and lots and lots of sweet stuff, which overpowers your brain, and then gain lots of fat, which numbs your body. But despute the obvious insanity of that approach, many of us use food as a drug because its so socially acceptable, readily available, and doesn't require a prescription.

Ironically, once I lost weight and lost my (overeating) coping mechanism, I became even MORE depressed!! That's why welbutrin is my friend. Its a little pill and has zero calories. Gives me the benefits I need and lets me stay thin. I love it.


P.S. Its way cheaper than binge eating, too!

Greta said...

I don't "like" reading results of a study that show that mood and anxiety disorders including depression are 25% more common in obese people than normal weight people. It's contrary to earlier research that showed no difference, so it makes me wonder which is correct. Obese people already endure a certain amount of scorn from normal weighted folks. Too often I hear comments about gluttony and lack of control with regard to obesity. A study like this gives people fodder to say that the obese have "something" wrong with them mentally, too.

If the obese are more depressed, I would wonder what is the cause and what's the effect. Does depression lead to overeating? (quite possibly) or is the state of being obese with its difficulties in mobility and flexibility CAUSE depression? (seems possible) Could the differences in exercise level between normal weight people and obese people be a causative factor? It seems that obese folks probably don't exercise as much as normal weighted people so perhaps they aren't producing the "feel good" biochemicals from exercise that normal-weighted people have in their bodies.

PS. Am I the only one who has a hard time figuring out what letters are shown to me in the "word verification" at the bottom of the page?