It is one thing to worry about putting on a few extra pounds here and there. But what if worrying could be the very thing that is causing your weight gain? Or worse, can obesity actually lead to anxiety?
DR. CHRISTOPHER MCGOWAN
Dr. Christopher McGowan, MD, a leader in endobariatrics, specializes in non-surgical obesity treatments and is triple-board-certified in Internal Medicine, Gastroenterology, and Obesity Medicine. Renowned for pioneering endoscopic sleeve gastroplasty (ESG) with over 2,000 procedures, his global influence and research contributions define him as a top expert.
The relationship between excess body weight, depression, and anxiety is complex. Research increasingly shows that these conditions are connected, though, and the relationship between being anxious and being overweight might work both ways.
Does Obesity Cause Anxiety?
Research does not indicate that obesity causes anxiety directly, but being overweight could contribute to a host of factors that put you at a higher risk for anxiety. Lower quality of sleep, decreased self-esteem, lowered levels of activity and exercise, and more are all associated with being overweight, and all of these factors are strongly correlated with depression and anxiety.
Though worrying doesn’t automatically make you pack on the pounds, having anxiety can expose you to several risk factors for obesity including:
- taking antidepressants
- sleep problems
- poor food choices
- higher levels of cortisol
- lowered activity levels
- lowered self esteem
Rather than uncovering a direct relationship between panic disorders or major depression and having a high BMI, research has shown that depression and obesity are strong predictors of one another. Many studies that have been done on these two conditions are cross-sectional, which means they identify links, but do not show causal relationships between weight gain and mental illness when these two health conditions appear as comorbidities.
It is important to note that there are a large number of psychiatric disorders, and how they correlate to obesity varies widely. With conditions such as eating disorders, significant weight gain would only be a risk for individuals whose symptoms manifest in binge eating. Other individuals might maintain a far less positive association with food, and weight loss could be a more common outcome.
Though the psychopathology that underpins unwanted weight gain, addictions, and other mental disorders are similar, not all forms of psychiatric disorders are associated with weight gain. For example, ongoing substance abuse disorders generally indicate low levels of obesity while past substance abuse issues correlate strongly with having a higher body mass index (BMI). It is also important to remember that multiple mental health conditions could be present at the same time, and their relationships to one another are often quite complex. For example, research has also shown a strong inverse correlation between weight gain and bipolar disorder in individuals who are also diagnosed with substance abuse disorders.
When trying to understand how obesity and mental health interact, it is useful to remember that the significant association between weight gain and mood disorders is strongest where the effects of a high BMI and depressive symptoms overlap. Both depressive disorders and obesity can negatively affect your quality of life by reducing physical activity, and disrupting sleep, and exposing you to other healthcare concerns such as hypertension and heart disease.
Larger public health concerns, such as the ongoing coronavirus pandemic, can also increase the likelihood of both obesity and psychological disorders. Social phobias can be heightened by the potential danger of disease transmission, and not being able to make it to the gym has left more than a few of us with some added pounds from this last year. These two conditions can feed on each other, as fears of being in public can lead to less activity, which can lead to lower self-esteem, further heightening anxieties and negative feelings about your social desirability.
How Does Obesity Affect Your Mental Health?
Having a higher BMI can help create conditions ripe for various mental problems. Being overweight can contribute to lowering overall activity levels, exposing you to social pressures related to weight, as well as other health concerns such as:
- diabetes
- hypertension
- heart disease
- chronic pain
- sleep problems
Some of the connections between obesity and mental health are fairly direct and obvious. In our image and fitness obsessed culture, negative feelings toward your own body are more common in overweight people than their peers who maintain a normal weight.
Other connections, such as the link between lower socioeconomic status and obesity as a risk factor for depressive symptoms have been studied, though the association is not strong enough to show as a significant causal factor of diagnosable mental health conditions.
Can Anxiety Make You Gain Weight?
The connection between anxiety and obesity is still being investigated, but ongoing research suggests it is strong, and bi-directional, meaning mental health concerns and obesity could contribute to one another. Not only does being overweight potentially contribute to the onset of anxiety, but being chronically anxious could also contribute to unwanted weight gain.
Links between weight gain and mental health disorders have been studied widely in the field of psychiatry. Though a direct causal relationship in either direction is not strongly supported, the links between these two comorbidities can be seen by looking at meta-analyses of many different studies. The picture that emerges through this kind of systematic review is one of significantly higher prevalence of mental health challenges in obese patients than within the general population.
Part of this larger picture of how anxiety and obesity relate to one another relies on understanding how anxiety and depression are linked. Anxiety and depression are strongly correlated, and the relationships between them are complex. Often, depressive symptoms can aggravate ongoing anxiety by reducing your quality of life and leading you toward behaviors that contribute to anxiety. This can include reduced activity, lowered confidence and self-esteem, decreased social interactions, and sleep disturbances. These depressive symptoms are all strongly correlated to both the onset of anxiety and with weight gain.
Treating Anxiety, Depression, and Obesity
The link between obesity and anxiety is just one more worrying way that being chronically overweight can have damaging effects on your life. In addition to the well-known physiological health problems of carrying extra body weight, obesity could put you at increased risk of mental disorders. Getting healthy in both body and mind may seem like an obvious goal, but the road to long-term health can present some challenges.
If you are suffering from the effects of both anxiety and excessive body weight, solving one condition may temporarily worsen the other. Taking antidepressants, for example, is an essential step for many people in treating anxiety, but weight gain is a common side effect of many antidepressant medications. In these cases, it is important to work closely with your doctor and your psychiatrist to ensure that the medications you are taking to solve one problem are not causing you more issues in another.
Similarly, obesity treatments can help you drop weight, but doing so may expose you to other stressors. Losing pounds may improve your quality of sleep and help you stay more active, but if you have difficulty with impulse control, the severe dietary restrictions of a bariatric surgery might create new difficulties. Similarly, if binge eating comfort food has been a coping mechanism for your chronic stress or depressive symptoms, not being able to eat in the way you are used to could leave you searching for new ways to cope with your anxiety.
Whatever path you choose to improve your mental or physical state, staying on track with treatment plans is a crucial part of treating anxiety and obesity. Improper treatment of mental health conditions can have spill-over effects in your physical health as well. Sudden changes in treatment, such as deciding not to take your medication, can lead to unhealthy behaviors like poor eating habits, a return to disturbed sleep patterns, avoiding social interaction, and other issues. All of these are strongly correlated to weight gain over time.
No matter how challenging it may seem, you owe it to yourself to do everything you can to treat obesity and anxiety. It can seem like you are out of answers if you have been suffering from either, or both, of these conditions for a long time, but help is possible.
At True You, we work closely with you to find freedom from the challenges of extra body weight. This means helping you establish realistic weight loss goals, understanding what it will take to get there, and then providing the treatment and support you need. The path will look different for everyone, whether that means getting back on track with a bariatric revision, starting a new chapter with a minimally invasive procedure such as the ORBERA® Managed Weight Loss System, or the helping hand of our medically assisted nutrition program.
If the time has come to take the next step in your journey to a healthy weight, request a consultation with us today to discover which option is right for you.
