How Depression And Weight Gain Are Often Related
By: Michael Puskar
Updated March 31, 2021
Medically Reviewed By: Aaron Horn
A widespread phenomenon seen in patients with depression is weight change. Depression weight gain can happen through a few different ways, namely due to changes to one's appetite (i.e., binge eating), hormones, or due to medication. This article will show you why this condition can be causing you to gain unwanted weight, as well as point you in the right direction to treatment.
Increased Appetite, Eating Disorders, And Obesity
Depression itself does not directly result in weight gain, in a pathological sense; however, the symptoms of it, such as sadness and loneliness, can cause people to overeat.
In a study consisting of 1,396 subjects, it was found that obese people were five times more likely to overeat than their non-obese counterparts during depressive episodes. It was determined that it was not the depression itself that caused the weight gain; instead, it was associated with a sense of hopelessness. 
Those who were obese also experienced more severe symptoms that were more persistent - episodes would last longer and occur more frequently. 
Binge eating is a psychiatric condition that can be comorbid with depression and is one of the primary reasons people overeat and gain weight. People will typically eat larger portions than what is normal, at a faster pace, and overall, feel like they lack control of their eating habits.
Binge eating is believed to alleviate symptoms of depression, but at the same time, the people who struggle with the condition will feel negative about overeating, and it can potentially make them more depressed. For example, an individual may feel embarrassed or disgusted about how they eat and may choose to do it alone. 
Changes in appetite and overeating can be connected to the brain's reward pathway, and those who consume more food during a depressed state may have increased activity when presented with food stimuli.  This is very similar to how "comfort food" works, which tend to be high in calories or sugar and lead to a boost in one's emotional well-being.
Conversely, some people have lost weight while depressed, and this can be attributed to the reward concept as well - those who have weak appetites will have reduced activity in this part of the brain when food is involved.
Decreased Physical Activity
Those with depression may find themselves lacking the motivation to go to work or do things that they normally enjoy.
For these individuals, going out and getting some exercise may be the last thing on their mind, but an increasingly sedentary lifestyle can cause someone to gain weight, especially if they were active once before.
This has to do with energy expenditure, and when people do not participate in any physical activity, even a light walk around the neighborhood, fewer calories are being burned, and this excess energy will be stored in the body, leading to weight gain.
When paired with overeating, this inevitably leads to obesity because the individual is consuming more calories from the food than it can naturally burn. Exercise will help to an extent by burning extra energy; however, dietary changes, namely eating less, will also be required to address this.
Nonetheless, outside of energy expenditure and weight loss, exercise is also beneficial in treating symptoms of depression directly, and studies show that moderately-intense physical activity can improve peoples' mood. 
There are several different mechanisms in which this can occur. The most well-known idea is that the brain releases endorphins which elevate one's well-being, but it is also believed that neurotransmitters, such as serotonin, dopamine, and norepinephrine are also boosted during and following exercise. 
Additionally, psychological factors, like being distracted from depressing thoughts and an enhanced sense of self-efficacy, are also hypothesized to have a role in exercise and reducing depression. This can help people become more motivated and stick to workout and dietary routines, and feel better about themselves overall.
In response to stressful events, the body is known to secrete hormones to help regulate specific processes.
One of the primary chemicals related to this is cortisol, which is released from the adrenal glands, Low levels of it can make you feel tired and weak. Cortisol has a bad reputation, but it is not inherently harmful, It can help keep blood pressure and glucose levels under control, and even treat inflammation.
However, when cortisol levels are too high, it can be problematic and lead to a variety of symptoms, including weight gain.
Excess cortisol due to stress can increase one's appetite, especially for foods that are high in fat and sugar, because they can provide emotional comfort. Cortisol is also correlated with insulin levels, and junk food can cause a spike in blood sugar and increase the intake of calories, which can cause depression weight gain. 
One study demonstrated that depression patients and those who are at-risk for the condition, have exhibited higher cortisol levels in the morning and the evening compared to control groups.  If cortisol secretion is persistent throughout the day, this can lead to chronic overeating.
Although the food may provide temporary relief to stress, it is not the best for the long-term. It may take time to get used to, but getting into the habit of being mindful of what you eat will go a long way.
Additionally, exercise can help dampen the effects of stress and depression and effectively reduce the need to reach out for comfort foods, especially in high quantities.
The use of antidepressants has been correlated with weight gain, but the specific reasons for why this occurs is still unclear. Nonetheless, there are still speculations as to why this is a common phenomenon.
One hypothesis is that the medications can boost a person's appetite, and therefore, cause him or her to eat more. However, SSRIs (Selective Serotonin Reuptake Inhibitors), which is one of the most common and diverse groups of antidepressants, are formulated to increase serotonin levels in the brain, but this chemical is typically supposed to suppress appetite and make people feel satisfied following a meal.
Despite this, there are multiple types of medications available that function differently than SSRIs and tricyclic antidepressants, in particular, may be more likely to raise appetite. 
On the other hand, the use of SSRIs has been linked to unhealthy behaviors, such as a sedentary lifestyle, smoking, drinking alcohol, and the Western diet, which can directly contribute to obesity. 
Another possible scenario is that the connection between depression and weight gain might be more apparent in those who had weak appetites before taking medication. In this case, it could be an indicator that the antidepressants are working and the patient is showing improvements. 
Overall, more research needs to be carried out to determine whether weight gain is truly a direct side-effect of antidepressants or if it is more-so influenced by lifestyle factors instead.
If you have noticed weight gain after starting antidepressants, it is advised that you discuss it with your primary doctor or psychiatrist. Abruptly ending the use of any medication can be dangerous, and discontinuing should be supervised by a medical professional.
If you are depressed, weight gain may be uncomfortable and hard to deal with, especially if you do not understand why it is occurring, but hopefully, this article has given you some insight as to why that might be.
Thankfully, by adjusting some lifestyle factors, this issue can be resolved, but it will take some work on your part. Weight gain, in most cases, is caused by excessive food consumption, and by selecting and sticking to a healthy, well-balanced diet in smaller portions, you can lose weight, especially when paired with regular exercise.
This may sound daunting to some, and if depression and stress are holding you back, counseling from BetterHelp.com is always available to get you through it.
By learning how to manage your symptoms through therapy, you will not need to resort to food for comfort, and instead, find more productive strategies. With assistance and support, depression and weight gain can be a thing of the past, and you can look and feel your best with time and effort.
- Murphy, J. M., Horton, N. J., Burke, J. D., Monson, R. R., Laird, N. M., Lesage, A., & Sobol, A. M. (2009). Obesity and weight gain about depression: Findings from the Stirling County Study. International Journal of Obesity,33(3), 335-341. doi:10.1038/ijo.2008.273
- Peterson, R. E., Latendresse, S. J., Bartholome, L. T., Warren, C. S., & Raymond, N. C. (2012). Binge Eating Disorder Mediates Links between Symptoms of Depression, Anxiety, and Caloric Intake in Overweight and Obese Women. Journal of Obesity, 2012, 1-8. doi:10.1155/2012/407103
- Simmons, W. K., Burrows, K., Avery, J. A., Kerr, K. L., Bodurka, J., Savage, C. R., & Drevets, W. C. (2016). Depression-Related Increases and Decreases in Appetite: Dissociable Patterns of Aberrant Activity in Reward and Interoceptive Neurocircuitry. American Journal of Psychiatry, 173(4), 418-428. doi:10.1176/appi.ajp.2015.15020162
- Craft, L. L., & Perna, F. M. (2004). The Benefits of Exercise for the Clinically Depressed. The Primary Care Companion to The Journal of Clinical Psychiatry, 06(03), 104-111. doi:10.4088/pcc.v06n0301
- Harvard Health Publishing. (2012, February). Why stress causes people to overeat. Retrieved May 30, 2019, from https://www.health.harvard.edu/staying-healthy/why-stress-causes-people-to-overeat
- Dienes, K. A., Hazel, N. A., & Hammen, C. L. (2013). Cortisol secretion in depressed, and at-risk adults. Psychoneuroendocrinology, 38(6), 927-940. doi:10.1016/j.psyneuen.2012.09.019
- Fava, M., (2000). Weight gain and antidepressants. [Abstract]. Journal of Clinical Psychiatry, 61(Suppl11), 37-41. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/10926053.
- Shi, Z., Atlantis, E., Taylor, A. W., Gill, T. K., Price, K., Appleton, S., . . . Licinio, J., (2017). SSRI antidepressant use potentiates weight gain in the context of unhealthy lifestyles: Results from a 4-year Australian follow-up study. BMJ Open, 7(8). doi:10.1136/bmjopen-2017-016224
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