There is a common portrayal in the media, movies and society that overweight people are more "jolly" or "happy", however this is not reflected in the research literature.
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There have been many studies that have found a relationship between being overweight and high levels of psychological distress, in particular with symptoms of depression and anxiety.
Obesity in particular has been shown to be associated with more severe experiences of psychological distress, while those with lower levels of anxiety or depression appear to be able to achieve and maintain somewhat higher levels of weight loss over time.
The causes or directions of these relationships are not yet well understood and are likely to have multiple explanations. For example, a common symptom of depression is difficulty finding the initiative, enthusiasm or energy to do things. This is often a barrier to engaging in exercise or other healthy behaviours which might facilitate weight loss.
Being overweight or obese can also negatively affect a person's confidence and self-esteem, which may result in the avoidance of social activities and contribute to depression or anxiety. Thus, it is possible that the experience of psychological distress contributes to weight gain and that being overweight contributes to psychological distress.
It has also been proposed that there are genetic and bodily processes associated with both obesity and some mental health disorders. One proposed shared process is the overactivity of the stress system in the brain. This system plays a role in the regulation of several bodily processes, including our stress response, moods and emotions, digestion, the immune system, and our energy storage and output. Overactivity of this system has been found to be associated with depression and anxiety symptoms, as well as obesity.
Although the nature of these relationships is not fully understood yet, recognition of their possible impact on psychological distress and obesity is important for treatment and support.
In addition to these factors, it is likely that there are a range of other variables that contribute to the relationship between psychological distress and being overweight or obese. These include diet, experiences of weight-related stigma, body image dissatisfaction, and style of coping. For example, one study of older adults in Queensland found that the relationship between depression and obesity was mediated by the type of diet. Depression was related to obesity particularly when there was a high-fat meat and energy food intake with a lower consumption of vegetables and fruit.
Given all of these interacting factors, most strategies aimed at weight reduction now have psychological, diet and exercise components. While all of these are likely to be important for weight loss and maintenance, for those experiencing persistent symptoms of depression or anxiety it is recommended they seek help.
■ Krystal Sattler is a PhD student, School of Psychology, University of Wollongong. Prof Frank Deane is director, Illawarra Institute for Mental Health, University of Wollongong.
*These health tips are provided by researchers affiliated or associated with the Illawarra Health and Medical Research Institute, which runs the HealthTrack study. Please consult your doctor for specific medical advice.
