Severely Obese Face Major Depression Risk...

Severely Obese Face Major Depression Risk
Tue Jan 6,11:48 PM ET Add Health - HealthDay to My Yahoo!


By Randy Dotinga
HealthDay Reporter

TUESDAY, Jan. 6 (HealthDayNews) -- In a variation on an age-old question,
researchers have long asked themselves which comes first -- obesity or
depression?

A new study doesn't resolve the debate, but it does suggest the risk of
mental illness is a major problem for the severely obese, and less of a
threat for the merely overweight.

Women of average height who weighed more than 240 pounds and men of average
height who weighed more than 278 pounds -- defined as morbidly obese -- were
five times more likely to be depressed than people of average weight.

However, women who were overweight, but not obese, were also more likely to
be depressed.

"It's good news for the general population because it means the depression
burden might be lower among the obese than we worry it is," says study
co-author Dr. Chiadi U. Onyike, a psychiatric researcher at Johns Hopkins
Hospital in Baltimore. "But it's not good news for people who are morbidly
obese."

The suspected link between depression and obesity is nothing new. "It seems
an obvious connection," Onyike says. But why? Do fat people get depressed
because of social stigma, or because of the chemical makeup of their bodies?
Or does depression cause a chemical reaction in the body that leads to
obesity?

In the new study, the researchers examined statistics from a 1988-94 federal
study of the health and nutrition of Americans. They looked at 8,410 people
who responded to a psychological questionnaire. The findings appear in a
recent issue of the American Journal of Epidemiology.

The people most likely to be depressed -- five times more so than those of
normal weight -- were those with a body mass index of more than 40, making
them morbidly obese. The index, a ratio of height to weight, is a
measurement of obesity.

For people who are 5-foot-4, their BMI will reach 40 when they hit 240
pounds. For those who are 5-foot-10, their BMI will reach that level at 278
pounds.

Among women, simply being obese, a step above being overweight, spelled
trouble, but not as much as among the morbidly obese, the study found. The
risk of depression doubled among those women who had BMI of 30 or more. That
translates to a weight of 180 or more for someone who is 5-foot-5. But the
same was not true for men.

The study reveals the importance of screening severely obese patients for
signs of depression, says Onyike. "Depression can undermine their compliance
with weight-reduction treatments," he says.

But what of the perception that fat people are the life of the party?

Some obese people do indeed seem happy, but that's because they're
successfully using food -- a "natural antidepressant" -- to treat their
depression, says Dr. Albert Ray, an obesity expert and physician advisor
with the Kaiser Permanente Health Plan's Positive Choice Wellness Center in
San Diego.

"What a physician normally does is throw a diet at them, [tell them to] go
out and exercise and lose weight and come back in a month," Ray says. "It
doesn't happen that way. The doctor hasn't gotten to the underlying problem,
which is depression or some inner psychological problem."

Once obese people come to terms with their depression, often related to
childhood traumas such as abuse, they can begin losing weight, he says.
Counseling and medication are often very useful in treating the depression,
he adds.

But "there's a lot of denial," Ray says. "These patients don't want to
recognize that they're depressed, that they grew up in homes with heavy
levels of dysfunction."
--
Ken

"One of the common denominators I have found is that expectations rise above
that which is expected."

-President Bush -2000