TO READ: Depression and Obesity. . . and Depression

"Theory and research suggest that obesity and depression may be causally linked," says the summary of a new study in the journal Clinical Psychology: Science and Practice. If you are living with depression, chances are that you've already made that connection on your own -- after all, while some of us tend to eat (and sleep) less when we're depressed, there is also a substantial proportion of us who tend to eat and eat and sleep and sleep to try to ease the pain.

I happen to be an eater and sleeper; I especially crave carbohydrates (i.e., cookies and scones from Starbucks) when I'm way down. And, despite being a healthy weight until taking an atypical antipsychotic (which shall go unnamed) a few years ago when absolutely nothing else was helping, I'm now 20-30 pounds above where I'd like to be. It was much worse for awhile -- I gained 80 pounds in less than a year on this stuff. Very fortunately, when I finally got off of it to try a newly-released alternative, 40 pounds evaporated on its own. I've dieted to get rid of some of the rest, but it comes and goes and comes and stays -- and it's somewhat "depressing." And it often does feel like there's a chicken-and-egg quality to the situation.

So when I saw this research study suggesting that depression can lead to obesity and obesity can lead to depression, I took note. Long-term studies show that obesity predicts later depression. The authors propose that this may be due to either health or appearance issues. Meanwhile, there's some data showing that depression increases the risk of obesity, likely due to lack of exercise, negative thoughts or lack of social support. The suggestions for treating both of these include, not surprisingly, "behavioral activation" (diet and exercise) and cognitive-behavioral therapy -- but the scientists emphasize that no one's really studied how to treat both together yet.

What do you think? If you're living with both these conditions, which came first, and to what do you attribute the other? If you've recovered from one or both of these, how did you do it? I myself consider my bipolar disorder (mostly depression) well-managed now, but when I'm even slightly down, I judge myself harshly for my excess pounds. I can imagine these problems going either way.

For more info: Clin Psychol Sci Prac 15:1-20, 2008.