Depression and obesity - a vicious cycle

People with obesity had a 55% increased risk of depression over time, and those with depression also had a 58% increased risk of obesity.

This is a meta-analysis of eight studies on the two-way relationship between depression and obesity, recently published by the International Federation of Bariatric Surgery (IFSO). In 2019, IFSO also reported that 16% of obese people suffered from depression. Another study found that obese adolescent girls were nearly four times more likely to suffer from major depression. However, this risk was not significant for men.

Obesity is a disease caused by excessive fat accumulation in the body. According to the Ministry of Health, people are considered obese when their body mass index (BMI) is over 25, and BMI over 35 is considered severely obese. The biggest problem for this group is that their overweight body causes many difficulties and deadlocks in life, causing them not only physical illness but also severe mental problems.

Like Ms. Trang, 30 years old, in Hanoi, she gained weight uncontrollably after giving birth to her second child. When Covid-19 broke out, she had to stay at home, take care of her young child, her daily routine was disrupted, she did not exercise, and her weight was 30 kg above the standard. When her weight reached 82 kg, she was easily irritated, always tired, had difficulty concentrating and had sleep disorders.

Obesity caused her to suffer from many diseases such as fatty liver, fatty blood, snoring, and dangerous sleep apnea syndrome. She felt self-conscious about her appearance, lost interest and motivation in life, and even had suicidal thoughts. Worried, her husband took his wife to the 108 Military Central Hospital for examination and was diagnosed with anxiety disorder and depression, stemming from obesity.

Mr. Cuong, 35 years old, in Hai Phong, gained more than 10 kg in just one year, reaching 94 kg. In the past three months, he has been in a state of anxiety, stress, uncontrolled eating, irritability and insomnia, and had to see a doctor for treatment.

These are two of many obese patients treated by Associate Professor, Dr. Nguyen Anh Tuan, Head of the Department of Digestive Surgery, 108 Central Military Hospital. Most of the patients are extremely obese, weighing more than 100 kg, some as much as 180 kg.

Obese people are at high risk of depression. Photo: Freepik

According to Dr. Tuan, obese people often feel self-conscious about their bodies, tend to have difficulty accepting and loving themselves. These people are often discriminated against and isolated in society. They feel dissatisfied with their self-image or are under pressure from society, have low tolerance, and are prone to anxiety and stress. Over time, this condition leads to depression, when the patient loses the motivation to live, often having suicidal thoughts.

Stress is also one of the causes of obesity. This condition negatively affects cognition, changing behavior and habits in a negative way. The most obvious manifestation is unhealthy eating, living and exercising.

"Their common mentality is to be impatient to lose weight, using weight loss support methods or products on their own, making the obesity treatment process ineffective," Associate Professor Tuan said, adding that this can have a serious impact on the patient's psychology and health.

According to Dr. Tuan, for obese patients, weight loss is the key to breaking the vicious cycle. Signs of depression will change positively when the patient regains his or her figure through diet changes, exercise, or surgery.

In fact, many people are stuck and worried, using functional foods even though they do not know the ingredients. Some people go for liposuction or inject substances of unknown origin, leading to unpredictable consequences.

Mr. Tuan explained that obese people have a desire to eat that is always beyond their control. This is a disorder of psychology and the process of metabolism, endocrine, and metabolism. Therefore, psychological counseling is very important. to help patients get out of a deadlock and despair, giving them motivation and belief in their ability to overcome obesity.

Doctors need to develop a clear treatment plan and goals for patients, creating confidence for patients to be determined to undergo treatment. Some patients come to the doctor for consultation dozens of times, some people approach and follow the doctor's lectures for up to three years before accepting treatment. "This treatment process is not just for a few years but for their entire life," said Mr. Tuan.

In addition, obesity treatment needs to combine psychological therapy or depression treatment regimen. When the patient feels better and treatment begins, food choices can be made to change the scientific diet under the guidance of a doctor or nutritionist.

If you have tried everything but have not been effective in adjusting your weight, you may need gastric bypass surgery. This method is indicated for people with a BMI over 35, obesity combined with diabetes, high blood pressure, joint pain; or people with a BMI of 27-30, obesity with diabetes but insulin resistance.

Associate Professor Tuan noted that surgery is only a measure to help reduce food intake. Patients need to proactively change their lifestyle, reduce food intake, and increase physical exercise to quickly reach their ideal weight and good health.

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