7 Ways to Manage Weight Gain or Loss From Depression
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If you have depression and are experiencing changes in your weight, you’re not alone. In fact, changes in appetite and weight are so common that they’re part of the criteria used to diagnose a depressive episode.
Weight changes can differ from person to person. Some people with depression lose weight, while others gain weight. And researchers continue to learn about the complicated relationship between depression and obesity, revealing an emerging picture of a strong link between mood and weight.
How Does Depression Impact Weight?
Although there’s still a lot for researchers to uncover about the relationship between depression and weight changes, there are a number of known ways depression can affect weight.
Increased or decreased appetite are common symptoms of depression. Overall, depression can alter motivation, self-concept (how a person sees, feels, and thinks about themselves), energy, and activity levels. All these factors can contribute to weight loss or weight gain among people with depression.
In addition, research has shown that depression and obesity are linked, and the relationship appears to go both ways: Depression is a risk factor for obesity, and obesity is a risk factor for depression.
This relationship between obesity and depression has shed light on some of the biological contributors to the connection between weight and mood. The contributors include inflammation, the microbiome (the community of natural bacteria, viruses, and fungi that live in the body), and the neuroendocrine system (the system that creates and releases hormones in the body) which mediates metabolism and the body’s response to stress, according to research.
Lastly — but of equal importance — the medications that are used to treat depression can also affect weight. Medications such as mirtazapine (Remeron) as well as antipsychotic medications, which are sometimes used as add-on treatment for severe or treatment-resistant depression, are known to cause weight gain, per research.
Studies have also shown that selective serotonin reuptake inhibitors (SSRIs) — the most commonly prescribed antidepressants — also cause weight gain and changes in cholesterol in some people. Although medications for depression overall are less likely to lead to weight loss than other types of medications, bupropion (Wellbutrin) appears to be least likely to cause weight gain, according to prior research.
Why Do Weight Changes Matter?
Although weight changes are just one potential symptom of depression, they’re an important one.
Weight loss due to depression can result in a lack of nutrients or hormonal changes that can affect the body’s state of nutrition, activity, and rest, which play key roles in regulating mood and health, according to Madison Avenue TMS & Psychiatry.
In addition, people diagnosed with depression are more likely to have diabetes, high cholesterol, high blood pressure, cardiac disease, and stroke — and weight gain is a known contributor to these conditions — according to a review of research published in August 2019 in the Lancet Psychiatry.
There may be additional risk factors besides weight that contribute to these higher rates of disease among people with depression. But weight is an important and modifiable risk factor (meaning it can be changed).
How Can You Manage Weight Changes Associated With Your Depression?
Most people can list at least a few changes they could make to help with weight management and to improve their overall health. They often know they should eat more fruits and veggies and fewer processed foods. They often agree that being physically active is important to health.
But research shows that actually making a lifestyle change — even after a person decides to — is way easier said than done. Add major depression to the mix, and change can feel impossible.
So, how do you manage your weight when managing anything feels out of reach?
Here are seven handy tips. Please keep in mind that how you relate to yourself and can best support yourself in making changes like these is personal and is something that is best explored in therapy.
1. Know Your Baseline
This first tip is not so much about how to make a change as how to know when change is imperative. For many people with depression — especially chronic depression or multiple depressive episodes — changes in weight and cholesterol can happen slowly over time, masking how much the disorder is impacting their physical health.
If you have been diagnosed with major depressive disorder, it’s a good idea to get some baseline information about your physical health, including current weight, cholesterol, triglycerides (fats), and hemoglobin A1C (a measure of blood sugar levels).
You and your healthcare providers should follow these numbers over time. It’s helpful to have concrete information to show if either your depression or treatment for your depression is causing changes in these numbers that need to be addressed.
2. Ask — Are Your Medications Working for You or Against You?
As mentioned earlier, certain medications may lead to weight gain, whereas others are less likely to. If you are going to be taking medication daily, why not try to take a medication that works for you instead of against you?
If you are struggling to keep weight on, ask your provider about antidepressants that may increase your appetite. On the other hand, if you are struggling to keep weight off, ask your doctor if your medication may be contributing (and if so, whether there are other treatment options you could try instead).
3. Make a Clear Plan to Address Weight Changes
If you have decided with your primary care provider or a mental health professional that your weight needs to be addressed, make a clear plan with them.
If you want to gain weight, decide how. Will you eat more calorically dense foods? If so, which ones? Will you eat more frequently during the day? If so, will you set alarms to remind yourself to eat or plan meals with friends?
If you want to lose weight, again, decide how. What foods will you replace? How will you better keep track of portion sizes? Are there any specific behaviors, like eating while watching TV, that you can stop?
The plan may be a team effort. For example, it could help to meet with a registered dietitian for help creating a safe schedule for gaining or losing weight.
4. Ensure Your Plan Is Doable for You
Once you have your plan, set yourself up for success by making it fairly easy to follow.
Part of this means understanding your own depression. If you are less motivated when depressed, this might not be the right time to commit to learning new cooking techniques. If you struggle with self-confidence when depressed, maybe it’s not the best time to join a new gym or try a new group workout class.
The change itself will be hard, so cut yourself some slack on the logistics. For instance, when it comes to eating, stock up on nutritious options you like that are quick and ready-to-go. If you do this, you boost your odds of grabbing something healthy that gets you toward your goal. Some options that don’t require much prep or cooking time are:
- Yogurt
- Premade overnight oats
- Apples
- Bananas
- Blueberries
- Steam-ready bags of vegetables or rice
- Prepackaged chopped salads
Making your plan easy also means making changes small and manageable. For example, instead of drastically overhauling your diet, consider starting with one or two approaches and gradually adding more. Or if you want to start exercising, commit to 5 to 10 minutes a day as a starting point. If you start small and follow through, you’ll feel productive and improve your self-confidence.
RELATED: Depression: 6 Tips for Eating Well When Cooking Feels Impossible
5. Remember That ‘Perfect’ Is the Enemy of ‘Good’
What makes change during depression especially difficult for some people is that many things they do may feel “not good enough” to them. Whether it’s the depression talking, expectations from social media, or remembering what they used to feel capable of before their depressive episode, some people will say, “Who cares that I walked 10 minutes? That’s nothing.” Or, “Who cares that I ate well today? I’ll probably have a bag of chips tomorrow.”
There’s no such thing as a perfect diet or perfect exercise, and our desire to strive for an unrealistic ideal can get in the way of achieving what’s good for us. Instead of comparing yourself to some arbitrary expectation or to the person you were before you developed depression, start with where you are right now.
Also, keep in mind that when we have thoughts like “I should be doing more,” those thoughts are contributing to the stigma around mental health conditions. Certainly, we would be understanding of ourselves taking a slower entry back into exercise if we were physically injured. Similarly, when you are in a depressive episode, there are actual, legitimate road blocks you’re dealing with.
If you managed to get up and make some healthy choices despite those roadblocks, it’s worth celebrating.
6. If Your Plan Doesn’t Work, Adjust It — Don’t Blame Yourself
Similarly, it’s easy to blame yourself or feel like a failure when you don’t follow through with goals when dealing with depressive symptoms. If you create a plan and continuously are unable to follow through, don’t keep trying that plan and blaming yourself for not achieving it.
Instead, stop and reconsider the plan. What I tell people is that they did not fail the plan — the plan failed them. Negative self-talk won’t help, but creating a different plan might.
7. Harness Your Energy When You Feel Your Best
One major theme here is that making changes can be hard for everyone, but it can be especially hard for many people with depression because of symptoms like lack of energy.
With this in mind, try to create and implement healthy habits when you’re feeling well. Although it may be tempting to say “Well, I feel better now, so maybe I don’t need to do this,” when you aren’t feeling depressed is actually the time to create habits that you may be able to continue when dealing with depressive symptoms.
And if this isn’t reason enough, research also shows that healthy eating and exercise both help prevent the onset of future depressive episodes.
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