Excess Body Fat Can Increase Risk of Depression

Carrying ten kilograms (22 pounds) of excess body fat can increase a person’s risk of depression by 17 percent, according to a new study from Aarhus University and Aarhus University Hospital in Denmark.

In fact, the research shows that the more excess fat a person has, the greater the probability of developing depression — and the researchers believe it is the psychological aspect of carrying the extra weight, not the biological effects of the fat, that is driving the depression.

“Our study also indicated that the location of the fat on the body makes no difference to the risk of depression,” says Dr. Søren Dinesen Østergaard, a professor at the Department of Clinical Medicine at Aarhus University. “This suggests that it is the psychological consequences of being overweight or obese which lead to the increased risk of depression, and not the direct biological effect of the fat.”

“If the opposite was true we would have seen that fat located centrally on the body increased the risk the most, as it has the most damaging effect in biological terms.”

The findings are published in the journal Translational Psychiatry.

Previous studies on this topic have predominantly used body mass index (BMI) to measure obesity. BMI is calculated solely on the basis of body weight and height and is therefore a fairly crude measure, which does not, for example, take build and muscle mass into account.

“BMI is an inaccurate way of measuring overweight and obesity. Many elite athletes with a large muscle mass and a low body fat mass will have a BMI above 25, which is classified as overweight according to the common definition. This obviously doesn’t make much sense,” said Østergaard.

“Therefore, one of the strengths of our study is that we’ve been able to zoom in and look at the specific relationship between the amount of body fat and the risk of depression.”

In the study, the researchers analyzed data from two large genetic data sets: the UK Biobank, which contains information on the association between genetic variants and fat mass based on a study of 330,000 people, including body fat mass distributed around parts of the body; and the Psychiatric Genomics Consortium, which contains data on the association between genetic variants and depression based on a study of 135,000 people with depression and 345,000 control subjects.

Østergaard emphasized that the findings are particularly significant in light of the fact that almost 40 percent of the world’s adult population is overweight.

“In addition to the known physical consequences of obesity such as diabetes and cardiovascular disease, there is also a significant and now well-documented psychological component, which needs to be dealt with as well. This is yet another argument for resolving the obesity epidemic,” he said, before emphasizing that it is important to have a balanced approach to the issue.

“As it appears to be the psychological consequences of obesity, such as a negative body image and low self-esteem that is the main driving force behind the increased risk of depression, society’s efforts to combat obesity must not stigmatise, as this will probably increase the risk of depression even further. It is important to bear this in mind so we can avoid doing more harm than good in the effort to curb the obesity epidemic,” Østergaard said.

The Aarhus University research group included Maria S. Speed, Oskar H. Jefsen, Anders D. Børglum, Doug Speed and Østergaard.

Source: Aarhus University

Is it Hard to Lose Weight on Psychiatric Drugs?

People who take antidepressants and/or antipsychotics and participate in a weight management program can still lose a significant amount of weight, regardless of the weight gain potential of their mental health medication, according to a new Canadian study published in the journal Obesity.

Individuals with mental health disorders are at an increased risk of having obesity, in part because many of the medications used to treat these conditions are known to cause weight gain, say the researchers.

However, it has remained unclear if taking these medications would put people at a disadvantage for weight loss. The study is the first to examine weight loss outcomes in individuals taking antidepressants or antipsychotics alone, in combination or not at all.

“The results of this study are relevant not only to the healthcare professionals providing care to those who have both excess weight and mental illness, but also to the patients who experience these comorbidities themselves,” said lead author Rebecca Christensen, a Ph.D. student at the University of Toronto’s Dalla Lana School of Public Health in Canada.

For the study, the researchers reviewed data from 17,519 patients enrolled in a life-style weight loss program at the Wharton Medical Clinic (WMC) in Ontario, Canada.

Because of known gender differences in weight loss and prevalence in mental health conditions, the researchers conducted separate analyses for male and female patients. They examined weight change differences based on psychiatric medication group and weight gain potential.

Participants were categorized as taking an antidepressant(s) alone, antipsychotic(s) alone, a combination of both, or no psychiatric medication. The authors also conducted a sub-analysis, where patients were categorized as taking psychiatric medications known to cause weight gain, or medications that are weight neutral and/or can cause weight loss.

Overall, more than 23 percent of patients were taking at least one psychiatric medication.

Trained medical professionals took participants’ height and weight measurements, and patients met with a physician and/or bariatric educator monthly for dietary and physical activity suggestions based on current lifestyle practices.

WMC staff provided treatment in accordance with Canadian clinical practice guidelines on the management and prevention of obesity in adults and children and the National Institutes of Health guidelines on the identification, evaluation and treatment of overweight and obesity in adults.

The findings show that while men lost a significant amount of weight regardless of the type of psychiatric medication, men taking antidepressants alone lost slightly less weight than men taking both antidepressants and antipsychotics, and men taking neither medication. Women lost a similar amount of weight regardless of their psychiatric medication use.

Christensen and colleagues also observed that both men and women were able to lose a significant amount of weight regardless of the weight gain potential of their mental health medication.

The results of this study are promising, said Christensen, but additional research is needed to confirm the findings.

Source: The Obesity Society



Physical Well-Being Needs to Be Addressed Along With Mental Health

A new UK study finds that people with mental illness may live longer if they address both their physical and mental health.

University of Queensland researchers found patients’ physical health was often overlooked in pursuit of treating the mind. UQ psychiatrist, Associate Professor Dan Siskind, said it was time to prioritize the physical health of such patients.

The study was a part of an effort to improve mental health care in the UK with findings appearing in the journal Lancet Psychiatry.

“One in five people across the world live with mental illness and people with mental illness can die up to 18 years earlier than the general population,” Siskind said.

“Contrary to popular belief, this is not because of suicide. It is from physical health issues associated with mental illness like diabetes, cardiovascular disease, and lifestyle factors.

“This commission aimed to find out how great the life expectancy gap really is between those living with mental illness and the general population, discover the causative pathways for this gap, and look at practical strategies to narrow it.”

Siskind said conditions such as diabetes served as a stark example, with rates twice as high in those with mental illness compared to the general population.

“Getting people more physically active, improving nutrition and stopping smoking and substance abuse are all lifestyle factors that can be modified to improve health outcomes,” he said.

“We also looked at issues caused by medications and how these can be managed to mitigate side-effects such as obesity.”

The researchers hope the findings serve as a blueprint for doctors and healthcare professionals treating patients with mental illness.

“It can be hard for people with mental illness to engage with primary health care providers, although they may still see their psychiatrist,” said Siskind.

“We wanted to empower psychiatrists to be involved in the primary health care of their patients and engage the efforts of a multi-disciplined team, a team that includes not only psychologists and nurses but also nutritionists and exercise physiologists.

“A ‘one-stop-shop’, where patients can have their mental health and physical health needs met by a team of experts, can lead to improved health care outcomes.”

Siskind believes this multidisciplinary approach will help patients take back control of their well-being, and overcome debilitating lack of motivation.

“Motivation is often lost among people with mental illness,” he said.

“If we can remove barriers to treatment, then we can start to make improvements across a broad range of physical conditions. This is about making everyone realize patients are whole people; it’s not just about eradicating mental health problems; we need to look after physical health too.”

Source: University of Queensland/EurekAlert

Fun, Structured Programs Improve Mood in Obese Kids as Much as Exercise

Regular exercise offers a variety of benefits for overweight and obese children, but when it comes to their mental and social health in particular, other kinds of adult-led afterschool programs may be just as beneficial, according to a new study published in the journal Translational Behavioral Medicine.

The findings show that a program with attentive adults, clear rules, routines and activities and a chance to interact with peers seems to work just as well as an exercise program for improving a child’s quality of life, mood and self-worth.

“For me the take-home message is yes, exercise has many wonderful benefits but some of that is because you are in a program run by caring adults,” says study author Dr. Catherine Davis, clinical health psychologist at the Medical College of Georgia (MCG) Prevention Institute.

Previous studies, including some led by Davis, have shown that regular physical activity in children who are overweight or obese and inactive can yield a variety of physical benefits, including reduced weight, improved fitness and insulin sensitivity — which reduces the risk of diabetes and other maladies — as well as other mental/emotional benefits, such as improved cognition and reduced anger and depression.

In the new study, the researchers wanted to directly compare an exercise program to a similar sedentary program, and see how each program affected the psychosocial wellbeing of these children.

The study involved 175 predominantly black children, ages 8 to 11, who were overweight or obese and previously inactive. Children participated in either a fun-driven aerobic exercise program for 40 minutes per day, based on their interests and abilities, or a sedentary after-school program where they worked with board games, puzzles, music and/or arts and crafts. Children were free to talk as long as it wasn’t disruptive.

At the beginning and end of the study, the children were evaluated for depressive symptoms, anger expression, self-worth and quality of life. At the start, around 10 percent of children in both groups exhibited depressive symptoms, including sad mood, interpersonal problems and inability to feel pleasure. Depressive symptoms and quality of life were measured again about a year later.

Before the study began, the researchers hypothesized that the exercise intervention would be more effective at improving quality of life, mood and self-worth than the sedentary program.

Instead, they found that while the exercise program had the additional benefits of reducing body fat, improving fitness, and even improved brain health, there was no mood advantage. In fact, in the case of the boys, those in the sedentary group reported depressive symptoms actually decreased more over time than their peers in the exercise group.

Among girls, depressive symptoms yielded similar improvements whether in the exercise or sedentary group, says first author Celestine F. Williams, senior research associate at the Georgia Prevention Institute.

According to the researchers, the gender differences could be due to males in the sedentary group not being under pressure to participate and succeed in physical activities and finding instead an opportunity to pursue more artistic and social endeavors, which children of this age tend to prefer.

In addition, relationships the children built with each other over the course of both programs likely were beneficial in elevating their mood and quality of life, Williams says. The sedentary program may have given children more time to socialize and develop friendships with little competitive pressure.

The fact that both programs provided psychosocial benefit to the children led the researchers to conclude that some benefits of exercise found in previous studies resulted from the regular opportunity to be with attentive adults who provide behavioral structure. It also resulted from the children enjoying interacting with each other, sharing snacks and other activities, while spending less time watching television.

“Exercise is very well demonstrated to improve mood. However, I think you have to consider exercise in the context that it occurs, so the social context counts too,” says Davis.

Source: Medical College of Georgia at Augusta University

Self-Criticism About Weight May Originate With Others

Some overweight and obese individuals are more likely to engage in “self-stigmatization,” in which they internalize their weight stigma experiences and begin to blame and devalue themselves.

In a new study of more than 18,000 adults, researchers from Penn Medicine and the University of Connecticut Rudd Center for Food Policy and Obesity wanted to better understand who is at greater risk for this type of behavior, which has been associated with poor mental and physical health.

Their findings show that participants who reported experiencing weight stigma from others — particularly from people they know such as family, friends and coworkers —  had higher levels of internalized weight bias than those who reported no experiences of weight stigma.

The study is published in the journal Obesity Science and Practice.

In addition, those who internalized weight bias the most tended to be younger, female, have a higher body mass index (BMI), and have an earlier onset of their weight struggle. Participants who were black or had a romantic partner had lower levels of internalization.

“We don’t yet know why some people who struggle with their weight internalize society’s stigma and others do not,” said the study’s lead author, Rebecca Pearl, Ph.D., an assistant professor of psychology in psychiatry in the Perelman School of Medicine at the University of Pennsylvania.

“These findings represent a first step toward helping us identify, among people trying to manage their weight, who may be most likely to self-stigmatize. People who are trying to lose weight may be among the most vulnerable to weight self-stigma, but this issue is rarely discussed in treatment settings.”

In this study, the researchers surveyed surveyed more than 18,000 adults enrolled in the commercial weight management program WW International (formerly Weight Watchers Inc.) in order to identify the key characteristics and experiences of people who internalize weight bias. The study is the largest investigation of weight self-stigma to date.

The participants recalled when they had experienced weight stigma from other people during their lifetime, how frequent and how upsetting the experiences were, and who it was that called them names, rejected them, or denied them an opportunity simply because of their weight.

The results show that nearly two-thirds of the participants reported experiencing weight stigma at least once in their life, and almost half reported experiencing these events when they were children or teens. The researchers looked at the relationships between these experiences and levels of self-directed stigma.

Participants who reported experiencing weight stigma from others had higher levels of internalized weight bias than those who reported no experiences of weight stigma.

This link was even stronger among participants who had weight-stigmatizing experiences early in life and who continued to have these upsetting experiences as adults. Those who experienced weight stigma from family members or friends, or from those in their workplace, community, or health care setting, also had greater evidence of weight self-stigma compared to participants who did not encounter weight stigma from those sources.

“Our findings can inform ways to support people who are experiencing or internalizing weight stigma, including opportunities to address weight stigma as part of weight management and healthy lifestyle programs,” said principal investigator Rebecca Puhl, Ph.D., a professor of Human Development and Family Sciences at the University of Connecticut.

The study sample represented only a small percentage of WW members, so the findings may not generalize to all members or to adults trying to lose weight in other ways. Some previous research has suggested that people who internalize weight bias may have worse long-term weight loss outcomes, but more research on this topic is needed.

The research team is developing a psychological intervention for weight self-stigma that can be incorporated into weight management.

Source: University of Pennsylvania School of Medicine

Drinking Coffee May Help Activate the Body’s Fat-Fighting Defenses

Coffee lovers everywhere can rejoice once again, as scientists may have found yet another reason to continue enjoying a morning cup of joe.

A new U.K. study suggests that drinking caffeinated coffee can help stimulate “brown fat,” the body’s own fat-fighting defenses which help regulate how quickly we burn calories as energy.

At this time, the researchers believe that caffeine is the responsible component in this activation, but they will be conducting more studies to see if other components may be involved.

Brown fat is one of two types of fat found in humans and other mammals. Initially only attributed to babies and hibernating mammals, it was discovered in recent years that adults can have brown fat too. Its main function is to generate body heat by burning calories, as opposed to white fat, which stores excess calories.

Researchers believe that brown fat could play a key role in tackling obesity and diabetes. In fact, people with a lower body mass index (BMI) have a higher amount of brown fat.

“Brown fat works in a different way to other fat in your body and produces heat by burning sugar and fat, often in response to cold,” says Professor Michael Symonds from the School of Medicine at the University of Nottingham.

“Increasing its activity improves blood sugar control as well as improving blood lipid levels and the extra calories burnt help with weight loss. However, until now, no one has found an acceptable way to stimulate its activity in humans.”

“This is the first study in humans to show that something like a cup of coffee can have a direct effect on our brown fat functions. The potential implications of our results are pretty big, as obesity is a major health concern for society and we also have a growing diabetes epidemic and brown fat could potentially be part of the solution in tackling them.”

The researchers began with a series of stem cell studies to see if caffeine would stimulate brown fat. Once they had found the right dose, they moved on to humans to see if the results were similar.

The team used a thermal imaging technique, which they’d previously pioneered, to trace the body’s brown fat reserves. The non-invasive technique helped the team locate brown fat and assess its ability to produce heat.

“From our previous work, we knew that brown fat is mainly located in the neck region, so we were able to image someone straight after they had a drink to see if the brown fat got hotter,” said Symonds.

“The results were positive and we now need to ascertain that caffeine as one of the ingredients in the coffee is acting as the stimulus or if there’s another component helping with the activation of brown fat. We are currently looking at caffeine supplements to test whether the effect is similar.”

“Once we have confirmed which component is responsible for this, it could potentially be used as part of a weight management regime or as part of glucose regulation programme to help prevent diabetes.”

The findings are published in the journal Scientific Reports.

Source: University of Nottingham