June 13, 2010
Depression Predisposes To Obesity
Depression makes you fat?
“We found that in a sample of young adults during a 15-year period, those who started out reporting high levels of depression gained weight at a faster rate than others in the study, but starting out overweight did not lead to changes in depression,” said UAB Assistant Professor of Sociology Belinda Needham, Ph.D.. The study appears in the June issue of the American Journal of Public Health.
“Our study is important because if you are interested in controlling obesity, and ultimately eliminating the risk of obesity-related diseases, then it makes sense to treat people’s depression,” said Needham, who teaches in the UAB Department of Sociology and Social Work. “It’s another reason to take depression seriously and not to think about it just in terms of mental health, but to also think about the physical consequences of mental health problems.”
One can easily imagine a number of mechanisms for how this would work. For example, depressed people are more lethargic, often sleep longer hours, and therefore burn fewer calories. Also, depressed people might seek out the pleasure of eating food as a temporary relief from the pain of living.
The fact that humans get depressed in the first place is interesting. One evolutionary purpose might be to help people store up food and burn less food during winter months. In other words, depression could be a milder version of hibernation. Dampen down activity once the crops are in and just eat and gain weight until spring. This might explain seasonal affective depression which comes on when the days are shorter.
I think depression is an adaptation to remove unsuccessful, dead-weight members from a group. They just wander off into the woods and die, the group no longer has to feed them, and more successful, livelier relatives live on more easily.
If you're depressed, the message is clear; do everyone a favor and off yourself.
That's so cool, ASPIRANT! Why bother with genocide when you can "accidentally" alter the environment so as to depress a target group? First they get fat, and everyone can ridicule them for being fat, and then you can tell them their suicidal feelings are "RIGHT ON"! Plausible deniability is where its at nowadays isn't it?
PS: It helps if you're trying to get feed non-vibrant folks like Scandinavians to more vibrant, energetic and full of passionate intensity, immigrants.
> One evolutionary purpose might be to help people store up food and burn less food during winter months. In other words, depression could be a milder version of hibernation.
This is a pretty weak hypothesis. There is no reason the adaptation should be so crude, unless of course it is very new (I'm sure you're familiar with the evolutionary logic of all that). I call it crude because non-depressed people are more likable and less irritable. If you are gonna sit around conserving energy, you may as well be chewing the fat with your allies amiably. Depression also features a significant lifetime risk of suicide.
Also, there is not much of a racial difference in depression when you look at blacks, who of course hail from a winterless clime.
In general, I think evo psych theorizing about adaptiveness of depression is pretty cool, a worthy effort. But, I think I have heard most or all of the hypotheses, and they are all pretty darn far from convincing, at least if you try to apply them to chronic (multi-year) depression. It is of course much easier to imagine transient depression being adaptive.
It is possible that depression conferred some sort of evolutionary advantage in terms of the way the sufferer saw the world - i.e people who are depressed see the world in a realistic way whereas happy people are often irrational.
Studies have shown that happy people usually attribute their failures and set-backs to bad luck and successes to their hard-work and skill (when obviously it can sometimes be the other way round) and can be irrationally optimistic about the likelihood of success of a particular endeavour they are engaged in.
Depressed people on the other hand are often far more accurate in assessing their place in the world (the status of their job, how attractive they are to the opposite sex etc.). In an evolutionary environment depressed people may have been able to provide a more realistic assessment of the threats and opportunities that there were.
I say that as a long-time sufferer of depression.
Yes, James, as somebody who also went through depression, I second Aspirant's explanation: It's a form of social apoptosis, that removes from society people who are consuming resources without any prospects. Mind you, it does tend to cause you to underestimate your long term ability to turn things around, but in an evolutionary environment where the life expectancy was in the 20's, that made perfect sense, most people didn't HAVE a long term in which to turn things around.
I spent decades depressed. Married late, came out of it, plunged back in after the divorce, came back out when I remarried, and now, with an infant son to support, find myself remarkably upbeat despite two cases of cancer, and being diagnosed with cataracts. Makes perfect sense from a social apoptosis standpoint; I'm not a waste, I'm contributing to the next generation, and my hind brain sees that every time I look at my son. I expect I'll be in trouble once he doesn't heed my support anymore, though...
My satire was perhaps too oblique. There really is a problem with genocide here, the Global Brain notwithstanding.
I was depressed before I was fat. Then I treated the depression with SSRI (Sertraline). Then I got really fat. The effect of SSRI on weight is well known -- and a bitch.
I second the comment on depression confering some kind of advantage in how you view the world. Depressed people view the world in a way similar to how Spock from Star Trek views it, in a more logical way. When I do drugs, such as GHb or amphetamines, my depression is temporarily abated and I view te world through a happy persons point of view, and the world is a completely different place.
The only problem is, 99 % of depressed people (myself included,maybe) are not smart enough to utilise the advantages confered by having a depressed brain mode of logical thinking.
This is going to get considerably worse as more patients with depression who do not respond fully to SSRIs or SNRIs (the standard first-lines) are given atypical antipsychotics (AAPs) as well.
These drugs, such as quetiapine/norquetiapine (Seroquel and Seroquel XR) and olanzapine (Zyprexa, or compounded with fluoxetine for Lilly's Symbyax) come with astonishingly high rates of weight gain, glucose/insulin dysregulation, and with prolonged use carry a high risk of cardiometabolic problems such as diabetes, hypercholesterolemia, and high blood pressure.
They have much higher risks in this area than the tricyclics or MAOIs that have been traditionally used for treatment-resistant depression, but no one is promoting the old-school antidepressants.
I hardly need to mention that the AAPs are generally still on-patent...and expensive, and well-promoted.
There is no evidence for any superior/unique efficacy of antipsychotics as antidepressants, other than the fact that the APs are major tranquilizers with massive appetite stimulating properties. (Put the patient to sleep and make them hungry -- that's worth at least 2-8 points on the HAM-D -- and you've got yourself an FDA approval!)
Now, I have seen the prudent use of antipsychotics -- for psychosis, mania, even seriously agitated depression or severe OCD -- but I am alarmed by the promotion of atypical antipsychotics for an ever-widening range of patients.
It sure won't diminish the link between depression and obesity...