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The Insider’s Guide to Healthy Hawaii: How Obesity Affects Your Mental Health

The Insider’s Guide to Healthy Hawaii: How Obesity Affects Your Mental Health

Your weight can up your risk of anxiety and depression.

Nearly 24 percent of Hawaii’s adults are obese, according to The State of Obesity, a report issued by the Trust for America’s Health and the Robert Wood Johnson Foundation. And that number is on the rise. An estimated 15.7 percent of adults in Hawaii were obese in 2000, up from 8.9 percent in 1990. It’s well established that carrying an excessive amount of body fat increases the risk for a slew of chronic health conditions, including blood pressure, high cholesterol, type 2 diabetes and heart disease, which is the leading killer of US men and women.

"There's not one medical discipline that obesity doesn’t touch,” says Michael L. Green, Jr., MD, the bariatric medical director with Medical City Fort Worth in Fort Worth, Texas.

What some people may not realize is that obesity can also take a toll on your mental and emotional health, making daily activities like socializing, dating and even traveling more challenging. Taking steps to lose weight by making lifestyle adjustments could help ease the mental and physical burden associated with the condition.

The emotional toll of obesity
“We need to understand all of the social, physical and mental components of obesity,” Green says.

Anxiety, for example, is a mental health issue that affects about 19 percent of US adults each year—and it's thought that obesity may raise your risk for the condition. An October 2016 study of nearly 76,000 adults between 18 and 85 years of age found that obese adults are more likely to be diagnosed with anxiety than those who are a normal weight.

Green attributes this to the “the social stigma placed on individuals, which may make them feel uncomfortable in their own skin.” Obese people may fear being humiliated by doing things like going to the mall, working out at the gym or flying, where they may have to request a seatbelt extender or be asked to purchase two airline seats.

Anxiety disorders are frequently associated with depression, which affects about 16 million US adults every year. In fact, roughly 43 percent of adults with depression are also obese, according to the U.S. Centers for Disease Control and Prevention.

People affected by depression feel sad or hopeless and might lose interest in activities they once enjoyed. They may also be irritable, restless and have trouble sleeping.

“Sometimes people don’t feel good about themselves, because they're fatigued and can't get around to do what they want to do," suggests Green. "Or, they're short of breath from walking, so they can become depressed.”

Genetics could also play a role. Researchers in the UK analyzed 73 genetic markers linked to a high body mass index (BMI) to investigate the causal relationship between obesity and the mood disorder. The November 2018 study, which was published in the International Journal of Epidemiology, involved about 49,000 adults between 37 and 73 years old with depression and more than 290,000 similar people who did not have the condition. They found that genes associated with high BMI but low risk for metabolic diseases, like diabetes, were associated with greater odds for depression, particularly among women. These findings suggest that excess body fat is associated with an increased risk for depression, even in the absence of inflammation and other physiological effects of obesity.

How weight affects relationships
Your weight, along with the emotional toll of being obese, may impact relationships with those closest to you. Anxiety and depression can make social activities less desirable. Just leaving the house may be a challenge. This can cripple your ability to grow and maintain connections with the people you love.

Your intimate relationships may suffer as well. Feelings of inferiority related to your weight may:

  • Make you less likely to date or go on dates in public
  • Cause you to accept less than you deserve, or keep you in an unhappy relationship
  • Negatively impact your performance in the bedroom

Physically, excess body weight can also lower your libido, as well as up a man’s risk for erectile dysfunction, making sex very difficult. This can contribute to anxiety, depression and low self-esteem.

A 2013 study of 408 women bolsters the connection between appearance, including weight, and self-esteem. Low self-esteem was more prevalent among participants who felt their body type did not fit the norm or mimic the “ideal.” Lower rates of healthy eating were also reported among women with low levels of self-confidence. This creates an unhealthy cycle of feeling down, eating poorly and continuing to pack on the pounds.  

What you can do about it
According to 2013 guidelines released by the American Heart Association (AHA), American College of Cardiology and The Obesity Society, obesity is considered a disease, and healthcare providers (HCPs) are urged to treat it as such.

If you’re struggling with either depression, weight loss or both, start by speaking with your HCP. They will be able to help you figure out the next steps towards treating both conditions.

A March 2019 study published in JAMA found that integrating weight loss treatment and problem-solving therapy with as-needed antidepressant medication led to reductions in both weight and depressive symptoms compared with usual care. While the availability of integrated therapy and weight loss programs is limited, it’s important to keep each one of your healthcare professionals informed about the various treatments. They can better work as a team to treat both conditions.

A doctor may suggest implementing a few lifestyle changes, including but not limited to:

  • Eating a healthy, balanced diet
  • Moving your body
  • Getting enough sleep
  • Limiting alcohol and caffeine intake
  • Taking time to relax, meditate or practice yoga
  • Spending time outside during daylight hours

“Don't let someone get in the way of you becoming a healthier you,” says Green. “Get out and be confident, then we can start finding solutions for you.”

This article was updated on April 9, 2019.

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