A 'vicious circle' of depression and obesity

Kolkata: More than 30% of obesity patients in the city could be suffering from depression, said a study. Conducted by bariatric surgeons and psychiatrists, the study also claims that obesity-induced depression has never been more prevalent in Kolkata - and most patients were women.
Scrutiny and disapproval by peers on social media has made it so that depression and obesity now form a vicious circle that has been getting tougher to break out of, the report said.
"It is well-established that being fat tends to make you sad, eventually leading to depression. This is probably truer for women since they attach a lot of importance to their body image. More often than not, obese people try to beat their blues by eating more and end up accumulating more fat, which in turn makes them more depressed," said Om Tantia, bariatric surgeon at ILS Hospital, Kolkata.
Those who are active on social media, specially youths, were more conscious of their appearance and tended to slip into depression faster. than the rest, the study said. Response to posts and pictures on Facebook, Twitter and Whatsapp are taken very seriously by the overweight and were often responsible for depression.
"Social media is now the mirror. Response to posts and pictures is taken to be the real indicators of an individual's popularity," said Siladitya Ray, psychiatrist.
He cited the instance of a 28-year-old executive who quit her job and cut herself off from everyone after a series of her posts failed to draw any response on Facebook. "She was marginally overweight, but her depression made her overeat for weeks and she ended up weighing 92kg in two months," Ray said. The woman had to be counselled for weeks and has since joined a gymnasium.
Obese people turn depressed due to three major reasons - low self-esteem, altered self-perception and poor sex life, said Sarfraz Baig, consultant bariatric surgeon at Belle Vue Clinic. "Frequent attempts to control diet leave them frustrated. Food is an emotional stimulant and curbing it leaves you sad. Self-perception is very important and it could lead to an emotional distress if there's a sudden alteration in the way one looks. Poor professional performance is another important trigger. Obese people can't work hard and are taken to be lazy. Finally, being overweight affects the sex life and leads to an emotional distance between partners, which is bound to cause depression," explained Baig.
The depressed were physically less active and usually had a low basal metabolic rate, which made them put on weight quickly, said Tantia. "It becomes difficult to dissuade them from eating and after a stage they reach a point of no return. Many tend to indulge in binge eating as well. Bariatric surgery is the only option for such patients, though often it has to be supplemented with counselling," he said.
However, it is debatable if obesity creates depression or it is the other way round, felt Baig. "For endogenous depression or that which is triggered by clinical factors, weight loss surgery doesn't work. It is often genetic or is caused by biological or psychological factors. For exogenous depression or the one caused by external factors, surgery helps," said Baig.
Sudden onset of depression should be taken seriously for it is often the first indicator of obesity, resulting in diabetes, said Debashish Basu, consultant diabetologist, Apollo Gleneagles Hospital. "An overwhelming majority of diabetics in Kolkata are not only overweight, but also suffer from depression. One leads to another till both depression and the resulting illnesses go out of control," said Basu.
Experts said obese people have a 20% higher risk of lapsing into depression. Depressed people often have unregulated levels of cortisol hormone in their blood, which prompts overeating and increased fat tissue production. "Even a 20% weight loss can significantly reduce depression," said Tantia.