Mind/body health: Obesity

Obesity is one of the nation's fastest-growing and most troubling health problems. Unless you act to address the emotions behind why you overeat, you could be facing long-term problems. If you have a very high body mass index (BMI) — that is, your weight is significantly more than what is generally considered healthy for your height — you may be increasing the risk of many serious health conditions, including hypertension, heart disease and stroke, Type 2 diabetes, gallbladder disease, chronic fatigue, asthma, sleep apnea and some forms of cancer.

For women, obesity can lead to problems in the reproductive system. And studies show that severe cases of obesity can reduce your life expectancy, particularly if you are a young adult.

The causes of obesity are rarely limited to genetic factors, prolonged overeating or a sedentary lifestyle. What we do and don't do often results from how we think and feel. For example, feelings of sadness, anxiety or stress often lead people to eat more than usual. Unless you act to address these emotions, however, these short-term coping strategies can lead to long-term problems.

A mind-body interaction

Obesity is also frequently accompanied by depression and the two can trigger and influence each other.

Although women are slightly more at risk for having an unhealthy BMI than men, they are much more vulnerable to the obesity-depression cycle. In one study, obesity in women was associated with a 37 percent increase in major depression. There is also a strong relationship between women with a high BMI and more frequent thoughts of suicide.

Depression can both cause and result from stress, which, in turn, may cause you to change your eating and activity habits. Many people who have difficulty recovering from sudden or emotionally draining events (e.g., loss of a close friend or family member, relationship difficulties, losing a job or facing a serious medical problem) unknowingly begin eating too much of the wrong foods or forgoing exercise. Before long, these become habits and difficult to change.

Binge eating, a behavior associated with both obesity and other conditions such as anorexia nervosa, is also a symptom of depression. A study of obese people with binge eating problems found that 51 percent also had a history of major depression. Additional research shows that obese women with binge-eating disorder who experienced teasing about their appearance later developed body dissatisfaction and depression.

What you can do

Dealing with obesity and similar weight-control problems requires adopting new habits that foster a healthier lifestyle, but don't attempt radical changes to your diet or activity patterns. You risk not only compounding what is already a precarious health situation, but also overlooking the core attitude and emotional issues that caused obesity in the first place.

Instead, consider a team approach that involves several qualified health professionals. Your physician will help you develop a safe plan for losing weight that includes both diet and exercise. A psychologist can help you with the emotional side of the equation-the stress, depression or experiences that caused you to gain weight.

Here are some other things to consider in helping you or someone you know take action against obesity:

• Think about what you eat and why. Track your eating habits by writing down everything you eat, including time of day and amount of food. Also record what was going through your mind at the time. Were you sad or upset with something? Or, had you just finished a stressful experience and felt the need for "comfort food?"

• Cut down on portions while eating the same foods. Along with making dieting feel less depriving, you'll soon find that the smaller portions are just as satisfying. This will also give you a platform to safely curb your appetite even more.

• Note that while treating obesity often helps decrease feelings of depression, weight loss is never successful if you remain burdened by stress and other negative feelings. You may have to work to resolve these issues first before beginning a weight-loss program.

• Losing weight is always easier when you have the support of friends and family. Try to enlist the entire household in eating a healthier diet. Many hospitals and schools also sponsor support groups made up of people who offer each other valuable encouragement and support. Research shows that people who participate in such groups lose more weight than going it alone.

• Use the "buddy system." Ask a friend or family member to be "on-call" for moral support when you're tempted to stray from your new lifestyle. Just be sure you're not competing with this person to lose weight.

• Don't obsess over "bad days" when you can't help eating more. This is often a problem for women who tend to be overly hard on themselves for losing discipline. Look at what thoughts or feelings caused you to eat more on a particular day, and how you can deal with them in ways other than binge eating. A psychologist can help you formulate an action plan for managing these uncomfortable feelings.

The American Psychological Association gratefully acknowledges the assistance of Sara Weiss, PhD, and Nancy Molitor, PhD, in developing this fact sheet.