Eating behaviors and moods

The urge to eat in response to emotional distress is not only a psychological pattern or habit ingrained in childhood, but may represent a physiological response to changes in fundamental brain chemistry. For this reason, treatment of the underlying anxiety and depression can often remove the urge to overeat and provide the motivation and confidence necessary to succeed in a dietary program. This is especially true with compulsive overeating or binge eating disorder.

Many people who have suffered with depression off and on throughout their lives assume that it is simply a part of their existence — something to be tolerated like one's height or eye color. In reality, however, people who tire easily, have trouble getting started, feel tired and weak, want to oversleep, or have trouble sleeping,often suffer from a medical disorder, much like high blood pressure or diabetes. Medications that are helpful in reversing these symptoms of depression can also help prevent recurrences.

Many people wonder how a pill could help with sadness or anxiety or if it is only a crutch. They are confusing the ordinary and universal human conditions, such as frustration, disappointment, adversity, job dissatisfaction, and failure in relationships with depression, an excessive physiological response to stress.

Depression in the medical sense means that certain vital functions, including eating, sleeping, energy, concentration, and activity, have been altered. When people show changes in many of these areas at the same time, they are reflecting a fundamental shift in the brain chemistry that regulates daily vital functions. This over-response to stress may eventually resolve on its own, but this process can take months or even years, leaving the person's life devastated and disrupted.

Clinical studies of outpatients with depression show that weight gain is one of the most common symptoms.  Appropriate treatment with newer antidepressants significantly reduces the urge to overeat, restores normal appetite function, and improves the motivation and commitment to follow through on a dietary program. This is especially important in the acute phase of weight loss, when so many people who have had weight problems are vulnerable to failure and defeat their intense efforts.

Part of a comprehensive evaluation of obese individuals is to determine whether they are experiencing depression and could benefit from appropriate medications. Comprehensive physical examinations, laboratory tests, and sometimes endocrine tests, can be extremely helpful in identifying the patients who can benefit from antidepressant therapy.

Click here for general information on depression

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My sincere appreciation to David Sack, M.D. for his assistance and commentary.