Guess That’s Why They Call It the Blues: Women, Depression and Obesity

By Anna Stoto, Member of The George Washington University’s Research Team for the STOP Obesity Alliance

How are depression and obesity related for women?  On December 9, 2010, the Society for Women’s Health Research hosted “Holiday Blues: Women, Depression, and Obesity,” a briefing which addressed that very question.  Four panelists each provided a different piece of the context around the issue and suggested ways to move forward.

Depressive symptoms often predict the development of obesity, found Lauren Shomaker, Ph.D., a fellow in the Section on Growth and Obesity in the Program in Developmental Endocrinology and Genetics at the Eunice Kennedy Shriver National Institute of Child Health and Human Development.  Dr. Shomaker’s presentation revealed that the increased instance of obesity among teens who displayed depressive symptoms is related to greater food intake, including foods that are high in fat and sugar, as well as eating patterns which reflect a loss of control.

Belinda Needham, Ph.D., of the University of Alabama, examined the temporal relationship between depression and obesity, studying subjects over a 20-year period.  Dr. Needham’s study indicates that depression often causes weight gain, leading to obesity.  Women, the study found, were twice as likely to experience a depressive incident as men.  Furthermore, women began the study with a higher body mass index (BMI) which increased at a faster rate.[1]

Christine Ferguson, Director, STOP Obesity Alliance, and a professor at the George Washington University Department of Health Policy, provided additional context for the discrepancies between men and women related to obesity.  Ferguson presented the results of her team’s study calculating the annual costs of overweight and obesity for women and men using medical and employment data.  Women who are obese, the study found, incur an average of $4,879 each year in additional costs related to obesity, which is nearly twice the $2,646 incurred by men.  This difference, it turns out, is largely driven by non-medical factors, primarily job-related costs such as lost wages.  This finding is further supported by a 2006 study in which 25 percent of participants – women who were overweight or obese – reported experiencing job discrimination because of their weight.  In addition, 54 percent reported weight stigma from co-workers or colleagues and 43 percent reported experiencing weight stigma from employers or supervisors.[2]

The background for depression and obesity among women presents a fairly grim picture.  However, one group is working to improve the situation: the Holyoke Health Center in Massachusetts.  Jay Breines, Executive Director, presented a program the community health center developed to help patients learn how to self-manage their weight.   Based in a primarily Puerto Rican community in Massachusetts, the patient self-management program uses “promotoras” (community leaders) to help engage the community and teach them about nutrition and physical activity.  This model has been remarkably successful and has used innovative, interactive techniques to help one community in Holyoke attain a healthy weight.  These include nutrition classes, support group meetings, exercise classes, a teaching kitchen, and a class held at a grocery store.

 

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[1] Needham BL, Epel ES, Adler NE, Kiefe C.  “Trajectories of change in obesity and symptoms of depression: the CARDIA study.  Am J Public Health. 2010 Jun;100(6):1040-6. Epub 2010 Apr 15.  Available from: http://www.ncbi.nlm.nih.gov/pubmed/20395582

 [2] Puhl, R., & Brownell, K.D. (2006). Confronting and coping with weight stigma: An investigation of overweight and obese individuals. Obesity, 14, 1802-1815.