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Around 9% of adult Americans have depression, and at any given time, around 3% have major depressive disorder, a more severe and long-lasting form of depression. For Americans between ages 15 and 44, major depression is the leading cause of disability, according to the Centers for Disease Control. In some cases, being overweight and being depressed go together, and rates of both obesity and depression are increasing in the United States. Could losing excess weight break the cycle of depression for some people?
What Is Obesity?
Obesity may be defined in a couple of different ways. The body mass index, or BMI, is the primary way of measuring obesity. “Morbid obesity” was defined in 1991 by the National Institutes of Health as a BMI of greater than 35. Later definitions put morbid obesity at a BMI of 39 or greater. Obesity is also sometimes defined as having body weight more than 50% greater than a person’s ideal body weight. So-called class-1 obesity, which is less severe than morbid obesity, is defined as a body weight 20% to 35% greater than the ideal for the person’s height. Obesity is correlated with numerous health problems, including increased risk of heart disease, high blood pressure, diabetes, and osteoarthritis.
What Is Depression?
Depression has a psychological component affecting mood, and a physical component that affects bodily functions like sleep, energy levels, and appetite. Cognitive markers of depression include, but aren’t limited to:
- Pessimism
- Feelings of guilt or inadequacy
- Self-loathing
- Suicidal thoughts
- Feelings of worthlessness
Physical symptoms of depression include, but aren’t limited to:
- Loss of pleasure
- Loss of energy
- Changed sleep patterns
- Changed appetite
- Fatigue

Which Came First, and Does It Matter?
Researchers don’t know whether obesity causes depression or whether depression causes obesity, but the two are linked. Some professionals consider obesity and depression a “double epidemic.” Studies of people seeking weight-loss surgery have found that two-thirds of these patients have a history of at least one mental health disorder. Complicating matters further, many of the medications people take for mental health issues including depression can cause weight gain. Ultimately, the answer to this chicken-or-egg question may not matter, because successfully treating depression can help people be motivated to lose weight, and successfully treating obesity can help people overcome depression.
Studies of Depression in Bariatric Surgery Patients
A study of over 2,000 patients at Scottsdale Bariatric Center evaluated patients for depression both before and after weight-loss surgery and after additional post-surgical weight loss. Specifically, the study defined “improvement of depression” as:
- Reduced thoughts of worthlessness and personal failure
- Reduced feelings of sadness, crying, and mood swings
- Increased energy and better sleep patterns
Six months after surgery, the decrease in excess body weight was accompanied by an average 13% decrease in symptoms of depression. After a year, researchers found a drop of 18% in markers for depression. So it appears that tackling weight problems can positively affect mood as well.
Xenical and Weight Loss
Xenical is the only FDA-approved drug for long term use in weight loss efforts. Unlike other prescription weight loss drugs that affect brain chemistry, Xenical works in the digestive tract, reducing the amount of fat that is absorbed from foods. It is the top-selling weight loss drug for a simple reason: it gets results. And while specific double-blind studies of Xenical and depression have not been conducted, studies of bariatric surgery patients indicate that weight loss is often accompanied by improvement in symptoms of depression. It makes intuitive sense that obesity exacerbates depressive symptoms due to social isolation, ridicule, and body image issues, and that tackling weight problems can have positive results for people dealing with depression.
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