Later On

A blog written for those whose interests more or less match mine.

The tantalizing link between obesity and depression

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I saw this article and was intrigued. Two weeks ago I started taking an antidepressant (Pristiq, which seems to work well across genetic types because it doesn’t depend on specific metabolic pathways as do other depressants, which must be metabolized to work; Pristiq does not require that). After a couple of days, I noticed that my appetite was much closer to normal: one good bowl of stew, for example, satisfied me, when before it had taken two, plus a late-evening snack. It really seemed as though whatever was driving my need to consume food had let up a lot. In the past two weeks, I’ve shed 5 lbs without effort.

Shefali Luthra reports in Politico:

About 15 years ago, Sue McElroy, a psychiatrist in Mason, Ohio, started noticing a pattern. People came to see her because they were depressed, but they frequently had a more visible ailment as well: They were very overweight.

McElroy was convinced there had to be a connection. “Many of my [depressed] patients were obese. And they were very upset by obesity,’’ McElroy recalled. ”I looked into the literature, and it said there was no relationship. It didn’t make sense.”

That disconnect has started to change, promising new avenues for treatment but also presenting a puzzle: Just how can you chart the relationship between the two? And how to link treatment of two disorders that exist in totally different parts of the health care system?

Ingrid Donato, a top official in the federal agency that promotes mental health treatment, says that both conditions are on the rise, heightening the need to unlock the connection and develop treatments that address both conditions simultaneously. “You can’t address obesity in a person that’s struggling with major depression without addressing that major depression,” said Donato, chief of mental health promotion at SAMHSA, the Substance Abuse and Mental Health Services Administration.

But how to address it? That’s a puzzle—one whose solution lies partly in policy, partly in research. The relationship between obesity and depression is what researchers call “bidirectional”: Being obese or overweight ups the odds of depression, and vice versa. For example, about 43 percent of people with depression are obese, according to the federal Centers for Disease Control and Prevention, compared with a third of the general population. People who are obese are 55 percent more likely to be depressed, and people with depression 58 percent more likely to develop obesity, according to one 2010 study. “This is a massive public health issue when you have numbers that large,” Donato said.

While on the surface the two conditions appear to be very different, they share some important similarities. Both are chronic diseases that are tricky to treat, requiring long-term physical and mental health interventions. When the two conditions occur at the same time, treatment becomes even more complex, with the best outcomes resulting from coordinated care from a range of professionals – doctors and nurses as well as dietitians, behavioral health specialists and physical therapists – all working together to address the full spectrum of a patient’s needs.

That kind of coordinated care is still a rarity in many parts of the U.S. health care system.

“We need to find synergistic therapies—or it’s going to be the same kind of messy system in which we spend a lot of money and don’t get any return,” said William Dietz, director of George Washington University’s Sumner M. Redstone Global Center for Prevention and Wellness, who researches obesity interventions.

A growing body of evidence supports the idea that this kind of coordinated approach could help address both diseases in tandem. A 2011 paper by researchers from the University of Texas-Southwestern found that patients’ depressive symptoms were reduced when physicians gave them prescriptions for weekly exercise sessions, which were supervised at the Cooper Institute in Dallas or at the patient’s home. And in 2014, a study at Duke University found that simply helping obese women maintain their weight—via small lifestyle changes and monthly dietitian check-ins—cut their rates of depression in half.

Still, this kind of care-syncing is not yet the norm. While the Affordable Care Act promoted coordinated care as part of its efforts to lower costs, those initiatives haven’t yet been directed toward depression and obesity. . .

Continue reading.

Written by LeisureGuy

13 August 2017 at 9:12 am

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