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The Bidirectional Relationship Between Depression and Obesity


An association between obesity and poor mental health, particularly depression, is becoming increasingly recognised. Research indicates a bidirectional relationship between the two (Milaneschi et al., 2019), with each condition exacerbating the other through intricate biological, psychological, and behavioural mechanisms.

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Biological Mechanisms:

There are several biological mechanisms relating to depression and obesity. Dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis (Ouakinin et al., 2018) and genetic predisposition  (Herrera & Lindgren, 2010; Mullins, N & Lewis, 2017) play pivotal roles. Chronic stress, a prevalent symptom of depression, can disrupt cortisol levels, fostering the accumulation of abdominal fat and subsequent weight gain  (Van der Valk et al., 2018). Moreover, neurotransmitters like serotonin and norepinephrine also play significant roles in both conditions, influencing mood regulation and appetite control (Hainer, et al., 2006).

Psychological Factors:

Psychological factors can also contribute to the relationship between depression and obesity. Eating is a common coping mechanism for individuals dealing with depression, which can lead to weight gain. Additionally, dissatisfaction with one’s own body and low self-esteem associated with obesity can also exacerbate depressive symptoms (Son & Kim, 2012; Moradi et al., 2021). These can combine to create a vicious cycle of negative emotions and maladaptive behaviours.

Sociocultural Influences:

Other factors, including socioeconomic status, cultural norms and access to health resources, also play a role in the relationship between depression and obesity. Individuals from disadvantaged backgrounds can often face barriers to accessing healthy food options (Ravikumar et al., 2021), safe environments for physical activity (Timperio et al., 2015) and health services (Kirby and Kaneda, 2006), exacerbating both obesity and depression. Similarly, stigma and discrimination surrounding obesity and mental illness can further compound psychological distress and hinder the development of help-seeking intentions.

Intervention Strategies:

Addressing the complex relationship between depression and obesity does require an integrated approach. Treatment strategies should encompass both mental health and weight management interventions, tailored to individual needs and preferences. Cognitive behavioural therapy (CBT), lifestyle modifications and drug therapy (Cao et al., 2022) could become part of the treatment, depending on the severity of the conditions.

Promoting Holistic Well-being:

Promoting holistic well-being involves addressing not only the symptoms but also the underlying factors contributing to both depression and obesity. This includes fostering social support networks, promoting healthy coping mechanisms and reducing stigmatism surrounding mental illness and obesity (Dandgey & Patten, 2023). By adopting a multidisciplinary approach that addresses biological, psychological, and sociocultural aspects, individuals can become better supported in their journeys towards improved mental and physical health.

smiling and frowning face stickers being held up against a blue background



The intricate relationship between depression and obesity underscores the interconnectedness of mental and physical health. Recognising and addressing this relationship is crucial for healthcare providers, policymakers, and society as a whole to combat the burden of both these conditions effectively.


Almeida, O. P., Pirkis, J., Kerse, N., Sim, M., Flicker, L., Snowdon, J., ... & Pfaff, J. J. (2012). Socioeconomic disadvantage increases risk of prevalent and persistent depression in later life. Journal of Affective Disorders, 138(3), 322-331.

Cao, B., Xu, J., Li, R., Teopiz, K. M., McIntyre, R. S., & Chen, H. (2022). Interventions targeting comorbid depression and overweight/obesity: A systematic review. Journal of Affective Disorders, 314, 222-232.

Dandgey, S., & Patten, E. (2023). Psychological considerations for the holistic management of obesity. Clinical Medicine, 23(4), 318.

Hainer, V., Kabrnova, K., Aldhoon, B., Kunesova, M., & Wagenknecht, M. (2006). Serotonin and norepinephrine reuptake inhibition and eating behavior. Annals of the New York Academy of Sciences, 1083(1), 252-269.

Herrera, B. M., & Lindgren, C. M. (2010). The genetics of obesity. Current diabetes reports, 10, 498-505.

Kirby, J. B., & Kaneda, T. (2006). Access to health care: does neighborhood residential instability matter?. Journal of Health and Social Behavior, 47(2), 142-155.

Milaneschi, Y., Simmons, W. K., van Rossum, E. F., & Penninx, B. W. (2019). Depression and obesity: evidence of shared biological mechanisms. Molecular psychiatry, 24(1), 18-33.

Moradi, M., Mozaffari, H., Askari, M., & Azadbakht, L. (2021). Association between overweight/obesity with depression, anxiety, low self-esteem, and body dissatisfaction in children and adolescents: a systematic review and meta-analysis of observational studies. Critical Reviews in Food Science and Nutrition, 62(2), 555-570.

Mullins, N., & Lewis, C. M. (2017). Genetics of depression: progress at last. Current psychiatry reports, 19, 1-7.

Ouakinin, S. R., Barreira, D. P., & Gois, C. J. (2018). Depression and obesity: Integrating the role of stress, neuroendocrine dysfunction and inflammatory pathways. Frontiers in endocrinology, 9, 358454.

Ravikumar, D., Spyreli, E., Woodside, J., McKinley, M., & Kelly, C. (2021). A rapid review of factors influencing food decisions among economically disadvantaged families. European Journal of Public Health, 31(Supplement_3), ckab165-401.

Son, Y. J., & Kim, G. (2012). The relationship between obesity, self-esteem and depressive symptoms of adult women in Korea. The Korean journal of obesity, 21(2), 89-98.

Timperio, A., Veitch, J., & Carver, A. (2015). Safety in numbers: does perceived safety mediate associations between the neighborhood social environment and physical activity among women living in disadvantaged neighborhoods?. Preventive medicine, 74, 49-54.

Van der Valk, E. S., Savas, M., & van Rossum, E. F. (2018). Stress and obesity: are there more susceptible individuals?. Current obesity reports, 7, 193-203.


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