I was recently interviewed by a journalist about weight issues and mental health. Here are my responses.
Is being overweight related to our mental health?
There is an interplay between weight and mental health. Being overweight may be linked to mental health conditions such as mood disorders, personality disorders or eating disorders (binge eating). The individual may eat more than usual and undertake less activity, or their motivation to exercise may be lessened.
Equally being overweight or obese can affect self-confidence and trigger a depressed mood. A vicious cycle of low mood and overeating can be established. ‘Emotional eating’ to soothe emotions such as stress, sadness or anxiety can occur, and cause a great deal of distress and sabotage efforts to lose weight.
Mental illness may co-exist with alcohol abuse, and alcohol has many calories. Some people self-medicate with alcohol when anxious or depressed.
Does your mental health play an important role in your weight and living a healthy lifestyle?•
It does play an important role.
• Having a positive mood and outlook can assist us in eating healthily and exercising.
• Stress or anxiety may trigger us to eat more or look to carbohydrates to soothe ourselves.
• Not sleeping well, which may occur in mood disorder or anxiety, makes us tired, and again we often look to food for energy.
• Some conditions such as mood disorders and schizophrenia can adversely affect motivation, and we need motivation to eat healthily and to exercise.
Would you say compulsive eating and over eating are serious mental illnesses?
Occasional over eating is not uncommon, but when the individual repeatedly engages in binge eating episodes where a large amount of food is eaten in a short period of time, with a sense of loss of control over the eating, then we talk about Binge Eating Disorder (BED). The person may not be able to stop even if they want to. BED is distressing and is often associated with anxiety, depression or personality disorder.
How does diet affect your mental health?
Our body and mind need regular nutrition. The brain in particular uses a lot of energy. It is best to eat regularly to ensure the brain has a supply of energy and can function well. Skipping breakfast or lunch is not a good idea as we need food to sustain us during the day. It is better to eat three meals a day, to stimulate our metabolism, rather than just one large meal at night when we are also going to be inactive and thus more likely to store the energy as fat.
We need amino acids from protein (such as in meat and dairy foods) which are precursors for neurotransmitters or chemicals within the brain which help us think and also feel good. Remember too that some vitamin deficiencies, such as low Vitamin B12 or Vitamin D, can be associated with depressed mood, as can low iron levels.
What psychological issues lead people to over eat?
Many emotions can be related to eating food for comfort, including boredom, stress, sadness and loneliness. When there is episodic overeating which is hard to control, we think about Binge Eating Disorder. Low mood or anxiety can also trigger overeating. Sometimes past traumas are present.
Some medications, such as some antidepressants plus antipsychotic drugs (such as those used to treat schizophrenia), can trigger weight gain.
What help is available to people who are overweight?
Some psychologists, mental health professionals or medical practitioners have an interest in weight-related issues. They can assess for any mental health issues and a doctor can also screen for any related physical problems (such as thyroid disorders). They will look at learnt messages about food, such as ‘eat everything on your plate’, and assess readiness to change behaviours. Information about eating and mental health can be provided, and goals set. Seeing a dietician can be very helpful too. They can assist you with dietary measures, understanding and support.
General lifestyle issues can be addressed, including drinking enough water, exercising regularly and reducing stress. Mindfulness of eating is a very useful tool to raise awareness about food being consumed. Cognitive behaviour therapy can assist in identifying triggers to overeating and to monitor moods and thoughts. Sometimes we think in ‘black and white’ ways, and might say to ourselves, ‘well, I’ve had some chocolate now, the day is ruined, I may as well have the rest of it.’
The individual can learn to soothe emotions in ways other than food and engage in activities they enjoy. Sometimes relationship issues are contributing to the overeating and these need to be addressed. Hypnotherapy can also assist. Self-care is important, such as having a regular massage, as is recognising successes.
At Dr Cate Howell and Colleagues, several of the clinicians have a particular interest in weight-related issues. Dr Cate is currently writing an e-book on EMOTIONAL EATING which will soon be available on the website. Watch out for it!