Excess Belly Fat Linked to Depression
Tom Valeo, Evansville Courier & Press
Posted Nov 26, 2012
Accumulating fat around the belly has long been linked to
metabolic syndrome, a collection of problems that include high
blood pressure, cholesterol and blood glucose. Recently, metabolic
syndrome was linked to a greater risk of Alzheimer's disease and
other forms of dementia later in life. Now depression has been
added to the list of ailments linked to excessive belly fat, and
losing weight through dieting doesn't seem to reverse the problem.
"Weight gain is the major contributor to metabolic syndrome and
depression, but we also observed that in many people who are obese,
losing weight is not enough to reduce the symptoms of depression,"
said An Pan, a nutritionist at the Harvard School of Public Health
and one of the authors of the study, which appears in a recent
issue of Diabetes Care. "In fact, losing weight by dieting may
actually increase stress and depressive symptoms."
A better approach, he says, would involve more exercise, which
helps the body burn some of the deep fat packed around abdominal
organs - the cause of the large belly often carried by people with
metabolic syndrome. He encourages those wanting to lose weight to
eat a healthy diet and participate in physical activity. Pan also
recommends psychiatric counseling for people who are depressed.
The paper found evidence of a vicious cycle - metabolic syndrome
contributes to depression, and depression contributes to metabolic
syndrome, apparently by causing people to overeat.
Pan and the other authors of the paper suggest several possible
mechanisms for this two-way interaction.
For example, depression affects the metabolism in ways that could
increase blood pressure, reduce the body's ability to absorb
glucose and promote the accumulation of belly fat. Also depressed
people are more likely to lack the motivation to get exercise.
On top of that, some antidepressant medications promote weight
In the other direction, metabolic syndrome promotes inflammation,
which has been linked to depression, and makes the body less
sensitive to leptin, the hormone that suppresses appetite after
Low levels of leptin, as well as leptin insensitivity, have been
shown to produce depressive symptoms. Also, damage to blood vessels
in the brain caused by high blood pressure and other consequences
of metabolic syndrome may produce symptoms of depression, and are
believed to promote dementia, as other studies have found.
Another study, just published in the journal
Neuropsychopharmacology, reports that pioglitazone, a drug that
helps prevent diabetes by enhancing the body's sensitivity to
insulin, also appears to boost the effectiveness of antidepressants
in people with major depression.
The drug helped even when taken by depressed people who didn't
have the metabolic problems that signal the approach of diabetes.
The authors believe that pioglitazone (sold as Actos) counteracts
depression by helping the body use glucose more efficiently, just
as exercise does.
Apparently the accumulation of belly fat, which may be a
consequence of too much sugar in the blood, also contributes to
elevated blood sugar and several other problems, including
"I think the major message of our paper is that depression,
cardiovascular disease, stroke and other problems begin early even
in people who do not have diabetes," said Pan.
"So prevention should begin early for people with metabolic
syndrome. We should pay attention to their mental health, and for
people with mental health problems we should monitor their blood
glucose, blood lipids and blood pressure to control their risk of
cardiovascular disease and stroke."
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