Rates of obesity and clinical depression are on the rise. Experts predict nearly 50% of Americans will have obesity by 2030. And nearly 30% of US adults report a depression diagnosis at some point in their lives — a rate increase of 10% since 2015. That’s an alarming trajectory considering obesity and depression both heavily contribute to chronic disease, death, disability, and the ever-increasing cost of health care.
Obesity and depression aren’t separate problems: current evidence shows they often go hand in hand, with one condition fueling the other — leading to ever increasing complications. If we want to get a handle on the $4.5 trillion dollars spent on chronic conditions every year in the US, it’s time we treat obesity and depression together as interconnected conditions.
Obesity and Depression share similar health risks…
Numerous studies underscore the bidirectional nature of obesity and depression, emphasizing that people with obesity are 55% more likely to develop clinical depression, while those with depression experience a 58% heightened risk of obesity. The data points to a connection beyond mere coincidence and makes a compelling case for integrating behavioral and physical health care to comprehensively address these co-occurring conditions.
Like obesity, clinical depression is a major risk factor for cardiometabolic disease, cardiovascular disease, stroke, Type 2 diabetes, dementia, autoimmune disorders, and premature death. The shared risks of obesity and clinical depression prove we urgently need to integrate mental and physical healthcare more often.
…and costs to productivity
While the risks of obesity are well established, many don’t realize the longstanding health and economic consequences of depression. According to the World Health Organization, depression is a leading cause of disability among working-age people — affecting 350 million people worldwide.
Depression alone carries a hefty economic burden, costing US employers approximately $187.8 billion annually in health care, absenteeism, and lost productivity. The National Institute for Mental Health advocates that alleviation of clinical depression is an important tool in both preventing and treating chronic physical health conditions, which overwhelm our healthcare system, families, workplaces, and the economy. Addressing depression not only improves individual well-being but helps alleviate the substantial financial strain on employers, highlighting the societal benefits of integrated care.
Weight loss can benefit physical and mental health — but it can also complicate it
There is promising evidence that weight loss may improve symptoms of depression in individuals with both obesity and depression. Some even predict that new weight loss medications like GLP-1s will bring mental health benefits too. Yet, it’s clear that we can’t simplify the mental health needs of those living with obesity down to a maxim of “skinny makes you happy.”
The weight loss journey itself often brings complicated feelings to the surface. People undergoing significant weight loss, such as after bariatric surgery or taking GLP-1s, need prolonged mental health support throughout their experience. During and after weight loss, people face substantial changes in their relationships, coping strategies, and self-image. While mental well-being may initially improve, studies show increased mental health visits following significant weight loss after bariatric surgery. We can assume people would have similar experiences on GLP-1s. If we want weight loss outcomes to last, we need to provide mental health support.
Cognitive behavioral therapy is integral to clinical obesity treatment
The most hopeful and impactful commonality in these twin epidemics is that both respond extremely well to interventions. Most people who experience depression also have other issues in their lives, but with treatments like CBT, they can get symptom relief in 10-12 weeks. CBT is an ideal treatment to accompany preventative efforts like weight loss. Studies have found CBT to be as effective as antidepressant medications without the counterproductive side effect of potential weight gain. Additionally, CBT prepares patients for the anticipated challenges to relationships, self-image, and coping strategies that Troisi cautions for those who have significant weight loss and lifestyle change.
Innovative cardiometabolic solutions pave the way forward
The case for integrated behavioral and physical health care is imperative; we can’t ignore one side of the coin. Mental health conditions like clinical depression impact the same chronic illnesses as obesity. And traditional healthcare models don’t do enough to address these comorbidities.
We need innovative care pathways that bring together physical and mental health under one umbrella. Some virtual cardiometabolic solutions are paving the way by providing multidisciplinary care teams made up of physicians, registered dietitians, therapists, and more to get at obesity and depression from all angles.
Adopting an integrated approach enhances individual well-being, decreases the risk of chronic diseases, reduces economic burden, and improves overall health. As we navigate the complex landscape of human health, integrated care stands as a beacon of comprehensive and holistic support, acknowledging both sides of the coin.
Claudia Ryan
Claudia Dillon Ryan is a Licensed Clinical Social Worker (LCSW) with extensive experience in healthcare and mental health. She holds a Bachelor of Social Work from Virginia Commonwealth University and a Master of Social Work from the University of Maryland. Claudia has held significant roles at the National Institutes of Health (NIH), Virginia Commonwealth University (VCU) Medical Center, Bon Secours-Richmond Health System, and Vida Health. At Vida Health, she serves as Senior Director of Therapy and Care Navigation, overseeing all mental health programs. Claudia specializes in integrated behavioral health, CBT, Motivational Interviewing, and trauma-informed care. At Vida Health, she has developed CBT programming for integrated behavioral health and weight loss. She has been a committed advocate for mental health in health care through her work with the Greater Richmond Trauma-Informed Community Network. Her career is marked by a dedication to integrated behavioral health and supporting healthcare professionals.
