This article is an excerpt from the Shortform book guide to "Lost Connections" by Johann Hari. Shortform has the world's best summaries and analyses of books you should be reading.
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What is the link between depression and obesity? Why is it so difficult for depressed people to shed weight successfully?
Establishing the link between depression and obesity requires an understanding of why depressed people put on weight. They put on weight as a subconscious effort to protect themselves from feeling vulnerable again. Shedding weight becomes very difficult because they will lose the sense of safety that comes with it.
Read on to learn more about the relationship between depression and obesity.
The Depression and Obesity Link
Researchers didn’t discover the link between depression and obesity until the 1980s. The discovery itself was the accidental product of a study that was completely unrelated to depression. In that study, Dr. Vincent Felitti put people who were dangerously overweight on a medically supervised extreme diet. Most people did lose weight, but there was a catch: Those who lost the most weight also started experiencing intense anxiety and depression. Many of them dropped out of the program and quickly put all the weight back on.
Instead of simply moving on without these participants, Felitti reached out to them to ask what happened—why would they suddenly run away when they’d already achieved so much? In a series of interviews, he discovered the depression and obesity link. He learnt that almost all of these participants first began to put on weight after experiencing abuse as a child. They’d gained weight as a subconscious attempt to protect themselves from feeling that vulnerable again. The extra weight provided a sense of security in three ways:
- For women in particular, gaining weight reduced the perceived threat of sexual assault. Traditional Western beauty standards value thin bodies over fat ones, so women who’d been assaulted in the past felt that being heavier would make them less attractive to men and therefore safe from sexual violence.
- In a similar way, carrying extra weight provided a sense of physical protection. For example, two male prison guards in the program felt that extra weight made them look more intimidating to inmates who might get violent. Losing that weight made them feel far more vulnerable and less confident that they could defend themselves if they had to.
- Lastly, being overweight lowered other people’s expectations. After surviving abuse, many people in the program wanted to attract as little attention as possible—the fewer people who noticed them, the fewer potential threats they had to worry about. Modern culture associates large bodies with laziness and ignorance, so being overweight ensured no one would ask them to do something that might attract a spotlight.
Almost everyone who had abandoned the program and regained the weight fell into one of these categories. They’d successfully lost the weight—but when the weight was suddenly gone, so was the sense of safety that came with it.
Ultimately, Felitti realized that obesity—much like depression—doesn’t pop up randomly; it’s a symptom of a much deeper, hidden issue. In other words, treating obesity by focusing on weight loss—or treating depression without addressing childhood trauma—is like trying to put out a house fire by focusing on blowing away the smoke.
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Here's what you'll find in our full Lost Connections summary :
- The psychological and social factors that contribute to mental illness
- The history of antidepressants and the science behind them
- Why Amish people hardly ever get depressed
