Sometimes I wonder what kind of a difference those of us who have dedicated our lives to improving people’s health, are actually making.
Today is one of those days. Catching up with last week’s tabloids, I came across the headline "Losing weight can make you depressed” in the Pretoria News. This evoked intense déjà vu of a study from a few years ago, which reported that significantly more patients who had successfully lowered their cholesterol levels committed suicide than those who did not.
The current study was conducted at the University College London with approximately 2 000 overweight and obese subjects of both sexes over the age of 50, for a period of 4 years to determine to what extent weight loss improved their psychological outlook and feelings of depression.
Read: Weight-loss myths debunked
Dr Sarah Jackson, reported that 278 people or 14% of the participants managed to lose at least 5% of their initial body weight in the study period. On average, these subjects lost 6.8 kg per person, which is a most encouraging result. However, Dr Jackson found that 78% of those people who lost weight were more likely to report that they were feeling depressed. This is indeed disappointing news.
Read: Depression, anxiety and self-deception
But if you consider the psychological makeup of human beings, it is not really so surprising that subjects who were successful and lost weight, did not feel that they had found the proverbial pot of gold at the end of the rainbow, but were feeling more depressed than the subjects who had continued to indulge their often dangerous eating habits.
The ‘Cinderella Syndrome’
Most people tend to suffer from what I think of as the "Cinderella syndrome". Most people want a happy ending and believe that instant results are possible. They want to lose 10 kg in a week without any effort or by swallowing a few pills and potions.
The whole advertising industry is based on our firm if gullible belief that, like Cinderella, we can be transformed by a ‘magic wand’ (e.g. a slimming pill, a way-out diet or a space suit for sweating it off) from fat and homely to slim and stunning.
Read: Dangerous diet pills: how to protect yourself
In the case of the UCL study, the subjects who lost substantial amounts of weight (nearly 7 kg each), undoubtedly discovered that the dream of instant, complete transformation did not come true. They had suffered to lose weight, and yet at the end of their long period of self-denial not much had changed.
Read: Eating to lose weight?
The problems they faced at the start of the study had not disappeared and they were not more successful, cleverer, or richer. Dr Jackson warns that “Aspirational advertising by diet brands may give people unrealistic expectations about weight loss.
They often promise instant life improvements, which may not be borne out in reality for many people. People should be realistic about weight loss and be prepared for challenges.”
Psychological well-being of patients
We live in a world filled with temptations, particularly in relation to food and drink, with super-sized portions of food leading us astray at every turn. As most individuals who have used a slimming diet will concur, constantly having to resist the temptations of unhealthy food tests human willpower to the utmost and may lead to depression.
Read: Physical and mental health closely linked
Dr Jackson points out that it is important for health professionals to not only to monitor the weight loss of their patients in terms of physical health improvements (which are usually highly positive), but to also keep track of the psychological well-being of patients who embark on programmes to lose weight.
The patients’ mental health is just as important as their physical health and, as this study indicates, gaining a healthy body does not necessarily or automatically produce a healthy mindset.
The physical benefits of weight loss
Many studies have repeatedly shown that losing weight, particularly of at least 5% of your initial body weight will greatly improve your health. For example, such weight loss will:
- Reduce blood pressure, reducing the risk of heart disease and stroke
- Lower triglyceride levels which reduces the risk of heart disease
- Improve blood glucose and insulin levels, reducing the risk of type 2 diabetes and all its complications
- Reduce stress on joints, leading to less cartilage and skeletal damage
- Reduce other diseases of lifestyle such as gout, gallbladder disease and metabolic syndrome
- Reduce the risk of certain cancers (e.g. breast cancer)
There is no doubt that being lean and trim keeps our bodies healthy, but it does not instantly follow that weight loss will also make us happy.
The most important conclusions that we can reach in relation to the findings of this new study are:
- Weight loss is vital for people who are overweight or obese, and health professionals should, if possible, assist patients to achieve a loss of at least 5% of their initial weight. (A person weighing 70kg would e.g. be encouraged to lose at least 3,5 kg.)
- However, health professionals should be aware of the fact that people who use slimming diets and procedures (e.g. bariatric surgery, liposuction, etc) have very high and often unrealistic expectations and expect that losing weight will cure all their problems. When these patients realise that losing weight may have changed only one aspect of their lives, they are at risk of developing depression and may need support to come to terms with this aspect of their weight loss journey
- Advertisers should be subject to a reality check when promising miracles of transformation to clients using slimming diets, pills, and procedures. A system of enforcing accountability for unrealised benefits promised by ads should be put in place to prevent unbridled hype, not only in slimming ads, but all advertising.
- Members of the public should attempt to use a realistic, adult approach to weight loss and not allow the “Cinderella Syndrome” to cloud their judgement or expectations.
- If you have lost weight and feel depressed, discuss this problem with your dietician, medical doctor or a psychologist to focus on your great achievement and come to grips with how to deal with other problems, one by one.
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- Boscarino JA et al (2008). Low serum cholesterol and external-cause mortality: Potential implications for research and surveillance. Journal of Psychiatric Research, 43(9):848-854;- Greenblatt JM (2011). Low cholesterol and its psychological effects. Published 10 June 2011 in The Breakthrough Depression Solution; - Daily Mail (2014). Losing weight can make you depressed;- Pretoria News, 8 October 2014, page 10; Jackson S et al (2014). Psychological changes following weight loss in overweight and obese adults: a prospective cohort study;- PLoSOne. 2014. Aug 6; 9(8):e104552;- UCL (2014). Losing weight won’t make you happy. UCL 7 August 2014. www.ucl.ac.uk/news/news-articles/0814/070814-Losing-weight-will-not-make-you-happy/