Excess adiposity correlated with stress/depression?

Medical Q&A [Moderated]
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Hey there, I just have a couple questions related to the stress response, particularly psychological stress in humans and how it is correlated with excess adiposity and overconsumption of calories. I ask this because I have personally dealt with mental health problems for much of my life and it seems to be correlated with stress and dietary patterns. Over the past few months I have had struggles maintaining any kind of consistency with sticking to a healthy dietary pattern. I tend to eat many calorie-dense foods when I become stressed or have stressful thoughts that come up. I have often felt depression over it because I feel as if I am being controlled by my emotions and internal experiences.

I listened to the BBM podcast several times about food environment and how it influences dietary patterns and choices, I just feel stuck because I can’t always control the environment I’m in. Obviously there are things I can do over time, but where I work there are always treats and snacks around. I also am around family members a lot who consume high amounts of saturated fat and have food described previously as well. From listening to the BBM podcast, obesity is obviously a complicated disease process influenced by many different factors. My questions are: if someone is stuck in a poor environment for a while, is there any kind of way to make changes that can at least influence better decisions?

Also, I mentioned some of my mental health struggles. I have been diagnosed with OCD and I also experience some depression as a byproduct of it. Lately I have been having thoughts that can be disturbing relating to whether I actually have any control over my behavior or choices or if I’m just a result of my genetics playing itself out in the environment, it seems like “self-control” is really an illusion and that I can’t really change my choices due to my environment, genes, psychology, etc. As a result of this I have felt depression and a sense of hopelessness at times, I have addressed these things through therapeutic exercises like CBT and ACT, but the strong emotions just seem to overwhelm me and come back stronger than before, so would there be another way to think about the whole dietary change process? I just feel as if I need input because I certainly am limited with my own biased and limited perspective and would love to change my mind.

Thanks again for all you guys do.

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Sorry to hear about these struggles. This is a very common situation out there, so you certainly aren’t alone here. Your observations about increases in appetite for certain types of foods when stressed is a well-known phenomenon as well. Similar things can happen with sleep restriction.

My questions are: if someone is stuck in a poor environment for a while, is there any kind of way to make changes that can at least influence better decisions?

There are, but this can be a pretty complex discussion that typically needs to be individualized for a given person’s situation and available resources. I’m not sure that we can adequately address this in the forum here, but if you’re able to check out Stephen Guyenet’s book “The Hungry Brain”, it may provide some helpful context and advice around this issue. Typically we aim to address things like sleep, stress management (which it sounds like you’re doing), habitual physical activity, the food environment and eating environments (to the extent that these can be modified), and centering the diet around high-satiety foods (typically single-ingredient foods high in protein, fiber, and/or water content). Outside of this, for individuals who continue to struggle, there can be a role for the use of medications to aid in the regulation of appetite and satiety under the care of a physician.