I often hear weight gain among the list of troubles of patients who are depressed.  Sometimes it’s just a few pounds, sometimes it is more.  Often, it is too many.  It makes sense that depression could lead to weight gain; being depressed makes it more difficult to get out of bed and be active.  Being depressed can make it harder to pay attention to what you are eating.  People who are depressed often turn to food to make them feel good or for more energy.  On top of this, gaining weight can lead to poor body image and self-esteem, which can leave people feeling more depressed.  

Research shows: Depressed people tend to gain more weight than those who aren’t depressed. Over 5,000 young people were followed for 20 years. Everyone-whether depressed or not – put on at least a few pounds.  BUT those who were depressed gained the most weight (particularly around the waistline). The study also showed that being overweight, does not necessarily lead to depression.*   

Weight gain and depression are complicated and can be influenced by a number of factors: 

Sleep Disturbances: Depression often causes a disruption of sleep and insufficient sleep can lead to depressive symptoms.  When tired, people turn to food for energy or can take in calories from late-night snacking. Insufficient sleep causes the excretion of ghrelin and leptin, which disrupt the sensations of hunger and feeling full so people might tend to eat more, and feel less full.  Not getting enough sleep also can cause increased fat storage. 

Stress: Stress moves us forward and helps cope with life's demands, but it also affects our mood and emotions.  When under stress our bodies store fuel, slow down metabolism and excrete cortisol and other hormones which are more likely to cause     obesity in the abdominal region.  Elevated cortisol levels also   increase appetite to help the body refuel after stressful times, so people with depression may eat more food – particularly high carbohydrate foods.  

Antidepressants: Unfortunately, weight gain is a side-effect of some anti-depressants; 25% of those on antidepressants gain weight.  Some people report they gain weight on anti-depressants because they start to eat and enjoy food more.  If a medication is effective but causes weight gain, the pressing need to getting depression under control may take precedence. There are antidepressants that are less likely to affect weight.  A conversation with your health care provider is recommended before you make any medication changes and to determine the best course of care.  Carbohydrate control can be a key component in weight control for those using psychotropic (i.e., mood altering) medications.   

Getting help:  

Losing weight is hard, and depression can make everything feel harder. Fighting depression while trying to lose weight can seem insurmountable.  Starting and making change is especially hard when depressed and therapy can be helpful with this.  If you are overweight, depressed or both, you can get help now.  Getting exercise is a prescription for depression and can allow you to sleep better.  A 20-minute walk not only helps to reduce levels of the “stress hormone” and lift the spirits, it burns extra calories. Bodywork, guided imagery, naturopathic work and hypnosis can all be helpful too.

In my practice at Partners in Healing, I incorporate psychological, behavioral and experiential tools and therapies into my work to address the complex interplay between depression and weight management challenges. 

By Alana Riss Fine, PhD

Dr. Alana Riss Fine will be a featured speaker at the Twin Cities Jewish Community Annual Conference on Mental Health on Sunday, November 13, 2011.  Dr. Fine will be speaking about obesity, body issues and mindful eating.  She will examine issues of overeating; the relationship between depression, anxiety and weight gain; food and exercise as coping tools; and the benefits of mindful eating.  The conference is free and open to all from 12:30-6 pm at Temple Israel, 2324 Emerson Avenue South, Minneapolis, MN. 

By Dr. Deborah Simmons

Many people make New Year’s resolutions and feel great initially about making a change.  It can be exciting to start something new.  By the second week of the year, energy and motivation are waning and the resolutions are skidding.  Uh-oh.  What do we do now? 

Hint #1:  Persistence is the wonder word to keep change going.  This isn’t magic, folks.  It is mindful doggedness.  Determination.  Pushing through.  Resilience.  Decide that it is time to do whatever it is you have decided to do. 

Hint #2:  You don’t need to like change to change.  Like Nike’s “Just Do It” Swoosh, you just need to do it.   Then do more of it. 

Hint #3:  Imagine the outcome of the change you want to make.  Let yourself see it in your beautiful mind, without any editing.  Dream about it at night.  Hypnosis is great to imagine and reinforce change. 

Hint #4:  Have some compassion for yourself when you get off track.  Is someone going to take away your birthday because your diet or exercise gets messed up?  Just get back on track and return often to Hints #1 and #2 and #3 and #4. 

All of us at Partners in Healing of Minneapolis believe in you!  Here are some other words of encouragement for you:     

•    Self-criticism is optional.   

•    You are a better person than you will ever know. 

•    You are more powerful than you give yourself credit for. 

•    You are more capable than you realize.   

•    You can persist even when you don’t think you can.

•    You are adorable.  It’s true!

We welcome other hints that have helped you to persist and reach your goals.  Share them with us and our community.  We are all here to help each other. 

         Brought to you by Diane Tanning, RN, MS, L.Ac.

Q:  Are acupuncture and traditional Chinese medicine (TCM) helpful with weight loss?

A:  Yes, indeed.  Here is an article from www.Acufinder.com explaining how specific foods chosen just for you, acupuncture, and herbs can help you to lose weight and maintain weight loss. 

“The Acupuncture Weight Loss Solution” by Diane Joswick, L.Ac.

I am going to tell you a secret. All diets will work if they lower your caloric intake and you STICK TO IT! It’s pure physics: Our weight is determined by the amount of energy that we take in, and the amount of energy we expend.

So why is obesity now a national epidemic?

The problem is that it is against our nature to limit calories. We instinctively eat more than we need to. This is a “gift” passed down from our hunter-gatherer ancestors from a time when there wasn't a drive-thru window on every corner.  We also tend to eat in excess due to our modern lifestyles, chronic stress, and other psychological “triggers”.

Going to Extremes

People will go to drastic measures to lose weight. Fad diets ask you to eat an unnatural and unhealthy diet, such as a meal plan of cabbage soup or pineapples or rice or no-carbs,  They may work in the short term because of the low caloric intake, but there is absolutely no way you can keep it up. Your body and mind will rebel and take revenge for putting it on such a restrictive regime, rather than providing whole foods and a “whole diet” with proper nutrients. Instinctively, your body will crave foods and gorge, filling up, terrified of and preparing for the next starvation, packing on fat for stored energy.

Eating an unnatural and highly restrictive diet can cause yo-yo dieting and drastic ups and downs in body weight. Improper diet practices can also cause malnutrition, organ damage, slow metabolic rate and imbalances within the body.

Wouldn’t it be great to decrease the amount of food that you take in, and increase the amount of energy you expend? It’s entirely possible, thanks to acupuncture and traditional Chinese medicine (TCM). Acupuncture and TCM address both the physiological and psychological aspects of weight loss. A comprehensive therapy for weight issues rooted in TCM promotes better digestion, smooths emotions, reduces appetite, improves metabolism, and eliminates food cravings.

Weight loss according to Traditional Chinese Medicine

According to TCM, the root of excess weight is an imbalance within the body caused by malfunctioning of the spleen and liver organ systems.

In five-element theory, the spleen is responsible for the proper functioning of the digestive system, ensuring that the food we eat is transformed into Qi — the vital substance of life. Disharmony of the spleen will have symptoms such as fatigue, slow metabolism, water retention, loose stool, and feeling of heaviness.
 
The liver’s job is to keep the flow of your body’s Qi and blood (as well as your emotions) running smoothly. Our modern, fast-paced lifestyle and chronic stress can negatively impact the liver’s ability to function properly and smoothly, which, in turn, can cause the spleen and the whole digestive system to function poorly and decrease your metabolism. Liver disharmony can also cause some of the “triggers” that lead to cravings and compulsive eating.

Backed by Research

A growing body of research supports the use of acupuncture and Asian medicine in weight loss:

    * A 2003 study published in The Journal of Medical Acupuncture found that participants receiving acupuncture lost more than three times more weight than the control group.

    * In a study conducted by the University of Adelaide in Australia in 1998, 95 percent of the participants receiving electro-stimulation on acupuncture points reported appetite suppression. The results showed that the acupuncture group was more likely to experience a reduced appetite and to lose weight than the control group.


The Acupuncture Weight Loss Treatment

From a TCM perspective, the acupuncture points, foods and herbs that are chosen to assist with weight loss directly influence the Qi of the spleen and liver systems to treat the root imbalances that are causing the weight gain.From a Western perspective, acupuncture and TCM have been shown to have an effect on the function of the nervous system, endocrine system, digestive system, food cravings, and metabolism. All of which can help to energize the body, maximize the absorption of nutrients, regulate elimination, control overeating, suppress the appetite, and reduce anxiety.

Acupuncture Points for Weight Loss

The beauty of acupuncture is that each treatment is catered to the needs of the individual patient. Acupuncture points on the body will be chosen for overall well being with the objective of increasing circulation of the blood and Qi (stimulating the metabolism) and calming the nervous system.
 
In addition to treating the root of the imbalance within the body, different acupuncture points may be chosen for each treatment as different symptoms arise. For instance, if you are experiencing a desire to overeat related to premenstrual syndrome (PMS) one week, then that can be addressed at that week’s appointment.

Generally treatments are scheduled once or twice a week for 8 to 12 weeks or until the goal weight has been reached. The treatments include a combination of auricular (ear) and body acupuncture, ear tacks or pellets to leave on in-between treatments, herbs and supplements, abdominal massage, breathing exercises, and food and lifestyle recommendations.

Ear Points

Acupuncture points on the ears have been found to be particularly effective for weight loss. The human ear has been described as a micro-system of the body in an inverted fetal position; it contains points relating to all major organs and body parts.
 
Auricular points for weight loss are stimulated with small tacks during treatment. Then seed-sized beads or magnets are taped to the points to enhance the effectiveness of the points at home. The beads will generally stay in place for 3 days to a week and can be gently massaged for 10-second intervals if cravings occur.

Here are some of the most commonly used auricular points:

    * Shenmen: Important point for calming the mind and reducing stress

    * Small Intestine: Reinforces spleen, promotes digestion.

    * Mouth: Calming point used for smoking, over eating and hyperactive talking.

    * Hunger Point: Used to relieve hunger and control compulsive eating

    * Endocrine point: Moves liver Qi and aids in the function of the metabolism


A Total Health Program

Most patients report a marked decline in appetite and cravings with acupuncture alone but herbs, healing foods, and exercises can definitely enhance the efficacy of the treatments.

Herbs and Healing Foods: The herbs and foods that are chosen during a weight loss treatment are for promoting healthy digestion, energizing the body, augmenting Qi, and improve elimination of water, toxins, and waste products. Foods that are bitter, sour and acrid to taste are especially good for weight loss, while sweet, salty and greasy foods should be reduced.

Abdominal massage/exercise: Points on the abdomen improve digestion, absorption of food and peristalsis of the intestines. The abdominal points can be stimulated with massage or by belly breathing, where the abdomen is consciously moving in and out with each breath. Deep breathing with visualization can also strengthen will power and be used as a tool to curb hunger and cravings.

Acupuncture and traditional Chinese medicine are powerful tools for healthy weight loss, by itself or as a supportive treatment in conjunction with other weight management programs.

In the struggle to eat less and expend more energy, you may find that acupuncture is just what was needed to overcome cravings, boost energy, enhance your metabolism, and increase your willpower to succeed!