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chennakesava reddy ringtoneAlthough the determination of the exact cause of noncompliance with a prescribed diet program is not always possible, various factors have been mentioned as contributing to the development of non-adherence in obese persons. Dieting has a strong emotional component, and when that is combined with stress, anxiety and depression, the effects can be devastating. Several studies have demonstrated that diet-induced weight loss is associated with reductions in depression and anxiety, and that when weight is regained, depression and anxiety often return to pre-diet values. Additional studies have also suggested that non-adherence to a prescribed diet is associated with improved psychological status. The results of two recent studies that examined a group of obese persons with binge eating disorder (BE) further support this conclusion.
The frequency and severity of binge eating behaviors are related to the intensity and duration of major depression. Approximately 20-30% of obese individuals also meet the diagnostic criteria for a depressive disorder, with many demonstrating at least two other symptoms (e.g. hopelessness, worthlessness, social phobia, irritability). Because the disorder is characteristically episodic, with the episodes occurring primarily during periods of depression, adequate treatment requires active consideration of the interplay between these two disorders.
A 2008 Meta-Analysis which included 21 papers, found that antidepressants, such as bupropion and fluoxetine, as well as an anti-depressant/anxiolytic drug combination, diet, and behaviour therapy, were more effective than placebo in reducing binge eating. While this and other studies that have followed have generally documented the efficacy of these treatments, no single treatment has yet emerged as the “best”. Because they are relatively safe, “minimally invasive” (as compared to some of the other treatments), and because they are often prescribed to many depressed patients, the more widely available antidepressants and anxiolytics have assumed a central position in the treatment of BE.
The “atypical” antidepressants may be superior to the traditional tricyclic antidepressants with regard to depressive symptomatology, as they are more likely to have a greater effect on specific symptoms of depression, namely, anxiety and suicidality.
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