Q: I have always heard that fat people are supposed to be jolly. Well, my wife has been fat for many years, and she has been depressed, not jolly.
Are fat people depressed more often than normal weight people?
A: In general, overweight people are more likely to be depressed then normal weight people. Distressing features of being overweight frequently include the negative attitude of others toward obese individuals and the view in this country that "thin is beautiful."
At the worst, these attitudes lead to subtle discrimination in hiring for jobs.
A recent study, however, has concluded that obesity itself is not an important cause of depression except in well-educated women. The results of this study are based on telephone interviews with about 2,000 men and women ages 18 to 90.
The author found that the leading cause of depression was attempting to follow a calorie-restricted diet in an effort to fit society's image of attractiveness.
The other major cause of depression in this study was the recognition that obese people are more prone to health problems than normal weight people.
The combination of these two factors accounted for 92 percent of the depression in the obese people interviewed.
By contrast, the results showed that exercise, in the form of walking or more strenuous activity, was associated with improved psychological well-being.
These findings further substantiate the importance of regular exercise as a critical part of any weight-loss program.
Dr. Margolis is professor of medicine and biological chemistry at the Johns Hopkins School of Medicine.