Food allergies or intolerances can have a great effect on your mood. For example, if you have gluten allergy or intolerance, consumption of gluten (found largely in wheat products) can leave you feeling sluggish or even depressed. Dietary changes have been suggested for children with ADHD or autism. This suggests there is a strong link between food, mood and behaviors.

Fluctuations in blood sugar also can change your mood. High blood sugar often can lead to irritability, while low blood sugar can bring about feelings of anxiety, depression and lethargy.

Research also suggests that low levels of vitamins, mineral deficiencies, and low intake of fatty acids and omega-3s can contribute to altered moods and mimic various mental health issues. Some believe that these deficiencies actually cause mental health issues. Insufficient levels of vitamin D, in particular, can lead to mood swings, depression and fatigue. If you have any deficiencies, your mood may be improved simply by adding supplements.

If you are interested in exploring how food may be affecting your moods, keep a food diary for at least two weeks. Record everything you eat and drink and your moods before and after. It may sound tedious, but it is beneficial. If you notice a pattern, you may wish to seek a nutritionist or experienced health care provider to assist you in making the necessary changes. Since diets should be individualized, you will want to make sure the changes you are making are appropriate and healthy for you.

Many people feel that it is difficult to eat healthy or to change their eating habits. It’s really simple if you keep it simple. Start slow and make changes over time. Using the all-or-nothing approach to cutting out certain foods typically leads to failure.

You can also make changes by slowly substituting bad foods with good ones. Experiment with different grains, fruits, and vegetables. Get online and find exciting new recipes, and you just may fall in love with a good food you never imagined you would eat.

Remember every change you make matters. If you fall off the wagon, just get back up. It’s about making changes to improve your emotional health. Don’t get discouraged or depressed if you slip up. Consider that day as a misstep and make healthier choices in the future. Here’s to a healthier you!

The statistics regarding obesity in America are alarming. Currently, 35 percent of American adults are obese (CDC, 2012), and that number is projected to rise to over 50 percent in most states by 2030 (Henry, 2011). We’ve been fighting the so-called “war against obesity” since the 1980s, and yet despite all of our efforts, the problem has only gotten worse. Clearly, what we’ve been doing to try to solve this problem isn’t working and is possibly making it even worse. In my opinion, the reason for this is that the psychological piece hasn’t been addressed yet and until it is, we will have an increasing problem on our hands.

Years ago I was seeing a client who we’ll call Sarah. Sarah was very obese and desperate to lose weight. Her doctor had recently told her that if she didn’t lose a significant amount of weight she would lose her mobility as well as have a host of other medical consequences. Sarah tried numerous diets and exercise programs but nothing worked. She even enrolled in a weight loss clinic but had no success. She actually ended up gaining even more weight during this time. Not knowing what else to do, Sarah’s doctor told her that she needed to talk to a therapist.

When I met Sarah she was quite desperate to lose the weight and very depressed. Much to her surprise, I told her that I didn’t want us to work on her losing weight, but rather I wanted to work on her depression and teach her to accept and love herself unconditionally. This seemed the opposite of what she needed in order to lose weight, but Sarah decided to trust me anyway. You see, like a lot of people, Sarah thought that if she could just hate herself enough, that would motivate her to do whatever it took to lose the weight. As a therapist, I know that that is simply not going to work. We therapists follow something called the “Rogerian hypothesis,” which states that people tend to move in a positive direction only when given unconditional love and acceptance. Well, I’m happy to say that after we had alleviated Sarah’s depression and she had learned to love and accept herself, the weight came right off.

The current methods for helping people lose weight seem to be the opposite of love and acceptance. Much of the efforts seem to involve trying to shame and scare people into losing weight. This simply doesn’t work. The worst thing you can do is give someone more anxiety and depression regarding their weight, and I’m going to explain why that is later on. Also, the ways we go about teaching people to lose weight are much more complicated than they need to be. One should not have to read a book, go to a clinic, or take a class to learn how to lose weight. There is a very successful diet that has been around for thousands of years and all of the big celebrities do it. Can you guess what it is? It’s called “Moving more and eating less.” How you go about accomplishing this is up to you. I believe that losing weight is not complicated and that people intuitively know how best to do it when it comes to themselves. They simply need to stop feeling so anxious and depressed about it.

Obesity and Genetics

Before I talk more about how obesity is linked to depression and anxiety, I first want to briefly address the popular belief that obesity is purely a problem of bad genes. This is the popular belief and I can see why it is so popular. In a society where people are constantly trying to shame you about your weight, it can feel good to be able to say “Hey, you have no right to shame me about my weight! It’s not something I can control! It’s because of these bad genes I have!” But in order for this to be true, it means that our genes would have had to somehow change since the 1960s. Scientists agree that genetics is not responsible for the obesity epidemic, although they do agree it is a factor. Depending on which study you look at, genes only account for between 1 percent and 5 percent of a person’s body mass index (Li et al., 2010). I think that most people would agree that 5 percent of bad genes doesn’t excuse the 95 percent of it that scientists claim is due to bad habits.

When confronted with these facts, people often cite that most of the people in their family are also obese, so it must be genetics. However, the more likely possibility is that families tend to eat the same foods and have similar habits. Genetics also doesn’t explain why obese people also tend to have obese pets (Bounds, 2011). Obviously the dog doesn’t share the same genes as the owner, but they do share the same environment. Of course, we can’t mention genetics without looking at twin studies. Since identical twins have identical genes, researchers often compare twins to examine the effects of genetics and the environment on a person.

Obesity and Depression

Researchers aren’t quite sure if obesity causes depression or if depression causes obesity, but the two are definitely linked. In fact, the two conditions are so intertwined that some are calling obesity and depression a double epidemic. Studies have found that 66 percent of those seeking bariatric, (weight loss) surgery have had a history of at least one mental health disorder. And of course, it doesn’t help that the medications people take for depression and other mental health issues can cause dramatic weight gain.

Consider this: According to the CDC, half of Americans will suffer from some sort of mental illness, and most of them will not receive any treatment for it. 63 percent of Americans are also overweight or obese. There are almost as many Americans taking diet pills as there are taking antidepressants (8 percent and 10 percent). People with mental health issues are twice as likely as those without them to be obese, and that’s even before they start taking psychiatric medication (McElroy, 2009).

So why are people with mental health issues so much more likely than those without them to be obese? We know that depression and bipolar depression slows down your metabolism (Lutter & Elmquist, 2009). Depression also depletes our willpower, making us less likely to avoid eating unhealthy foods. Depression also causes us to crave high-fat foods and sugar. This is where emotional eating comes in. When we’re feeling down, fatty and sugary foods make us feel better, at least temporarily. Of course, you don’t need to have depression or a mental illness in order to engage in emotional eating. It’s something we learn at a very young age. Eating something unhealthy is much easier than fixing the problem or dealing with what’s causing us to feel unhappy. Teaching people how to deal with unpleasant moods other than by eating would certainly cut down on emotional eating and would certainly lead to significant weight loss.

So if depression causes weight gain and antidepressants cause weight gain, then what is the solution? Well, research has shown that talk therapy is just as effective at relieving depression as antidepressant medication (Doheny, 2010), and talk therapy doesn’t have the negative side effects that medication does. Another option is exercise. In a 2005 study on the effects of exercise vs. Zoloft (anti-depressant medication) on the treatment of depression, participants were randomly placed into two groups. On group received 150 mg of Zoloft while the other group engaged in 20 minutes of cardiovascular exercise three to four times a week. After eight weeks, they found that the exercise was just as effective at reducing depression as the Zoloft! Another thing to consider is that Zoloft has negative side effects such as weight gain, sleep problems, and sexual dysfunction. As you can imagine, the side effects of exercising are the opposite of that.

The philosophical zombie is exactly like a human being, save that it doesn’t have conscious awareness, and it doesn’t think. We’ve all had episodes of zombie-dom. The most common example I’ve heard of is when you drive to work and can’t remember the drive. Your body does the drive on automatic.

In “Reinventing the Meal,” author Pavel Somov opines that many of us are food zombies. We eat. We don’t think about what we’re eating, or why. This mindless eating can result in eating too much, not eating the right foods, not enjoying our meals, and not respecting where the food came from. The book does a decent job of describing a plan that readers can follow to go from being food zombies to conscious and mindful eaters.

Somov’s plan starts with redefining the “course” in “three-course meal.” Instead of a three-course meal consisting of an appetizer, main course, and desert, Somov suggests that we should redefine it to be more of an eating process that includes relaxation, connecting with your body, and connecting with your food.

Somov dishes out a bunch of tips, or “amuse-bouches,” to help readers redefine the courses of their meals. As I read the tips, I couldn’t help but compare each one to a micro-blog or Facebook entry. Some examples of these tidbits are:

“We are tubes—conscious, even spiritual, but nevertheless digestive tubes that metabolize the environment, through a one-way transaction, to keep on living” (p. 18).

“Desert is entertainment for an empty mind with an already full stomach” (p. 97).

The first of Somov’s “courses” is to reconnect with your body by relaxing. He suggests humming before eating, or mmm-ing, and cites research that indicates we release nitrous oxide when we do this. Nitrous oxide relaxes us. Somov also points out that it’s more important to breathe out slowly than to breathe in slowly. Breathing out slowly is relaxing.

The second course is to reconnect with your mind. Clear your mind to get rid of any emotional baggage that might tempt you to overeat, the author says. Preload your meal by drinking a couple glasses of water. Clear out your nasal passages (going so far as to use a Neti Pot if necessary), and then preload your meal with smell. Hot food emits more molecules than cold food, so heat up your food. Take a deep whiff and mmm, or hum, it out slowly.

The third course is to reconnect with the world through your food. The “third course” chapter amounts to breaking a bunch of habits. When you eat your meal by habit, you aren’t thinking, and therefore aren’t mindful, we’re told. So, we are to try to break our habits by doing new or different things. Try different foods, Somov writes. Eat with your left hand if you’re right handed. Think about your plate and trace its shape with your finger. Use different utensils than you normally would. Sit with different posture. Learn what full is and stop eating when you’re 80 percent full. Eat just enough. Pause half way through your meal. Use only one bowl for your meal and wash it between each different food you eat. Close your eyes as you eat or change your setting.

From experience I can say that removing vision and setting can make a difference in eating mindfulness. I went to a “Blind Café” for dinner with my family once. The event is held in a room completely sealed off from light. There’s not a single LED blinking in the room or a drop of illumination. It’s darker than being outside at midnight. At the Blind Café, I tasted and experienced every morsel of food during that meal like I never had before — and I enjoyed it.

Somov also discusses eating mindfully in the social setting. Anyone that’s ever been on a diet knows that social eating can be the downfall of the best diets, and Somov posits that this is because group meals are time-based (instead of hunger-based), are “group mind” events, are distracting, and can be emotional.

He suggests shifting your focus at these meals by changing your mindset from social eating to social savoring, from all you can eat to all you can taste, and from a mouthful of food to an earful of attention. I’m not sure keeping his ideas in mind in a group-meal setting is that easily done. I do think, however, at least in the beginning of training yourself to eat mindfully, that group meals should be kept to a minimum. (And training is like forming a habit, so I wonder: Can you train yourself to do anything mindfully?)

As I read “Reinventing the Meal,” I kept mentally comparing it to Mindless Eating: Why We Eat More Than We Think, by Brian Wansink. I liked “Mindless Eating” better, probably because it describes a bunch of food experiments (some of which are unexpected and funny). “Reinventing the Meal” is good, too: it just has less science and more philosophy than Wansink’s book. 

If you’re interested in food, why we eat what we eat when we eat it, and the philosophical approach, then Somov’s book is definitely worth picking up.

Reinventing the Meal: How Mindfulness Can Help You Slow Down, Savor the Moment, and Reconnect with the Ritual of Eating
New Harbinger Publications, September, 2012
Paperback, 216 pages
$17.95

It should be noted up-front that these drugs are meant for people who are obese — those with a BMI number 30 or greater. While doctors often prescribe drugs for conditions not specifically approved by the FDA (called “off-label” use), doctors are likely to be more conservative in prescribing these two drugs when they first become available because of their unfamiliarity with them.

Both drugs can also be prescribed to people who are overweight, with a BMI of 27 or more and at least one weight-related condition such as type 2 diabetes, high blood pressure, or high cholesterol.

Qsymia (pronounced kyoo-sim-EE-uh and manufactured by Vivus Pharmaceuticals) and Belviq (pronounced bel-VEEK and manufactured by Arena Pharmaceuticals) have been shown to be effective in their clinical trials to help people lose significant amounts of weight.

Qsymia appears to be the more effective weight loss medication. People taking Qsymia for up to one year had an average weight loss of nearly 9 percent over those taking an inactive placebo. Over 70 percent of people taking Qsymia lost at least 5 percent of their body weight (only 20 percent of patients taking an inactive placebo lost this much weight).

People taking Belviq had an average weight loss that was 3 to 3.7 percent greater than people taking placebo. After taking Belviq for one or two years, some 47 percent of people without diabetes lost at least 5% of their body weight (only 23 percent of patients taking an inactive placebo lost this much weight.)

Although likely to be expensive, both weight loss drugs will likely be approved by insurance companies for treatment of obesity or being overweight with other health conditions. Why? Because obesity is a serious chronic health problem affecting more than one-third of U.S. adults (35.7 percent), according to the U.S. Centers for Disease Control and Prevention. As such, it costs insurers a lot of money. In 2008, medical costs associated with obesity were estimated at $147 billion. Anything to bring those costs down is likely to become approved for payment by insurance companies.

How Do Qsymia and Belviq Work?

Qsymia combines two generic drugs in a new formulation. One half the drug is composed of the seizure and migraine medication called topiramate. Topiramate causes weight loss in several ways, including increasing feelings of fullness, making foods taste less appealing, and increasing calorie burning. The other half of Qsymia is the appetite-suppressant called phentermine. Phentermine is thought to suppress appetite by triggering release of a brain chemical that increases blood concentrations of the appetite-regulating hormone leptin.

Belviq, on the other hand, appears to work by turning on a specific chemical “switch” in the brain that increases levels of serotonin. It’s not clear exactly why this helps a person lose weight.

Who Can’t Take These Drugs?

As with all medications, certain people cannot take these medications.

• Pregnant or nursing women should not take either Belviq or Qsymia.
• Qsymia:
  • People with glaucoma
  • People who have been told they have an overactive thyroid
  • People taking a type of antidepressant called a MAOI
  • People allergic to phentermine or topiramate
• Belviq:
  People taking drugs linked to valvular heart disease, such as cabergoline (Dostinex)
  • People taking certain medicines for depression; migraine; the common cold; or mood, anxiety, psychotic, or thought disorders
  • Men with conditions that predispose them to erections lasting more than four hours. These conditions include sickle cell anemia, multiple myeloma, and leukemia
  • Men with a deformed penis

When Can I Get Them?

Qsymia will be available sometime after September 2012, while Belviq won’t be available until early-to-mid 2013.

As with any medication, talk to your doctor to see if this medication may be right for you. Tell your doctor if you are on any other medications, nutritional supplements (including vitamins), pregnant, nursing, or have any other health condition.