Can exercise work as well as drugs for depression?

A recent NIH blog on antidepressants and weight gain struck me for what it didn't say. “Weight gain is one of the most common side effects of antidepressants,” states the NIH Research Matters blog. Nothing new there. However, if your doctor told you, "take this pill and you’ll likely gain weight" wouldn’t you be more disinclined to start with that medication?

Not being informed regarding the weight gain side effect of antidepressants is frustrating enough, but medical professionals also often fail to inform patients that exercise performs at least as well as antidepressants in treating (non-major) depression. Furthermore the efficacy of antidepressants is short-lived (averaging just a couple of months for the 50% of patients that respond at all). Meanwhile the vast majority of people stay on those meds indefinitely (wondering why they aren't feeling better) while having gained 10, 20, or even more pounds on the scale.

Part of the problem is that over time medical professionals develop a strong expectation of non-compliance regarding the likelihood of their patients actually making lifestyle changes. Then (partly because medical professionals are always short on time) they get in the habit of skipping straight to a pill. Of course there are also patients that come in specifically to ask for medications and some doctors may feel that if they don't prescribe it the patient will just find another doctor who will. Either way, the patient isn't provided with all the information they need.

So the physical activity option, which costs nothing and only has positive side effects, isn't discussed. That's too bad since most people will agree that they feel better both physically and emotionally when they exercise.

Here's the summary of a comprehensive review study on exercise and depression:

"... exercise appears to be an effective treatment for depression, improving depressive symptoms to a comparable extent as pharmacotherapy and psychotherapy. Observational studies suggest that active people are less likely to be depressed, and interventional studies suggest that exercise is beneficial in reducing depression. It appears that even modest levels of exercise are associated with improvements in depression, and while most studies to date have focused on aerobic exercise, several studies also have found evidence that resistance training also may be effective. While the optimal “dose” of exercise is unknown, clearly any exercise is better than no exercise. Getting patients to initiate exercise ---and sustain it – is critical."(1)

You can avoid antidepressants, and their associated weight-gain, by developing an activity plan that fits your life.

The good news is that there is no right or wrong way to do this. Personally I’m a huge fan of walking, no special equipment, or membership, necessary and you can do it anywhere. Outside activities also have the added benefit of full spectrum light, nature, and fresh air.

The NIH National Institute of Diabetes and Digestive and Kidney Diseases has a good check-list for getting started with regular walking, see: How do I start?

The bottom line is that while we wish there were, there simply are no magic pills, and physical activity remains the best prescription in the medicine chest for much of what ails us.

All the best!
-Dorene

References:

1. Is Exercise a viable treatment for depression? ACSM Health Fit J 2012;16(4):14-21.
2. Pharmacological management of obesity: an Endocrine Society clinical practice guideline.
   J Clin Endocrinol Metab 2015 Feb;100(2):342-62.

Does Protein Really Curb Your Appetite?

It's hard not to get misled by misinformation, or hype, when you're searching for reliable information on weight management. The daily rush to publish makes even seemingly reliable sources vulnerable to "getting it wrong"—because it takes time to do enough research to make sure you've got it right.

Nutrition Action didn't 'get it right' with their recent post on protein and appetite: Does Protein Really Curb Your Appetite?

After more than two decades specializing in weight management I have 52 papers tagged under "appetite regulation" in my research database. Appetite regulation is a fascinating and important topic within weight management. I covered it in my 6-hour Advanced Training in Weight Management CE workshop back in 2003 and 2004, and since then have only seen one other seminar on macronutrients and appetite regulation cross my desk. I know the key papers off the top of my head, and I know that the fact that protein has a higher satiety value is not even a question among researchers who are experts in that area.

That said, there are several important caveats...

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The 2016 Dieting Season is Off and Running...

After 22 years in this field I have to admit that I periodically get burnt-out on taking the time to read and review new diet books or websites!

Nearly 20 years ago Kelly Brownell PhD once likened fad-diets to trick candles that keep re-lighting when you try to blow them out. Each new crop of books (or websites) invariably claim, “to contain the REAL secrets to weight loss.” This of course is just basic marketing and it’s very effective, especially when the average consumer “knows” more misinformation than fact regarding human metabolism, energy balance, and body weight.

Since it’s January, I thought I’d take a look at what’s “hot” on the diet landscape

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Is FRAUD the New Business Model for (Some) Weight Loss Supplement Manufacturers?

Back in January I wrote about a growing problem—more and more weight loss supplements being found to include illegal drugs. The trend hasn’t let up, and the U.S. Department of Justice announced last week it was taking sweeping legal action:

As part of a nationwide sweep, the Department of Justice and its federal partners have pursued civil and criminal cases against more than 100 makers and marketers of dietary supplements. The actions discussed today resulted from a year-long effort, beginning in November 2014, to focus enforcement resources in an area of the dietary supplement market that is causing increasing concern among health officials nationwide. 

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Could YOU Triple Your Weight Loss?

The evidence seems to be stacking up that if you’re trying to lose weight, the more frequently you step on the scale the more weight you’ll lose.[i],[ii],[iii],[iv],[v] The most recent study was the first randomized-controlled clinical trial to address the question of self-weighing and weight loss.[vi]

Weighing yourself daily may be optimal…

Subjects that weighed themselves daily lost three times more weight over six months compared to participants who weighed themselves an average of 5.2 times per week.

That’s impressive; daily weighers lost 20.2-pounds over six months compared with 6.8-pounds for those who stepped on the scale “only” 5.2 times per week! What really stands out about this data is that the non-daily

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