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Does Dieting Trigger a Recurrence of Depression?

Mood and eating patterns are closely interlinked biochemically. Dieting has been shown to lower the availability of the serotonin (5-HT) precursor, tryptophan. Women who have experienced depression respond to tryptophan depletion with an acute lowering of mood (see Lancet 1997 Mar 29; 349:915). This study examined brain 5-HT function during dieting in 19 women who had recovered from major depression and remained medication-free for at least 6 months, and a control group of 23 women with no personal or family history of major psychiatric disorder.

Three weeks of a 1000-calorie/day diet lowered plasma tryptophan levels equally in both groups. Dieting also increased the prolactin response to tryptophan -- but only in the control subjects. The authors suggested that this impaired regulation of brain 5-HT function in women with a history of depression may make them vulnerable to mood changes while dieting.

Comment: This study involved a small number of subjects, and the authors did not rule out the possible influence of previous antidepressant use on the findings. Nevertheless, both depression and obesity are prevalent among women. Given the value society places on being thin, a large population who have experienced depressive illness may be attempting to diet. Although being heavier than one would wish undermines self-esteem and contributes to depressed mood, dieting itself may trigger the recurrence of depression. Clinicians can alert patients to this possibility, and they can discourage sudden decreases in caloric intake and encourage them to adopt sensible eating and exercise habits that allow for gradual weight loss.

— NL Stotland

Published in Journal Watch Women's Health April 1, 2000

Citation(s):

Smith KA et al. Impaired regulation of brain serotonin function during dieting in women recovered from depression. Br J Psychiatry 2000 Jan 176 72-75.

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