How Metabolic Psychiatry Can Help with Mood Disorders and Weight Gain

Over the recent years, the newly established branch of metabolic psychiatry has led to the emergence of new opportunities to treat the frequently overlooked relationship between mood disorders (depression, anxiety, bipolar spectrum) and metabolic wellbeing, such as weight gain, insulin resistance, and inflammation. This association can be better understood and treated to achieve good outcomes in mental health and metabolic wellness.

What is metabolic psychiatry?

Metabolic psychiatry is defined as the treatment of mental disorders through metabolic and biological interventions, i.e., insulin resistance, inflammation, disrupted energy metabolism in the brain, hormonal imbalances, sleeping disorders, and gut-brain axis failure. This view on mood disorders is not based on neurotransmitters only, but rather incorporates the general metabolic condition of the body and its influence on the health of the brain.

Here, the question is why weight gain and metabolic issues tend to co-exist with a mood problem.

Several overlapping pathways exist that assist in explaining why weight gain, metabolic dysfunction, and mood symptoms tend to accompany each other:

• There are also increased levels of obesity, insulin resistance, metabolic syndrome, and cardiovascular risk in many people with mood disorders. As an example, a study established that the rate of overweight, metabolic syndrome, and obesity was high among psychiatric in-patients, as opposed to the general population.
• There are psychiatric medications (in particular, with some antipsychotics and mood stabilizers) that are known to have long-established connections with weight gain and metabolic side effects.
• The metabolic dysregulation in mood disorders is also caused by lifestyle factors like disturbed sleep, reduced physical activity, emotional eating, cravings, and eating triggered by stress.

New studies indicate that even the energy metabolism of the brain itself can be altered in mood disorders, thus it is not only the case that there are more calories entering the body and brain, but also how the body and brain itself are using the energy. Indicatively, there is the concept of mood disorders as a failure of energy regulation in the body, which is taking root.

The role that metabolic-psychiatric-informed care can play

By combining metabolic care with psychiatric one, the intervention plan becomes more integrative. The following are some of how this approach can be of help:

1. Comprehensive assessment

Clinicians who have been trained in metabolic psychiatry will also measure metabolic markers: fasting glucose/insulin, lipid profile, waist circumference, body composition, inflammatory markers, sleep quality, diet, and physical activity, rather than merely examining mood symptoms. This provides a more comprehensive image of the health of the person and determines possible metabolic causes of mood or energy symptoms.

2. Combination of lifestyle, nutrition, sleep, and psychiatry

Diet and nutrition: Change in Diet to enhance insulin sensitivity, chronic inflammation, and brain energy. This may involve low glycemic load, foods rich in nutrients, and even specific dietary interventions (e.g., ketogenic or low-carb in some instances) that are currently under study as a mood stabilizer.

• Exercise: The exercise enhances insulin sensitivity, blood flow in the brain, mood, and weight control.
• Sleep and circadian support: Sleep deprivation and abnormal circadian cycles are some of the issues that lead to mood and metabolism issues. Dealing with sleep can therefore have two advantages.
• Medication review/optimization to reduce weight gain or metabolic risk: A metabolic psychiatrist can work with psychiatry to select weight-friendly medications, including adjunctive metabolic interventions (e.g., metformin in certain situations) and pay closer attention in these situations.
• Behavioral support: Emotional-eating, fast-food obsessions, sedentary habits- all tend to be manifested with mood disorders- are covered directly. Indicatively, one study indicates that the eating behaviours (disinhibition, sweets/fatty cravings) were predictive of weight gain in psychiatric patients.

3. Attack on the root causes, not the symptoms.

By targeting metabolic dysfunction, we may achieve better mental-health outcomes than are provided by traditional therapy/medication alone. As an example, improving brain energy metabolism and inflammation can result in easier mood regulation, sleep can become better sleep, and, weight/stamina can improve which, in turn, contribute to better resilience.

What does this entail for one experiencing mood and weight gain?

Might particularly be useful in case you are having persistent low mood, anxiety, a bipolar spectrum condition, and you are also experiencing unexplained weight gain, slow metabolism, waking up fatigued, can’t lose weight despite your efforts, or you have noticed that your metabolic lab is becoming more dysfunctional (complicated by high insulin, lipids, etc.), then the metabolic psychiatry approach is particularly helpful.

Ask your provider:

• Have I recently had my metabolic laboratory tests and body composition (insulin, lipids, waist circumference, etc.) checked?
• Is it possible that some of my psychiatric drugs are causing my weight gain or metabolic risk?
• Is it only mood symptoms that we are considering for my treatment plan, or is it also lifestyle, sleep, nutrition, and brain-metabolic health?
• Would it be justifiable to use the team-based approach (psychiatrist + endocrinologist/metabolic specialist + dietitian + sleep specialist) instead of the conventional mental-health care only?

Benefits & expectations

It is not a one-time solution, and you must realize, metabolic psychiatry does not substitute the basic psychiatric modalities (therapy, medication) when they are appropriate, but rather supplements them in significant ways. The advantages that can be expected are:

• Better energy, less clouded thinking.
• Improved capacity to deal with mood swings.
• Early metabolic issues (insulin resistance, high lipids, excess visceral fat): Prevention or reversal.
• Weight maintenance or the gradual intentional minuscule weight reduction as an additive to healthy behaviors and potentially metabolic-adjunctive medications.
• Increased physical health in the long term) (less cardiovascular risk, better longevity).

An appeal to your mental-metabolic health.

When you think you fight with the mood symptoms and the battle of weight/energy/metabolism going on at the same time, the good news is that these two issues are not independent; indeed, they are closely intertwined. It can be more sustainable to find care where the brain and the body are taken into consideration. Check the Bay Area (or any other location) and find psychiatrists or wellness clinics that put metabolic health at the center of their mental-health care approach. Those are the ones that are shaping the future of metabolic psychiatry.

Make the first step: schedule a consultation, bring your latest labs (or request them), offer your complete picture (mood, sleep, energy, weight/waist changes, lifestyle), and request an integrative plan. Your brain and your metabolism will not go wrong.

Call us: +1 (415) 712-8064