You may know about the physical health problems that often come with obesity. But did you know mental health issues and food insecurity have also been linked to having excess weight?

Research shows these three conditions are related, but it’s not clear if one (or two) of them tend to cause the other(s), or if they have other causes in common. Not only that, the relationships among these three conditions might differ based on sex or other factors. Unfortunately, not enough research has been done with diffferent groups to provide clear answers.

Even though researchers aren’t sure exactly how obesity, mental health problems, and food insecurity relate to each other, just knowing they are related is helpful. If you or someone you care for has or is at risk for one of these conditions, you’ll know to check for signs of the others.

Let’s take a closer look at these three conditions:

• Obesity is a state of excess body weight, defined as body mass index (BMI)—an indirect measure of body fat based on height and weight—of at least 30 kg/m2 . You can find your BMI by entering your height and weight into this calculator. Note: BMI does not take body composition into account. So while BMI is useful as a quick way to estimate body fat, it is not a perfect measure.   
• Mental health problems include mood and anxiety disorders, depression, and bipolar disorder, among others. Feelings of depression or excessive anxiety are not normal parts of aging. Even though they are treatable just like diabetes or high blood pressure, more than half of adults with mental health problems do not receive the care they need.
• Food insecurity has been defined as not having the resources to consistently access enough food for a healthy, active life. This is not the same as hunger, which refers to a personal, physical feeling of discomfort.

How common are obesity, mental health problems, and food insecurity in older adults in the U.S.?

• Almost 39% of people age 60 and older are living with obesity, which represents millions of older adults.¹
• Nearly 14% of people age 50 and older have some type of mental health concern.² Anxiety and depression are the most common.
• About 7% of people age 60 and older were food insecure in 2021, which is the most recent year for which we have data. This represents more than 5.5 million seniors across the country. This percentage varies by state, with a low of about 2.8% in North Dakota to a high of nearly 13.4% in Louisiana.³

COVID introduced new challenges for older adults trying to stay mentally healthy, access healthy foods, and manage their weight. For example, one survey found that people age 65 and older were more likely to report no change in their physical activity levels (52%) or lower levels of physical activity (27%) during the pandemic. Only 12% reported doing more physical activity.

What do we know about the connections between obesity, mental health issues, and food insecurity?

Obesity and mental health: Older adults who carry excess weight often struggle with depression and other mental health disorders. One research analysis found that "Psychological issues associated with obesity can contribute to a range of complications that impact mental health, physical health, and overall well-being." Another study found that middle- and older-aged adults with obesity and depression were more likely to develop disabilities compared with those who had normal weights or had obesity or depression alone.⁴

People with obesity may be more susceptible to mental health problems for multiple reasons, such as:

• Quality of life challenges (e.g., difficulty with physical and occupational functions)
• Weight bias and discrimination (negative stereotypes and attitudes that label people with obesity as unattractive, lazy, and undisciplined)
• Poor body image
• Systemic inflammation

Obesity and food insecurity: The relationship between obesity and food insecurity used to be considered counterintuitive. But with more research, scientists concluded that coexistence of the two conditions is expected given that both result from economic and social disadvantages.

People with low incomes and food insecurity can be more vulnerable to obesity because of the challenges they face to making healthy choices. These include limited financial resources, less access to healthy foods, high levels of stress, limited access to health care, and fewer opportunities for physical activity.

One study that looked at obesity, food insecurity, and depression found that women who had a BMI of 30 or higher—and also reported food insecurity—were at a significantly higher risk for depression than women who did not report food insecurity.⁵

Food insecurity and mental health: Struggling to put enough food on the table has been linked to poorer overall health, depression, muscle weakness, and decreased bone mass, which may lead to conditions like osteoporosis. A recent study suggested that food insecurity in adults age 50 and older is associated with more wear and tear on the body. But enrolling in the Supplemental Nutrition Assistance Program (SNAP) seemed to help protect against the poor health outcomes noted.⁶

What can older adults with food insecurity do to get help?

There are solutions to help older adults get enough nutrition to maintain a healthy, active, and independent life. One of them is SNAP, formerly known as food stamps. SNAP is a federal program that helps eligible people and families buy the food they need to maintain good health. Foods that can be purchased with SNAP benefits include fruits and vegetables, whole grain breads and cereals, dairy products, fish, lean meats and poultry, and more.

When older adults add more nutrient-rich foods to their diets using SNAP benefits, they can reduce their risk of health problems that compromise quality of life while also supporting efforts to manage their weight. The average SNAP benefit for a one-person senior household is $158 per month.⁷ You can learn more about SNAP at NCOA's BenefitsCheckup.org.

As an older adult, you may find it challenging to manage your weight and maintain positive mental health. Solutions like SNAP can help you address one or more of these conditions and improve your health and quality of life.

Sources

1. Centers for Disease Control and Prevention. Obesity and Severe Obesity Prevalence in Adults: United States, August 2021–August 2023. September 2024. Found on the internet at https://www.cdc.gov/nchs/products/databriefs/db508.htm

2. National Institute of Mental Health. Mental Illness. Found on the internet at https://www.nimh.nih.gov/health/statistics/mental-illness

3. Feeding America. The State of Senior Hunger in 2021. April 2023. Found on the internet at https://www.feedingamerica.org/sites/default/files/2023-04/State%20of%20Senior%20Hunger%20in%202021.pdf

4. Lin Lin, et. al. Comorbid depression and obesity, and its transition on the risk of functional disability among middle-aged and older Chinese: a cohort study. BMC Geriatrics. April 3, 2022. Found on the internet at https://pubmed.ncbi.nlm.nih.gov/35366819/

5. Manik Ahuja, et. al. Obesity, food insecurity, and depression among females. Archives of Public Health. September 17, 2020. Found on the internet at https://archpublichealth.biomedcentral.com/articles/10.1186/s13690-020-00463-6

6. Tae-Young Pak, PhD, et. al. Association of Food Insecurity With Allostatic Load Among Older Adults in the U.S. JAMA Network Open. December 7, 2021. Found on the internet at https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2786917

7. USDA. Characteristics of Supplemental Nutrition Assisance Program Households in 2020. June 2022. Found on the internet at https://fns-prod.azureedge.us/sites/default/files/resource-files/Characteristics2020.pdf