Each year, June is designated Men's Mental Health Month, in recognition that – while women are more likely to suffer from mental health issues such as depression and anxiety – men are less likely to seek help for them. Furthermore, while more women attempt suicide than men globally, men are twice as likely to die by suicide than women (and up to four times more in the USA1) – adding further to the need for open discussion around mental health conditions in men in order to reduce the stigma around them.
National Institute of Mental Health Data from 2021 estimated that ~21M Americans had at least one major depressive episode; for men this equated to a prevalence of 6.2% – or ~7.9M men (vs. 10.3% for women).2 The prevalence was greatest in those aged 18-25 years (18.6%) and in people of 2 or more races (13.9%) or American Indian/Alaskan Native (11.2%).2 In addition, more than six million men have anxiety and phobias.1
Alongside these concerning levels of psychiatric disorders, there has been an increasing prevalence of overweight and obesity over the last 40 years. High-income countries started experiencing epidemics of obesity and overweight in the 1970s and 1980s, followed by most middle- and many low-income countries.3 Indeed, these conditions are now recognized as a pandemic: globally, 43% of adults are overweight and 16% are living with obesity.4
Apart from the physical effects associated with overweight and obesity (including hormone disruption, increased risk of diabetes, heart disease and certain cancers, and osteoarthritis), it may also have social consequences (e.g., biases that affect employment and relationships) as well as emotional and psychological impacts (e.g., poor body image, low self-esteem, psychiatric disorders). Consequently, since the mid-20th century, researchers have investigated the association between mental health conditions such as depression and body size and/or metabolic syndrome.
Overweight/Obesity and Mental Illness
The link between mental illnesses and body size has been demonstrated in multiple reports. There is a 2- to 3-fold increased risk of obesity in people with mental health problems; conversely, obese individuals have a 30-70% higher risk of developing them.5 Most studies have focused on the connection between depression and BMI, but other psychiatric diseases also carry a risk of overweight and obesity, including schizophrenia and bipolar disorder.5 There are multiple factors that can contribute to weight gain in these circumstances, including side effects of medications (e.g., neurotransmitters that affect appetite and body weight regulation) and associated unhealthy lifestyles (smoking, reduced physical activity, poor food choices, alcohol overuse).5
As noted, being overweight or obese can also lead to mental health issues, such as increased depression scores and reduced quality of life.5 This association is more pronounced with physical impairment, so is more apparent in later life.5 Nevertheless, even in adolescence the link is recognized: obese adolescents have a 40% increased risk of being depressed (while depressed adolescents have a 70% increased risk of obesity).5 Furthermore, while adolescent girls have a stronger association between weight and mental health issues, adolescent boys are more psychologically sensitive to increases in their weight.6
The association between BMI and mental ill-health has been investigated specifically in more than 12,000 older Australian men over a 10-year period, revealing that for those with a BMI ≥30 kg/m2, the likelihood of developing depression was increased by 31% compared to non-obese men.7 Those with metabolic syndrome had a 137% increased risk of depression. Another Australian study produced similar results: compared to metabolically healthy normal-weight men, those with BMIs over 25 kg/m2 and/or who were metabolically unhealthy had increased odds of having depressive symptoms (though it was only significant in the metabolically unhealthy obese group).8 As in general, the prevalence of depression is greater in overweight or obese women compared to men,9 but this may also be due to reporting bias (where men are less likely to disclose their psychiatric symptoms).8
Implications
The strong association between overweight, obesity and metabolic syndrome and mental health requires that each condition be treated concurrently. By only treating mental ill-health, there is an increased risk of developing overweight and obesity. Conversely, psychiatric examinations should be part of the management of overweight, obesity, and metabolic syndrome. Thankfully, the development of glycogen-like peptide-1 (GLP-1) and other analogs to manage weight is allowing these chronic diseases to be effectively treated. Furthermore, the nutraceutical supplement Calocurb® provides another tool to help with weight loss.
Calocurb® contains Amarasate, a bitter extract of hop flowers that activates bitter taste receptors sitting on enteroendocrine L-cells throughout the gut. The L-cells then release GLP-1, cholecystokinin (CCK), and peptide YY (PYY). When taken an hour before a meal, Calocurb resulted in a 6.4-fold increase in GLP-1, a 6-fold increase in CCK, and a 2.7-fold increase in PYY.10 These gut hormones act to delay gastric emptying and increase satiety, so at the subsequent ad libitum meal, the participants consumed 18% fewer calories.10 Calocurb was also beneficial during a 24-hour water fast in healthy men, who experienced a 25% reduction in overall cravings when they took it, compared to the placebo arm of the study.11
Conclusion
In the context of Men's Mental Health Month, it's important to recognize that almost 40% of American men are obese12 and therefore have increased likelihood of depression and other psychiatric conditions. Any discussion around male patients' weight should include questions about their mental and emotional health – especially as they are less likely to reveal any symptoms unprompted than women are. Health care providers (HCPs) should therefore aim to create an environment that not only encourages open communication. If outside of the HCP's scope of practice, overweight and obese patients who have psychological symptoms should be referred to a mental health practitioner for further evaluation and management.
Conversely, when treating men's psychiatric symptoms, those who are overweight or living with obesity should be offered management of those conditions too, to keep them out of a vicious cycle of increasing BMI and mental ill-health. Offering Calocurb in addition to a GLP-1 receptor agonist (RA) may be particularly helpful in men as an adjunctive treatment, because a recent meta-analysis showed that men's weight loss with GLP-1 RAs is less than that of women (6.8% vs. 10.9% for women).13 Concurrent use of Calocurb may not only maintain production of their endogenous GLP-1 (which is blunted by GLP-1 RAs14) but also provide an additional boost to their weight management program.
Overweight and obesity are closely linked with mental health issues. A comprehensive and collaborative approach that addresses both conditions should therefore be adopted to successfully manage both.
Clinically Studied Formula
Harness the Power of Natural GLP-1 Activation
Calocurb® uses Amarasate, a bitter hop flower extract, to naturally trigger your gut's own appetite-suppressing hormones — GLP-1, CCK, and PYY. No synthetic compounds, just science-backed hunger control.
