A study conclusively confirms what’s been speculated and said for ages — being overweight can affect an individual’s mental health. But there is more to the link between obesity and depression than physical factors alone. Shaming people about body-weight, too, plays a role in making them prone to depression.

“[B]eing fatter leads to a higher risk of depression, regardless of the role of metabolic health,” Jessica O’Loughlin from the University of Exeter in the U.K., who co-authored the study, said in a statement. “This suggests that both physical health and social factors, such as social stigma, both play a role in the relationship between obesity and depression,” she added.

Published in Oxford’s Human Molecular Genetics, the study assessed genetic data from more than 145,000 participants from the U.K. Biobank, a large-scale biomedical database compiled to investigate contributions of genetic predisposition and environmental exposure to the development of disease. The study participants also filled in a mental health questionnaire designed to assess levels of depression, and anxiety, if any, besides general well-being.

Metabolic conditions linked to being overweight — like hypertension, diabetes, and cardiovascular disease — do put people at a higher risk of depression. But even in their absence, several study participants, who were overweight, were found to be depressed.

The researchers found two sets of genetic variants that influence one’s metabolic health. One puts people at a higher risk of gaining weight, but staying metabolically healthy; the other one also makes people more prone to gain weight, but makes them more prone to unhealthy metabolism.

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Experts have been saying for a long time that shaming someone won’t lead them to lose weight. “Shaming is the wrong way forward… All of the evidence is that fat-shaming just makes people feel worse. It lowers their self-esteem,” Jane Ogden, a professor of health psychology at the University of Surrey, told BBC.

In fact, a study from 2014 found that fat-shaming was counterproductive — it led people to put on more weight. “Shame leads to increased levels of the stress hormone cortisol, which can stimulate appetite, and increase [the] risk for depression and anxiety — both of which contribute to unhealthy eating habits,” explained Leslie Pristas, a bariatric surgeon from the U.S.

While being shamed for their weight can lead to binge-eating in some as a coping mechanism, putting them at greater “risk for experiencing more weight stigma,” according to Pristas, for some, the stigma surrounding weight-gain can lead to eating disorders too.

So, essentially, active shaming, as well as the stigma surrounding weight in society, can worsen people’s mental health.

“Obesity and depression are both major global health challenges, and our study provides the most robust evidence to date that higher BMI causes depression,” O’Loughlin noted. She believes that insights into how “physical or social factors are responsible for this relationship [between obesity and depression] can help inform effective strategies to improve mental health and well-being.”