Are body weight changes depressogenic? Even intentional weight loss correlates with increased depressive symptomatology among overweight or obese adults in the United States

Abstract

• Obesity relates to depression, but weight changes’ connections to mood are unclear. • A United States national sample of overweight or obese adults participated. • Weight gains and losses, even intentional losses, correlated with higher depression. • Some weight loss methods correlated with higher, and others lower, depression. • Weight losses possibly contribute to depression, but weight loss methods matter. Relations of body weight with depressive symptomatology are complex and incompletely understood. Obesity and depression are clearly linked, but weight loss has correlated with both lower and higher depressive symptomatology in past research. The current study aimed to clarify associations of body weight changes and weight loss methods with depressive symptomatology in a United States national sample. Community-sampled adults ( N = 16794) who were overweight or obese completed measures of weight changes, weight loss intentions, and weight loss methods used over the past year, plus current depressive symptomatology, as part of the National Health and Nutrition Examination Survey in years 2009-2018. Depression symptom severity and clinically-significant depression were modeled with linear and logistic regression, respectively. Both weight gains and losses correlated with greater depressive symptomatology, among adults who tried to lose weight and among those who did not. When adults tried to lose weight, some weight loss methods were associated with lower depressive symptomatology (e.g., exercise, joining a weight loss program) but others (e.g., skipping meals/fasting, using non-prescription weight loss medications) correlated with greater depressive symptomatology. Findings from this cross-sectional observational dataset suggested but could not establish causal connections of weight changes and weight loss methods with depressive symptomatology. Further longitudinal and experimental research is needed to clarify mechanisms and test causality. For overweight or obese adults, both weight gains and losses, including intentional weight losses, are potentially depressogenic. However, adults’ choices of weight loss methods could moderate relations of weight loss with depressive symptomatology.