Abstract
The direction of the association between mental health and adiposity is poorly understood. Our objective was to empirically examine this link in a UK study. This is a prospective cohort study of 3 388 people (men) aged ≥ 18 years at study induction who participated in both the UK Health and Lifestyle Survey at baseline (HALS-1, 1984/1985) and the re-survey (HALS-2, 1991/1992). At both survey examinations, body mass index, waist circumference and self-reported common mental disorder (the 30-item General Health Questionnaire, GHQ) were measured. Logistic regression models were used to compute odds ratios (OR) and accompanying 95% confidence intervals (CI) for the associations between (1) baseline common mental disorder (QHQ score > 4) and subsequent general and abdominal obesity and (2) baseline general and abdominal obesity and re-survey common mental disorders. After controlling for a range of covariates, participants with common mental disorder at baseline experienced greater odds of subsequently becoming overweight (women, OR: 1.30, 1.03 – 1.64; men, 1.05, 0.81 – 1.38) and obese (women, 1.26, 0.82 – 1.94; men, OR: 2.10, 1.23 – 3.55) than those who were free of common mental disorder. Similarly, having baseline common mental health disorder was also related to a greater risk of developing moderate (1.57, 1.21 – 2.04) and severe (1.48, 1.09 – 2.01) abdominal obesity (women only). Baseline general or abdominal obesity was not associated with the risk of future common mental disorder. These findings of the present study suggest that the direction of association between common mental disorders and adiposity is from common mental disorder to increased future risk of adiposity as opposed to the converse.
Highlights
Common mental disorder—comprising anxiety and depression—and obesity exact a considerable public health burden.[1,2] The secular rise in the prevalence of both in recent years has, in part, prompted speculation about their inter-relationship
The prevalence of common mental disorder was more frequent in women at baseline and at the re-survey studies
Age adjusted changes in GHQ score did not vary according to Body mass index (BMI) or waist circumference categories in both genders. Findings from this well characterized population-based cohort of British men and women provide evidence that common mental disorders may be a risk factor for future obesity. This relationship was found for measures of obesity based on BMI and waist circumference
Summary
Common mental disorder—comprising anxiety and depression—and obesity exact a considerable public health burden.[1,2] The secular rise in the prevalence of both in recent years has, in part, prompted speculation about their inter-relationship. Commonly used treatments for depression have known side effects that result in weight gain.[12,13] Given the public health importance of increasing rates of both obesity and common mental disorder, understanding the nature of the association between these two conditions is crucial as it could inform prevention and treatment. This is true in Western societies as the United Kingdom, where the prevalence of obesity almost doubled in the last three decades.[14,15]
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