Abstract
BackgroundObesity and depression are both highly prevalent public health disorders and evidence on their relationship is inconsistent. This study examined whether depressive symptoms are associated with current obesity, and further, whether obesity in turn is associated with an increased odds of depressive symptoms five years later after accounting for potential lifestyle confounders and depressive symptoms at baseline.MethodsData were obtained from the 1958 British birth cohort (N = 9217 for cross-sectional and 7340 for prospective analysis). Clinical Interview Schedule-Revised and Mental Health Inventory-5 were used for screening depressive symptoms at ages 45 and 50 years, respectively. General and central obesity were defined using measurements of body mass index (BMI) and waist circumference (WC) at 45 years, respectively.ResultsThere was a cross-sectional association between depressive symptoms and obesity: participants with ≥2 depressive symptoms had 31% (95%CI 11% to 55%) higher odds of general and 26% higher odds of central obesity (95%CI 8% to 47%). In prospective analyses, both general and central obesity were associated with higher odds of depressive symptoms five years later among women but not in men (Pinteraction < 0.01). After adjustment for depressive symptoms at baseline, sociodemographic and lifestyle factors, women with general obesity had 38% (95% CI 7% to 77%) and women with central obesity 34% (95%CI 9% to 65%) higher odds of depression compared to others.ConclusionsDepressive symptoms are associated with concurrent obesity and related lifestyle factors among women and men in mid-life. Our study suggests that obesity in turn affects long-term risk of depressive symptoms in women but not in men, independently of concurrent associations, providing an important target group for the implementation of preventative strategies.
Highlights
Obesity and depression are both highly prevalent public health disorders and evidence on their relationship is inconsistent
At age 45 years, around a quarter of participants were classified as having general obesity and 35% with central obesity
Sociodemographic and lifestyle factors associated with greater prevalence of general and central obesity were mostly associated with higher prevalence of depressive symptoms (Table 1)
Summary
Obesity and depression are both highly prevalent public health disorders and evidence on their relationship is inconsistent. Obesity and depression are interrelated; both are known risk factors for cardiovascular disorders and diabetes [4,5,6], and relate to negative health and lifestyles factors such as disturbed sleep patterns, sedentary behaviours and dysregulation in appetite and Previous observational studies on the association between obesity and depressive symptoms have provided mixed findings [10,11,12,13,14,15,16,17], with some suggesting a positive association [10], while others have reported an inverse association (obesity associated with lower risk of depression) [12], no association [13], or a u-shaped association (higher risk of depressive symptoms among underweight and obese individuals) [14] These inconsistencies can Mulugeta et al BMC Psychiatry (2018) 18:297 arise from differences in population characteristics (for example, ethnicity and age) [12, 15, 18], residual confounding [19, 20], or potentially, differences in measures used to define obesity [21]. Another possibility is that dysregulation of the hypothalamus-pituitary-adrenal (HPA) axis could increase the accumulation of fat around the abdomen as well as leading to alterations in mood [27], possibly indicating a greater importance of central rather than general obesity with respect to depression risk
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