Perceived weight discrimination mediates the prospective relation between obesity and depressive symptoms in U.S. and U.K. adults.

Eric Robinson,Michael Daly,Angelina Sutin

doi:10.1037/hea0000426

Abstract

Objective: Obesity has been shown to increase risk of depression. Persons with obesity experience discrimination because of their body weight. Across 3 studies, we tested for the first time whether experiencing (perceived) weight-based discrimination explains why obesity is prospectively associated with increases in depressive symptoms. Method: Data from 3 studies, including the English Longitudinal Study of Ageing (2008/2009–2012/2013), the Health and Retirement Study (2006/2008–2010/2012), and Midlife in the United States (1995/1996–2004/2005), were used to examine associations between obesity, perceived weight discrimination, and depressive symptoms among 20,286 U.S. and U.K. adults. Results: Across all 3 studies, Class II and III obesity were reliably associated with increases in depressive symptoms from baseline to follow-up. Perceived weight-based discrimination predicted increases in depressive symptoms over time and mediated the prospective association between obesity and depressive symptoms in all 3 studies. Persons with Class II and III obesity were more likely to report experiencing weight-based discrimination, and this explained approximately 31% of the obesity-related increase in depressive symptoms on average across the 3 studies. Conclusion: In U.S. and U.K. samples, the prospective association between obesity (defined using body mass index) and increases in depressive symptoms in adulthood may in part be explained by perceived weight discrimination.

Highlights

In US and UK samples, the prospective association between obesity and increases in depressive symptoms in adulthood may in part be explained by perceived weight discrimination
There is convincing evidence for a bi-directional link between obesity and depression: depression is associated with future weight gain (Grundy, Cotterchio, Kirsh, & Kreiger, 2014; Luppino, et al, 2010) and persons with obesity are at greater risk of developing depressive symptoms than their ‘normal’ weight counterparts (Faith et al, 2011; Herva et al, 2006; Roberts, Deleger, Strawbridge, & Kaplan, 2003)
There is evidence that the severity of obesity predicts the strength of the association between obesity and depression, whereby persons with class II obesity and above are most likely to suffer from depressive symptoms (Onyike, Crum, Lee, Lyketsos, & Eaton, 2003; Preiss, Brennan, & Clarke, 2013; Vogelzangs et al, 2010)

Summary

Methods

(2008/2009 – 2012/2013), the Health and Retirement Study (HRS) (2006/2008 – 2010/2012), and Midlife in the United States (MIDUS) (1995/1996 – 2004/2005), were used to examine associations between obesity, perceived weight discrimination and depressive symptoms among 20,286 US and UK adults

Results

Conclusions

Results and Conclusion

General Discussion

Limitations and Future