The Incidence of Antidepressant Use in Obese Veteran Outpatients at VA Mines Hospital

Abstract

The overall prevalence of depression in the obese population is not well agreed upon in the literature. The incidence is reportedly between 10-16%. Antidepressants are commonly used to treat depression and the types of antidepressants used have been associated with weight loss or gain. A retrospective chart review was conducted on 378 patients with a diagnoses of obesity (ICD-9-CM 278.00–278.01). Obesity was classified as a Body Mass Index (BMI) ≥ 30 or Ideal Body Weight (IBW) > 120%. Dosage, type and duration of antidepressants was recorded as well as weight changes. 272 veterans met the criteria for obesity. Mean age was 61 years ± 2.2 with a mean BMI of 37.5 ± 6.6. Antidepressant use was observed in 68 (25%) of the obese veterans. Average duration for antidepressant use was 8.8 months ± 5.7. There was no significant difference in mean age, BMI, weight change or time between weight measurements between those taking antidepressants and those not taking antidepressants. Use of tricyclic antidepressants was slightly higher than use of selective serotonin reuptake inhibitors (SSRI). There was a significant association between weight loss with use of SSRIs but not with Tricyclics (χ2–4.32, p<0.04). Analysis of variance showed a significant difference in mean weight loss between those taking Tricyclics vs. SSRIs vs. no antidepressants (p<0.007). It appears that the incidence of depression may be higher in our population of obese veterans than what is reported in the literature. The specific type of antidepressant being taken was related to either weight gain or weight loss, with tricyclics associated with weight gain and SSRIs with weight loss.