Abstract
BackgroundObesity is associated with an increased risk of mental illness; however, evidence linking body mass index (BMI)-a measure of overall obesity, to mental illness is inconsistent. The objective of this study was to examine the association of depressive symptoms with waist circumference or abdominal obesity among overweight and obese U.S. adults.MethodsA cross-sectional, nationally representative sample from the 2005-2006 National Health and Nutrition Examination Survey was used. We analyzed the data from 2,439 U.S. adults (1,325 men and 1,114 nonpregnant women) aged ≥ 20 years who were either overweight or obese with BMI of ≥ 25.0 kg/m2. Abdominal obesity was defined as waist circumference of > 102 cm for men and > 88 cm for women. Depressive symptoms (defined as having major depressive symptoms or moderate-to-severe depressive symptoms) were assessed by the Patient Health Questionnaire-9 diagnostic algorithm. The prevalence and the odds ratios (ORs) with 95% confidence intervals (CIs) for having major depressive symptoms and moderate-to-severe depressive symptoms were estimated using logistic regression analysis.ResultsAfter multivariate adjustment for demographics and lifestyle factors, waist circumference was significantly associated with both major depressive symptoms (OR: 1.03, 95% CI: 1.01-1.05) and moderate-to-severe depressive symptoms (OR: 1.02, 95% CI: 1.01-1.04), and adults with abdominal obesity were significantly more likely to have major depressive symptoms (OR: 2.18, 95% CI: 1.35-3.59) or have moderate-to-severe depressive symptoms (OR: 2.56, 95% CI: 1.34-4.90) than those without. These relationships persisted after further adjusting for coexistence of multiple chronic conditions and persisted in participants who were overweight (BMI: 25.0-< 30.0 kg/m2) when stratified analyses were conducted by BMI status.ConclusionAmong overweight and obese U.S. adults, waist circumference or abdominal obesity was significantly associated with increased likelihoods of having major depressive symptoms or moderate-to-severe depressive symptoms. Thus, mental health status should be monitored and evaluated in adults with abdominal obesity, particularly in those who are overweight.
Highlights
Obesity is associated with an increased risk of mental illness; evidence linking body mass index (BMI)-a measure of overall obesity, to mental illness is inconsistent
In unadjusted models (Model 1), waist circumference was significantly associated with the presence of both major depressive symptoms and moderate-to-severe depressive symptoms (P < 0.01, Table 2); the relationships persisted after adjusting for socio-demographic variables and lifestyle
Using a large, population-based sample from National Health and Nutrition Examination Survey (NHANES), we found that, among overweight and obese adults, waist circumference and/or abdominal obesity was significantly associated with increased prevalence and likelihood of having major depressive symptoms or moderate-to-severe depressive symptoms, suggesting abdominal obesity is a strong correlate of depression, for adults who were overweight by their BMI status
Summary
Obesity is associated with an increased risk of mental illness; evidence linking body mass index (BMI)-a measure of overall obesity, to mental illness is inconsistent. The objective of this study was to examine the association of depressive symptoms with waist circumference or abdominal obesity among overweight and obese U.S adults. The prevalence of obesity, defined as a body mass index (BMI) of ≥ 30 kg/m2, was 32% in the United States during 2001-2004 and increased slightly to 34% during 2005-2006 [2]. By using a large nationally representative sample, we sought to examine whether abdominal obesity measured by waist circumference was associated with depressive symptoms among overweight and obese adults after taking into consideration multiple risk factors including demographic characteristics, lifestyle factors, and coexistence of multiple chronic conditions. Our study makes a unique contribution to the literature by using a larger, populationbased, and nationally representative sample including both men and women with objective measures of overall and central obesity, which is rare for epidemiologic research
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