Depression, anxiety disorders in girls linked to BMI levels in adulthood

Treating female anxiety, depression vital part of obesity prevention.

Issue: September 2006

Depression and anxiety in childhood and adolescence may be an early predictor of risk for higher or lower BMI in adulthood, according to a prospective, longitudinal study.

Girls who first experienced depression at an earlier age tended to have a higher BMI later in life, compared with women who first experienced depression in adulthood, according to Sarah E. Anderson, PhD, of the Friedman School of Nutrition at Tufts University, Boston, and colleagues. However, the researchers found the opposite in boys; depression in childhood correlated with lower childhood BMI and there was no link associated with those who had anxiety disorders in childhood.

“These results … support treating female anxiety and depression as part of comprehensive obesity prevention efforts,” the researchers said.

The increasing prevalence of obesity among children and adults is becoming a public health crisis, according to the researchers. Understanding the social and psychological conditions that are associated with obesity could help predict which children and adolescents are likely to become obese adults, helping physicians target treatment and prevention efforts. Previous evidence suggests that psychological disorders may be one factor associated with weight gain, but studies in the area have been limited, according to the researchers.

Connection to weight

Anderson and colleagues evaluated the association between anxiety disorders and depression and weight gain from childhood into adulthood.

They analyzed existing data from 820 individuals (403 women and 417 men) from Albany and Saratoga counties in New York, who were assessed four times between 1983 and 2003. Participants ranged from 9- to 18-years-old at the beginning of the study and were 28- to 40-years-old at the most recent assessment.

At four separate assessments throughout the study, the participants or their parents, depending on age, provided information about height and weight and answered questions about whether they experienced symptoms of depression or anxiety. At each assessment, participants were interviewed to determine whether they met the clinical criteria for anxiety disorders or depression.

Anderson and colleagues calculated BMI and adjusted it for age and gender based on national reference data.

Findings indicated that 310 participants (119 men and 191 women) had anxiety disorders and 148 participants (50 men and 98 women) were depressed at some time during the study.

Women with anxiety disorders had significantly higher BMI scores than women of the same age and socioeconomic status without the condition. Women with a history of depression were heavier and experienced a greater yearly increase in their BMI scores than women without depression. Women who were younger when they developed depression had higher weights in adulthood than women who developed depression later.

In women, anxiety disorders were associated with higher weight, with average BMI scores ranging from 0.13 to 0.18 units higher than women without anxiety disorders. For example, an adult woman with history of an anxiety disorder who had an average height of 64 inches would weigh between six lb and 12 lb more than a woman without anxiety.

“Although these average weight differences are not large, obesity results from incremental increases in weight, and successful prevention is likely to require interventions targeted toward many factors, no one of which, alone, is sufficient to prevent obesity,” the researchers wrote.

An average-height woman diagnosed with depression at 14-years-old would weigh about 10 lb to 16 lb more than a nondepressed woman by the time both reached 30 years. Depression during childhood was associated with an initially lower BMI among boys, but over time, the weight difference in depressed and nondepressed men disappeared. Anxiety disorders did not appear to be linked to men’s BMIs at any point throughout the study.

“Our results suggest that efforts to improve mental health in populations may also help prevent female obesity; consideration of the potential for psychological antecedents and correlates of obesity could improve prevention and treatment,” they wrote in the Archives of Pediatrics & Adolescent Medicine.

For more information:

Anderson SE, Cohen P, Naumova EN, et al. Association of depression and anxiety disorders with weight change in a prospective community–based study of children followed up into adulthood. Arch Pediatr Adolesc Med. 2006;160:285-291.