Higher BMI linked to worse depressive symptoms among middle-aged and older adults
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Key takeaways:
- Having a higher BMI or waist-height ratio is tied to more severe depressive symptoms.
- A stronger relationship between adiposity and depressive symptoms was observed for women than men.
Adults with a higher BMI and waist-to-hip ratio may be more likely to report worse depression, according to study findings published in PLOS ONE.
“Other studies have demonstrated a relationship between overweight and obesity and depression,” Seán Millar, MPH, PhD, research support officer and postdoctoral researcher in the School of Public Health at University College Cork in Ireland, told Healio. “However, there has been a lack of research [that] has investigated whether this relationship is independent of lifestyle factors (such as smoking, alcohol use and low-level physical activity) and disease conditions, which are also related to both adiposity and depression, and which may confound the relationship. Our research suggests that the relationship between increased adiposity and depressive symptoms is independent of these factors.”
Millar and colleagues conducted a cross-sectional study with data from 1,821 adults aged 46 to 73 years who attended a primary care clinic in Ireland from May 2010 to April 2011 and had anthropometric and mental health data available. BMI was calculated using height and weight measurements obtained during a clinic visit. Waist circumference was also measured and used along with height to obtain waist-height ratio. Two questionnaires were used to assess depressive symptoms: the 20-item Center for Epidemiologic Studies Depression Scale (CES-D) and the five-item WHO Well-Being Index (WHO-5). A higher CES-D score indicated more severe depressive symptoms, whereas a higher WHO-5 score indicated greater well-being.
In a model adjusting for sex, age, education, lifestyle factors and disease conditions, higher BMI (beta = 0.743; P < .001) and higher waist-height ratio (beta = 0.719; P < .001) were associated with worse depressive symptoms on CES-D score. Neither measure was associated with scores on WHO-5.
“Several biological mechanisms are plausible linking increased adiposity with depression,” Millar said. “However, we note that increased weight may exacerbate depression through social means, such as prejudice, discrimination and self- and societal stigma. The chronic pain that is directly caused by obesity, such as joint pain, back pain and fibromyalgia, is also known to result in depression.”
In sex-stratified analysis, the association between higher BMI and higher CES-D score was stronger among women (beta = 0.806; P = .007) than men (beta = 0.573; P = .049). Similarly, the association between higher waist-height ratio and higher CES-D score was stronger for women (beta = 0.768; P = .01) than men (beta = 0.593; P = .044).
“This was a cross-sectional study, and it is possible that increased adiposity is a consequence of depressive symptoms rather than a cause,” Millar said. “Future studies using prospective data in diverse populations are needed. Also ... the mechanism of association between overweight and obesity and depression requires further research.”
For more information:
Seán Millar, MPH, PhD, can be reached at s.millar@ucc.ie.
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