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      Association between body size, weight change and depression: systematic review and meta-analysis

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          Abstract

          Background

          The association between body size, weight change and depression has not been systematically summarised, especially for individuals who are underweight.

          Aims

          To conduct a systematic review and a meta-analysis to examine the association between indices of body size, weight change and depression.

          Method

          A total of 183 studies were selected. Fully adjusted hazard ratios (HRs) or odds ratios (ORs) were extracted. A total of 76 studies contributed to data synthesis with a random-effect model, and subgroup analyses were conducted to evaluate the effect of potential moderators.

          Results

          In cohort studies, underweight at baseline increased the risk of subsequent depression (OR = 1.16, 95% CI 1.08–1.24). Overweight (BMI 25–29.9 kg/m 2) showed no statistically significant relationship with depression overall; however, the subgroup analyses found different results according to gender (men: OR = 0.84, 95% CI 0.72–0.97, women: OR = 1.16, 95% CI 1.07–1.25). In cross-sectional designs, obesity with BMI >40kg/m 2 showed a greater pooled odds ratio than obesity with BMI >30kg/m 2.

          Conclusions

          Both underweight and obesity increase the risk of depression. The association between overweight and depression differs by gender.

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          Jolly fat: relation between obesity and psychoneurosis in general population.

          Dimity Crisp, B McGuiness (1976)
          The relation between fatness and aspects of psychological status was investigated in a representative sample (339 men and 400 women) of a middle-aged suburban population. A significant positive relation was found between substantial obesity and low levels of anxiety (in men and women) and depression (in men).
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            Prevalence of depression among people with type 2 diabetes mellitus: a cross sectional study in Palestine

            Waleed M Sweileh, Hanadi M Abu-Hadeed, Samah W. Al-Jabi … (2014)
            Background Diabetes mellitus is a common chronic metabolic disorder and one of the main causes of death in Palestine. Palestinians are continuously living under stressful economic and military conditions which make them psychologically vulnerable. The purpose of this study was to investigate the prevalence of depression among type II diabetic patients and to examine the relationship between depression and socio-demographic factors, clinical factors, and glycemic control. Methods This was a cross-sectional study at Al-Makhfiah primary healthcare center, Nablus, Palestine. Two hundred and ninety-four patients were surveyed for the presence of depressive symptoms using Beck Depression Inventory (BDI-II) scale. Patients' records were reviewed to obtain data pertaining to age, sex, marital status, Body Mass Index (BMI), level of education, smoking status, duration of diabetes mellitus, glycemic control using HbA1C test, use of insulin, and presence of additional illnesses. Patients’ medication adherence was assessed using the 8-item Morisky Medication Adherence Scale (MMAS-8). Results One hundred and sixty four patients (55.8%) of the total sample were females and 216 (73.5%) were < 65 years old. One hundred and twenty patients (40.2%) scored ≥ 16 on BDI-II scale. Statistical significant association was found between high BDI-II score (≥ 16) and female gender, low educational level, having no current job, having multiple additional illnesses, low medication adherence and obesity (BMI ≥ 30 kg/m2). No significant association between BDI score and glycemic control, duration of diabetes, and other socio-demographic factors was found. Multivatriate analysis showed that low educational level, having no current job, having multiple additional illnesses and low medication adherence were significantly associated with high BDI-II scores. Conclusion Prevalence of depression found in our study was higher than that reported in other countries. Although 40% of the screened patients were potential cases of depression, none were being treated with anti-depressants. Psychosocial assessment should be part of routine clinical evaluation of these patients at primary healthcare clinics to improve quality of life and decrease adverse outcomes among diabetic patients.
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              Prevalence of comorbid depression and obesity in general practice: a cross-sectional survey

              Mariko Leanne Carey, Hannah Small, Sze Lin Yoong … (2014)
              Background General practice is a common setting for the provision of weight-management advice, as well as the treatment of depression. While there is some evidence of a reciprocal relationship between obesity and depression, there are limited data about the rates of depression among general practice patients who are underweight, normal weight, overweight, and obese. Aim To explore the prevalence of depression among underweight, normal weight, overweight, and obese general practice patients. Design and setting A cross-sectional survey was conducted in 12 Australian general practices. Method Patients aged ≥18 years and older who were presenting for general practice care were eligible to participate. Consenting patients completed a touchscreen computer survey assessing self-reported weight and height. Depression was assessed by the Patient Health Questionnaire-9 (PHQ-9), with a score of ≥10 used to indicate possible depression. Results Data were obtained from 3361 participants. The prevalence of depression was 24% (95% confidence interval [CI] = 11.86 to 39.28) among underweight participants, 11% (95% CI = 8.5 to 14.0) among normal weight participants, 12% (95% CI = 0.9 to 15.2) among overweight participants, and 23% (95% CI = 17.8 to 29.0) among obese participants. The prevalence of depression was higher for women than for men across all weight categories except underweight. Conclusion Weight and depression demonstrated a U-shaped relationship, with higher prevalence of depression observed among underweight and obese general practice patients. These conditions may act as red flags for opportunistic screening of depression in the general practice setting.
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                Author and article information

                Journal
                Journal ID (publisher-id): applab
                Title: British Journal of Psychiatry
                Abbreviated Title: Br J Psychiatry
                Publisher: Royal College of Psychiatrists
                ISSN (Print): 0007-1250
                ISSN (Electronic): 1472-1465
                Publication date Created: July 2017
                Publication date (Print): January 2 2018
                Volume: 211
                Issue: 01
                Pages: 14-21
                Article
                DOI: 10.1192/bjp.bp.116.186726
                PubMed ID: 28428339
                SO-VID: 06a31a32-0bcd-42b4-86de-2ab993023565
                Copyright © © 2018
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