Are bidirectional associations of obesity and depression already apparent in childhood and adolescence as based on high‐quality studies? A systematic review

Abstract

Our aim was to evaluate bidirectional associations of obesity and depression in cross-sectional and longitudinal studies with initial assessments in childhood or adolescence. The clarification of these relationships may support the development of innovative interventions, e.g. based on nutrition and mental health. A systematic literature search was conducted in MEDLINE. Main inclusion criteria were (i) assessment of subjects <18 years at baseline, (ii) use of validated psychometric instruments and (iii) elicitation of objectively measured anthropometric data at least at one time point. Twenty-four studies met our inclusion criteria. Out of 19, 14 cross-sectional studies confirmed a significant association of obesity and depression. Three out of eight longitudinal studies reported associations between obesity and subsequent depression in female children and adolescents only, and three out of nine studies obtained evidence in favour of the other direction with two studies revealing significant results only for female and one only for male children and adolescents. Evidence is mixed, and secure conclusions are hampered by the methodological variance of the included studies. Relationships are seemingly more readily detectable in female children adolescents and in the cross-sectional compared with the longitudinal analyses. Possibly, the joint development of obesity and depression in predisposed subjects accounts for the latter discrepancy.

Association between psychological problems and overweight and obesity in school children

“…Looking at gender differences in our study, the female sex did not explain the relationship between emotional problems and obesity as has been shown by other studies with children (Erickson et al, 2000;Gibson et al, 2008) and adolescents (Mühlig et al, 2016).…”

“…The relationship between a high BMI and psychological problems has been described for as early as 3 years of age (Griffiths, Dezateux, & Hill, 2011). Although the most related problems seem to be emotional, such as anxiety and depression disorders (Brumpton, Langhammer, Romundstad, Chen, & Mai, 2013;Chiang, Huang, Lo, Lee, & Wahlqvist, 2013;Esposito et al, 2014;Faith et al, 2011;Morrison, Shin, Tarnopolsky & Taylor, 2015;Mühlig, Antel, Föcker, & Hebebrand, 2016;Roberts & Duong, 2016), age, gender, the clinical or community sample, and cultural differences may explain the association with other psychological problems (Burke & Storch, 2015;Gibson et al, 2008;Griffiths et al, 2011;Sawyer et al 2006;Seyedamini, Malek, Ebrahimi-Mameghani, & Tajik, 2012;Ter Bogt et al, 2006;Tso, Rowland, Toumbourou, & Guadagno, 2017). In contrast, other authors have not found a relationship between psychopathology and overweight/ obesity (Freitas-Rosa, Goncalves, & Antunes, 2014), or the differences were so small that many associations became non-significant after adjusting for a range of sociodemographic covariates (Sawyer et al, 2006).…”

“…Specifically, the association between obesity and depression could differ in relation to gender and age (Anderson, Cohen, Naumova, & Must, 2006;Chiang et al, 2013;Pervanidou & Chrousos, 2011), as it is most problematical among adolescent females (Blaine, 2008;Mühlig et al, 2016;Rofey et al, 2009;Vámosi et al, 2010). Obesity may increase the risk of depression through stigmatization, body image dissatisfaction (BD), effects of dieting, and impairments in physical health and functioning.…”

Maternal Depression and Childhood Overweight in the CHAMACOS Study of Mexican-American Children

“…The relationship of maternal depression and childhood overweight/obesity has been hypothesized to be associated with parenting practices [16], as depressed mothers may have difficulty sustaining exclusive breastfeeding [1], recognizing child satiety cues [18,19], providing healthful food choices [18,24], and modeling physical activity behaviors relative to non-depressed mothers [23]. Maternal depression also increases risk for depression in children [5,14,15], which may in turn influence children's weight [25].…”

Intervention through internet to improve health cognitive factors in adolescents

“…The previous overview, all this is known as an obesogenic environment (Miqueleiz et al, 2015), which together with biological factors like certain hormones that stimulate hunger and satiety, the baby's weight at birth and genetic load, condition the excess of body fat in adolescents and metabolic problems (González et al, 2015., Landgraf et al, 2015. Consequently, on the one hand, non-transmissible diseases like diabetes, hypertension and metabolic syndrome are increasingly more common among adolescents and, on the other hand, obesity has also been associated with psychosomatic symptoms like depression and anxiety levels (Landgraf et al, 2015, Mühlig et al, 2016.…”