Depression and body mass index, differences by education: Evidence from a population-based study of adult women in the U.S. Buffalo-Niagara region

Abstract

The relationship between obesity and depression is well described. However, the evidence linking depression and body mass index (BMI) across the broad range of body size is less consistent. We examined the association between depressive symptoms and BMI in a sample of adult women in the Buffalo-Niagara region between 1997 and 2001. Using logistic regression, we investigated whether increased weight status beyond normal-weight was associated with a higher prevalence of depressive symptoms, and if educational attainment modified the association between obesity and depression. There was a trend for increased weight status to be associated with higher depressive symptoms (obese II/III, OR 1.57, 95% CI 1.03–2.41), whereas higher education was associated with lower odds of depressive symptoms, in an adjusted model including BMI (more than 12 but less than 16 years, OR 0.70, 95% CI 0.49–0.98; 16 or more years of education, OR 0.61, 95% CI 0.40–0.93). The association of being obese I with depressive symptoms was different for more educated (OR 2.15, 95% CI 1.27–3.62) compared to less educated women (OR 0.90, 95% CI 0.50–1.62); the sample was larger for the more educated women and reached statistical significance. There were no differences in the association for obese II/III women in strata of education. There was evidence of risk-difference heterogeneity (0.88, 95% CI 0.84–0.93). In this population-based sample of women in western New York State, increased weight was negligibly associated with depressive symptoms. The association of being obese I with depressive symptoms was different for more compared to less educated women.

Psychiatric morbidities of female obesity before and after dieting: an Egyptian sample

“…And regarding the significant morbidity of depression with obesity, various studies found a close association between obesity and depression [32][33][34][35][36][37] due to the positive relation between depression and emotional eating [38] as well as the associated poor body image, lack of competence, interpersonal problems, and internalization of weight bias with obesity [32].…”

“…Similarly, a study reflected that women with university degrees had a 2.1 kg/m 2 lower BMI compared to that of women with lower education levels because of being more preoccupied by body image issues and leading a higher energy expenditure lifestyle [61]. Also, the prevalence of depression was found to be associated with lower educational level [33,62], lower economic status, and metabolic syndrome than the control group [62].…”

The combined effect of socioeconomic status and metabolic syndrome on depression: the Korean National Health and Nutrition Examination Survey (KNHANES)

“…SES of patients with CMDs was inversely related to the prevalence of depression in both males and females, although the association was stronger in females [41]. In the other study, which was a population-based study of adult females in the United States Buffalo-Niagara region, the prevalence of depression plus obesity was higher in more educated women than in less educated women (OR=2.15, 95% CI 1.27-3.62) [42]. By contrast, the combination of education level and MS was more strongly associated with depression in males than in females in our study.…”

“…We observed similar trends in all three models. Two previous studies reported the prevalence of depression and its comorbidities according to SES [41,42]. In the MultiCare Cohort Study, lower SES was associated with a higher prevalence of chronic conditions, such as cardiovascular and metabolic disorders (CMDs), as well as the composite outcome of depression, anxiety, somatoform disorders, and pain.…”

Association between depression and the combination of lower socioeconomic status and metabolic syndrome: the Korean National Health and Nutrition Examination Survey (KNHANES)

“…SES was inversely related to the composite outcome including depression in both males and females, although the association was stronger in females [41]. In the other study, which was a population-based study of adult females in the United States Buffalo-Niagara region, the likelihood of depression plus obesity was higher in more educated women than in less educated women (OR = 2.15, 95% CI 1.27-3.62) [42]. By contrast, the combination of education level and MS was more strongly associated with depression in males than in females in our study.…”