“Jolly fat” or “sad fat”: a systematic review and meta-analysis of the association between obesity and depression among community-dwelling older adults

Yu, Mingming; Shi, Yu; Gu, Libin; Wang, Wenru

doi:10.1080/13607863.2020.1857687

Cited by 14 publications

(8 citation statements)

References 58 publications

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“… 9 On the other hand, however, some studies find that high levels of BMI help to reduce the risk of depression, 10 because a larger BMI means a higher reserve of muscle and skeletal mass, which helps to reduce depressive symptoms. 11 In addition, some studies also find that the relationship between BMI and depression is not clear and there is no sufficient evidence to suggest a significant association between the two factors. 12 This implies that the relationship between BMI and depression could be nonlinear, as suggested by a few papers exploring this connection.…”

Section: Introductionmentioning

confidence: 99%

The Nonlinear Relationship Between Body Mass Index (BMI) and Perceived Depression in the Chinese Population

Li¹,

Li²,

Liu³

et al. 2023

PRBM

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Purpose Existing studies on the association between BMI and depression report conflicting results with some demonstrating a positive relationship, while others a negative link or insignificant correlation. Very limited research on the nonlinear relationship between BMI and depression has yet to clarify the reliability and robustness of the potential nonlinearity and whether a more complex association exists. This paper aims to systematically investigate the nonlinear relationship between the two factors applying rigorous statistical methods, as well as explore the heterogeneity of their association. Materials and Methods A large-scale nationally representative dataset, Chinese General Social Survey, is used to empirically analyze the nonlinear relationship between BMI and perceived depression. Various statistical tests are employed to check the robustness of the nonlinearity. Results Results indicate that there is a U-shaped relationship between BMI and perceived depression, with the turning point (25.718) very close to while slightly larger than the upper limit of the range of healthy weight (18.500 ≤ BMI < 25.000) defined by World Health Organization. Both very high and low BMIs are associated with increased risk for depressive disorders. Furthermore, perceived depression is higher at almost all BMI levels among individuals who are older, female, lower educated, unmarried, in rural areas, belonging to ethnic minorities, non-Communist Party of China members, as well as those with lower income and uncovered by social security. In addition, these subgroups have smaller inflection points and their self-rated depression is more sensitive to BMI. Conclusion This paper confirms a significant U-shaped trend in the association between BMI and depression. Therefore, it is important to account for the variations in this relationship across different BMI categories when using BMI to predict depression risk. Besides, this study clarifies the management goals for achieving an appropriate BMI from a mental health perspective and identifies vulnerable subgroups at higher risk of depression.

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Section: Introductionmentioning

confidence: 99%

The Nonlinear Relationship Between Body Mass Index (BMI) and Perceived Depression in the Chinese Population

Li¹,

Li²,

Liu³

et al. 2023

PRBM

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“…(3) The cultural and ethnic differences (e.g., lifestyle, beliefs, values, genetic factors, etc.) between the West and the East may have an impact on the prevalence of obesity, depression, and SA in the population 43 . For instance, the well-known Chinese proverb “laugh and gain fat” refers to the relationship between enjoyment and obesity.…”

Section: Discussionmentioning

confidence: 99%

Gender differences in the association between body mass index and recent suicide attempts in Chinese patients with first-episode drug-naïve major depressive disorder

Liu,

Li,

Jia

et al. 2023

Sci Rep

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Controversial evidence exists on the relationship between body mass index (BMI) and suicide attempts (SA) in patients with major depressive disorder (MDD). This cross-sectional study aimed to explore the association between BMI and SA in first-episode drug-naïve (FEDN) MDD patients in China. The study was conducted from 2016 to 2018 in Taiyuan, China. Univariate and multivariate logistic regression analyzed the BMI–SA association, with subgroup analysis for gender. Threshold effects were examined using two-piecewise regression. In males, BMI was significantly associated with SA (OR = 0.84, 95% CI 0.74–0.94, P = 0.003) after full adjustment, but not in females (OR = 0.97, 95% CI 0.89–1.06, P = 0.541). The interaction with gender was significant (P for interaction < 0.05). Smoothing plots revealed an L-shaped BMI–SA relationship in both genders, with BMI inflection points at 27.3 kg/m2 in males and 21.4 kg/m2 in females. Below the inflection points, BMI is negatively associated with SA in males (OR = 0.75, 95% CI 0.66–0.86, P < 0.001) and females (OR = 0.48, 95% CI 0.32–0.72, P < 0.001). Above the inflection points, no association existed for both genders (all P > 0.05). Results showed an L-shaped nonlinear BMI–SA relationship in FEDN MDD patients but differing BMI inflection points between genders, thus contributing to effective prevention programs for suicide.

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“…Evidence from a meta-analysis indicates that current obesity status may be a protective factor against depression in older adults. 62 Older adults may experience unintentional weight loss due to some health conditions that may be also associated with obesity (e.g., cancer, gastrointestinal disease, cognitive impairment) 63 and this obesity-related morbidity has been found to be related to reduced psychological well-being. 64 Examining current weight status alone in older age participants may fail to address the role of previous obesity status in initiating subsequent adverse physical consequences that contribute to weight loss and current impaired psychological outcomes.…”

Section: Discussionmentioning

confidence: 99%

Obesity, psychological well-being measures, and risk of seven non-communicable diseases: evidence from longitudinal studies of UK and US older adults

Putra,

Daly,

Sutin

et al. 2023

Preprint

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Background: This study examined the role of psychological well-being measures in explaining the associations between obesity and risk of non-communicable diseases (NCDs: hypertension, heart disease, stroke, diabetes, arthritis, cancer, and memory-related disease) in older adults. Methods: Data were from the English Longitudinal Study of Ageing (ELSA), UK (baseline: Wave 4 – 2008/2009; n = 8,127) and the Health and Retirement Study (HRS), US (baseline: Waves 9 and 10 – 2008/2010; n = 12,477) with up to 10-year follow-up period in each study. Objective body mass index was used to define obesity. A range of well-being related psychological measures (e.g., depressive symptoms, life satisfaction) was available in ELSA (n = 7) and HRS (n = 15), and an index of overall psychological distress was developed separately in each study by combining select psychological measures. Health outcomes or NCDs were from a self-reported doctor diagnosis and/or other assessments (e.g., biomarker data) in both studies; and in ELSA, NCDs from linked hospital admissions data were examined. Longitudinal associations between obesity status, psychological measures, and NCDs were examined using Cox proportional hazard models (individual NCDs) and Poisson regression (a cumulative number of NCDs). Mediation by psychological measures was assessed using causal mediation analysis. Results: Obesity was consistently associated with an increased prospective risk of hypertension, heart disease, diabetes, arthritis, and a cumulative number of NCDs in both ELSA and HRS. Overall greater psychological distress and some individual psychological measures were associated with an increased prospective risk of heart disease, stroke, arthritis, memory-related disease, and a cumulative number of NCDs across studies. Findings from mediation analyses showed that neither the index of psychological distress nor any individual psychological measures explained (mediated) why obesity increased the risk of developing NCDs in both studies. Conclusion: Obesity and impaired psychological well-being independently and additively increase the risk of developing NCDs.

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“Jolly fat” or “sad fat”: a systematic review and meta-analysis of the association between obesity and depression among community-dwelling older adults

Cited by 14 publications

References 58 publications

The Nonlinear Relationship Between Body Mass Index (BMI) and Perceived Depression in the Chinese Population

The Nonlinear Relationship Between Body Mass Index (BMI) and Perceived Depression in the Chinese Population

Gender differences in the association between body mass index and recent suicide attempts in Chinese patients with first-episode drug-naïve major depressive disorder

Obesity, psychological well-being measures, and risk of seven non-communicable diseases: evidence from longitudinal studies of UK and US older adults

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