Obesity and psychopathology in women: a three decade prospective study

Abstract

Objective: To evaluate prospective associations between elevations in body mass index (BMI) at average age 27 and generalized anxiety disorder (GAD) and major depressive disorder (MDD) at average age 59 in a community sample of women. Design: Three waves of data collected over three decades were drawn from mothers in the Children in the Community (CIC) Study. Binary logistic regression was used to estimate predictive effects of two BMI cutpoints (X30 and X25) on GAD and MDD independent of other risks for psychopathology. Measurements: Information about height and weight was obtained by self-report in face-to-face interviews. GAD and MDD were assessed by structured interview covering DSM-IV diagnostic criteria. Other potential risk factors examined included age, race, education, prior depressive symptoms and marital status, chronic disease, social support and financial strain concurrent with GAD and MDD. Results: A baseline BMI X30 significantly increased the odds for subsequent GAD and MDD by 6.27 and 5.25 times, respectively, after adjusting for other significant risk factors. Odds of GAD also increased significantly given a baseline BMI X25 (by 2.44 times); however this association was not independent of other significant risk factors. Predictive associations between a baseline BMI X30 and MDD were not attenuated by attained BMI assessed at outcome. Conclusion: Findings extend existing evidence of the mental health consequences of obesity in a representative sample of mothers, and suggest that obesity may have long-term implications for mental distress in women at a clinical level over the adult years.

Depression and anxiety among US adults: associations with body mass index

“…After adjustment for all these variables, the associations between depression/anxiety and BMI levels remained significant in this study, which is consistent with the findings of most recent studies. [7][8][9][10][11][12][13][14][15] Moreover, our results agree with the earlier studies in that the mental disorder status or its association with BMI levels varies by gender. 7,20,28,29,40 However, our results differed from those of several other studies that have reported no relationship 26 or an inverse association of overweight/obesity with mental disorders in men.…”

“…3 A growing body of evidence has shown that obesity, highly prevalent and increasing in the United States and worldwide, [4][5][6] is associated with an increased risk of developing psychiatric disorders. [7][8][9][10][11][12][13][14][15] However, most of the earlier studies failed to evaluate the effects of obesity-related comorbidities (ORCs), lifestyle factors (such as smoking, alcohol drinking and physical activity) or other psychosocial factors (such as general health status, emotional support and life satisfaction) on mental health simultaneously, although these factors also affect mental health status 13,[16][17][18][19] or are associated with mental disorders. 16,[20][21][22][23][24][25] On the other hand, some other studies have found no relationship 26 or an inverse association of overweight/obesity with mental disorders in men.…”

The association between obesity and anxiety disorders in the population: a systematic review and meta-analysis

“…We found three additional studies through bibliography hand-searches, yielding 16 relevant publications for this systematic review. [30][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45] Inter-rater agreement was good for study screening (kappa statistic 0.72, 95% CI: 0.57-0.87) and for quality assessment (kappa 0.75, 95% CI: 0.62-0.88). Tables 1 and 2 summarize the characteristics and main findings of the prospective and cross-sectional studies, respectively.…”

“…In one study, 33 obesity had a significant positive effect on anxiety disorder in men but not in women. In the other women-only study, 38 obesity had a strong positive effect in women. Bjerkeset et al, 33 followed a large cohort (n ¼ 33 777) of Norwegian men and women for approximately 10 years (1984-1986 and 1995-1997).…”

“…When stratified by gender, the association strengthened for men but became nonsignificant for women. Kasen et al, 38 used a smaller sample (n ¼ 544) of American mothers interviewed on three occasions (1975, 1983 and 2002-2005). Past 6-month generalized anxiety disorder was ascertained from Diagnostic and Statistical Manual of Mental Disorder-IV diagnostic criteria.…”