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Risk of future depression in people who are obese but metabolically healthy: the English longitudinal study of ageing

Molecular Psychiatry volume 17, pages 940–945 (2012)Cite this article

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Abstract

There is some evidence to suggest that obesity is a risk factor for the development of depression, although this is not a universal finding. This discordance might be ascribed to the existence of a ‘healthy obese phenotype’—that is, obesity in the absence of the associated burden of cardiometabolic risk factors. We examined whether the association of obesity with depressive symptoms is dependent on the individual's metabolic health. Participants were 3851 men and women (aged 63.0±8.9 years, 45.1% men) from the English Longitudinal Study of Ageing, a prospective study of community dwelling older adults. Obesity was defined as body mass index ⩾30 kg m–2. Based on blood pressure, high-density lipoprotein cholesterol, triglycerides, glycated haemoglobin and C-reactive protein, participants were classified as ‘metabolically healthy’ (0 or 1 metabolic abnormality) or ‘unhealthy’ (⩾2 metabolic abnormalities). Depressive symptoms were assessed at baseline and at 2 years follow-up using the 8-item Centre of Epidemiological Studies Depression (CES-D) scale. Obesity prevalence was 27.5%, but 34.3% of this group was categorized as metabolically healthy at baseline. Relative to non-obese healthy participants, after adjustment for baseline CES-D score and other covariates, the metabolically unhealthy obese participants had elevated risk of depressive symptoms at follow-up (odds ratio (OR)=1.50; 95% confidence interval (CI), 1.05–2.15), although the metabolically healthy obese did not (OR=1.38; 95% CI, 0.88–2.17). The association between obesity and risk of depressive symptoms appears to be partly dependent on metabolic health, although further work is required to confirm these findings.

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Acknowledgements

The data were made available through the UK Data Archive. The English Longitudinal Study of Ageing (ELSA) was developed by a team of researchers based at University College London, the Institute of Fiscal Studies and the National Centre for Social Research. The funding was provided by the National Institute on Aging in the United States (Grants 2RO1AG7644-01A1 and 2RO1AG017644) and a consortium of UK government departments coordinated by the Office for National Statistics. MH was supported by the British Heart Foundation (RE/10/005/28296); GDB is a Wellcome Trust Career Development Fellow (WBS U.1300.00.006.00012.01); MK was supported by the National Heart, Lung, and Blood Institute (R01HL036310-20A2) and the National Institute on Aging (R01AG034454-01), NIH, US and the Academy of Finland. The funders had no role in the study design; in the collection, analysis and interpretation of data; in writing of the report; or in the decision to submit the paper for publication. The developers and funders of ELSA and the Archive do not bear any responsibility for the analyses or interpretations presented here.

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MH had full access to the data and takes responsibility for the integrity and accuracy of the results. All authors contributed to the concept and design of study, drafting and critical revision of the manuscript.

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  1. Department of Epidemiology and Public Health, University College London, London, UK

    M Hamer, G D Batty & M Kivimaki

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  1. M Hamer
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Correspondence to M Hamer.

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Hamer, M., Batty, G. & Kivimaki, M. Risk of future depression in people who are obese but metabolically healthy: the English longitudinal study of ageing. Mol Psychiatry 17, 940–945 (2012). https://doi.org/10.1038/mp.2012.30

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