Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Paper
  • Published:

Prospective association between obesity and depression: evidence from the Alameda County Study

Abstract

OBJECTIVE: To examine the temporal relation between obesity and depression to determine if each constitutes a risk factor for the other.

DESIGN: A two-wave, 5-y-observational study with all measures at both times.

SUBJECTS: A total of 2123 subjects, 50 y of age and older, who participated in the 1994 and 1999 waves of the Alameda County Study.

MEASUREMENTS: Obesity defined as body mass index (BMI)30. Depression assessed using DSM-IV symptom criteria for major depressive episodes. Covariates include indicators of age, gender, education, marital status, social support, life events, physical health problems, and functional limitations.

RESULTS: Obesity at baseline was associated with increased risk of depression 5 y later, even after controlling for depression at baseline and an array of covariates. The reverse was not true; depression did not increase the risk of future obesity.

CONCLUSION: These results, the first ever on reciprocal effects between obesity and depression, add to a growing body of evidence concerning the adverse effects of obesity on mental health. More studies are needed on the relation between obesity and mental health and implications for prevention and treatment.

This is a preview of subscription content, access via your institution

Access options

Rent or buy this article

Prices vary by article type

from$1.95

to$39.95

Prices may be subject to local taxes which are calculated during checkout

Similar content being viewed by others

References

  1. Reed DB . The relationship between obesity and psychological general well-being in United States women. Diss Ab Int 1985; 46: 3791.

    Google Scholar 

  2. Istavan J, Zavelta K, Weidner G . Body weight and psychological distress in NHANES 1. Int J Obes 1992; 16: 999–1003.

    Google Scholar 

  3. Ross C . Overweight and depression. J Health Soc Behav 1994; 35: 63–79.

    Article  CAS  Google Scholar 

  4. Han TS, Tijhuis MA, Lean ME, Seidell JC . Quality of life in relation to overweight and body fat distribution. Am J Public Health 1998; 88: 1814–1820.

    Article  CAS  Google Scholar 

  5. Carpenter KM, Hasin DS, Allison DB, Faith MS . Relationship between obesity and DSM-IV major depressive disorder, suicide ideation, and suicide attempts: results from a general population study. Am J Public Health 2000; 90: 251–257.

    Article  CAS  Google Scholar 

  6. Roberts RE, Kaplan GA, Shema SJ, Strawbridge WJ . Are the obese at greater risk for depression? Am J Epidemiol 2000; 152: 163–170.

    Article  CAS  Google Scholar 

  7. Roberts RE, Strawbridge WJ, Deleger S, Kaplan GA . Are the fat more jolly? Ann Behav Med 2002; 24: 169–180.

    Article  Google Scholar 

  8. Crisp AH, McGuiness B . Jolly fat: Relation between obesity and psychoneurosis in general population. BMJ 1975; 1: 7–9.

    Article  Google Scholar 

  9. Crisp AH, Queenan M, Sittampaln Y, Harris G . ‘Jolly Fat’ revisited. J Psychosom Res 1980; 24: 233–241.

    Article  CAS  Google Scholar 

  10. Hallstrom T, Noppa H . Obesity in women in relation to mental illness, social factors, and personality traits. J Psychosom Res 1981; 25: 75–82.

    Article  CAS  Google Scholar 

  11. Palinkas LA, Wingard DL, Barrett-Connor E . Depressive symptoms in overweight and obese older adults: a test of the ‘jolly fat’ hypothesis. J Psychosom Res 1996; 40: 59–66.

    Article  CAS  Google Scholar 

  12. Friedman MA, Brownell KD . Psychological correlates of obesity: moving to the next research generation. Psychol Bull 1995; 117: 3–20.

    Article  CAS  Google Scholar 

  13. Noppa H, Hallstrom T . Weight gain in adulthood in relation to socioeconomic factors, mental illness, and personality traits: a prospective study of middle-aged women. J Psychosom Res 1981; 25: 83–89.

    Article  CAS  Google Scholar 

  14. Kaplan GA, Roberts RE, Camacho TC, Coyne JC . Psychosocial predictors of depression: prospective evidence from the human population laboratory studies. Am J Epidemiol 1987; 125: 206–220.

    Article  CAS  Google Scholar 

  15. Perlis ML, Giles DE, Buysse DJ, Tu X, Kupfer DJ . Self-reported sleep disturbance as a prodromal symptom in recurrent depression. J Affect Disord 1997; 42: 209–212.

    Article  CAS  Google Scholar 

  16. Pi-Sunyer FX . Medical hazards of obesity. Ann Intern Med 1993; 119: 655–660.

    Article  CAS  Google Scholar 

  17. Wurtman JJ, Brzezinski A, Wurtman RJ, Laferrere B . Effect of nutrient intake on premenstrual depression. Am J Obstet Gynecol 1989; 161: 1228–1234.

    Article  CAS  Google Scholar 

  18. Wurtman RJ, Wurtman JJ . Carbohydrates and depression. Sci Am 1989; 260: 68–75.

    Article  CAS  Google Scholar 

  19. Lieberman HR, Wurtman JJ, Chew B . Changes in mood after carbohydrate consumption among obese individuals. Am J Clin Nutr 1986; 44: 772–778.

    Article  CAS  Google Scholar 

  20. Ross CE, Hayes D . Exercise and psychologic well-being in the community. Am J Epidemiol 1988; 127: 762–771.

    Article  CAS  Google Scholar 

  21. DiPietro L, Anda RF, Williamson DF, Stunkard AJ . Depressive symptoms and weight change in a national cohort of adults. Int J Obes Relat Metab Disord 1992; 16: 745–753.

    CAS  PubMed  Google Scholar 

  22. Roberts RE, Kaplan GA, Shema SJ, Strawbridge WJ . Does growing old increase risk for depression? Am J Psychiatry 1997; 154: 1384–1390.

    Article  CAS  Google Scholar 

  23. Roberts RE, Kaplan GA, Shema SJ, Strawbridge WJ . Prevalence and correlates of depression in an aging cohort. J Gerontol B 1997; 52: S252–S258.

    Article  CAS  Google Scholar 

  24. Kennedy GJ, Kelman HR, Thomas C . Persistence and remission of depressive symptoms in late life. Am J Psychiatry 1991; 148: 174–178.

    Article  CAS  Google Scholar 

  25. Blazer D, Burchett B, Service C, George LK . The association of age and depression among the elderly: an epidemiologic exploration. J Gerontol 1991; 46: 210–215.

    Article  Google Scholar 

  26. Lewinsohn PM, Rohde P, Seeley JR, Fischer SA . Age and depression: unique and shared effects. Psychol Aging 1991; 6: 247–260.

    Article  CAS  Google Scholar 

  27. Jorm AF . The epidemiology of depressive states in the elderly: implications for recognition, intervention, and prevention. Soc Psychiatr Epidemiol 1995; 30: 53–59.

    Article  CAS  Google Scholar 

  28. Stewart AW, Jackson RT, Ford MA, Beaglehole R . Underestimation of relative weight by use of self-reported height and weight. Am J Epidemiol 1987; 125: 122–126.

    Article  CAS  Google Scholar 

  29. Hill A, Roberts J . Body mass index: a comparison between self-reported and measured height and weight. J Public Health Med 1998; 20: 206–210.

    Article  CAS  Google Scholar 

  30. Nieto-García FJ, Bush TL, Keyl PM . Body mass definitions of obesity: sensitivity and specificity using self-reported weight and height. Am J Epidemiol 1990; 1: 146–152.

    Article  Google Scholar 

  31. Kuczmarski MF, Kuczmarski RJ, Najjar M . Effects of age on validity of self-reported height, weight, and body mass index: findings from the third national health and nutrition examination survey, 1988–1994. J Am Dietetic Assoc 2001; 101: 28–34.

    Article  CAS  Google Scholar 

  32. Benazzi F . Weight gain in depression remitted with anti-depressants: pharmacological or recovery effect? Psychother Psychosom 1998; 67: 270–274.

    Article  Google Scholar 

  33. Sussman N, Ginsberg D . Rethinking side-effects of the selective serotonin reuptake inhibitors: sexual dysfunction and weight gain. Psychiatr Ann 1998; 28: 89–97.

    Article  Google Scholar 

  34. Shiori T, Kato T, Murashita J, Yamada N, Takahaski S . Changes in the frequency distribution pattern of body weight in patients with major depression. Acta Psychiatr Scand 1993; 88: 356–360.

    Article  Google Scholar 

  35. Barefoot JC, Heitmann BL, Helms MJ, Williams RB, Surwit RS, Siegler IC . Symptoms of depression and changes in body weight from adolescence to mid-life. Int J Obes Relat Metab Disord 1998; 22: 688–694.

    Article  CAS  Google Scholar 

  36. Michelson D, Amsterdam JD, Quitkin FM, Reimherr FW, Rosenbaum JF, Zajecka J, Dundell KL, Kim Y, Beasley CM . Changes in weight during a 1-year trial of fluoxetine. Am J Psychiatry 1999; 156: 1170–1176.

    CAS  PubMed  Google Scholar 

  37. Brownell KD, Wadden TA . Etiology and treatment of obesity: understanding a serious, prevalent, and refractory disorder. J Consult Clin Psychol 1992; 60: 505–517.

    Article  CAS  Google Scholar 

  38. Rosenthal NE, Genhart M, Jacobson RG, Skwerer RG, Wehr TA . Disturbances of appetite and weight regulation in seasonal affective disorder. Ann NY Acad Sci 1987; 499: 216–230.

    Article  CAS  Google Scholar 

  39. Lobstein DD, Mosbacher BJ, Ismail AH . Depression as a powerful discriminator between physically active and sedentary middle-aged men. J Psychosom Res 1983; 27: 69–76.

    Article  CAS  Google Scholar 

  40. Black DA, Goldstein RB, Mason EE . Prevalence of mental disorder in 88 morbidly obese bariatric clinic patients. Am J Psychiatry 1992; 149: 227–234.

    Article  CAS  Google Scholar 

  41. National Institutes of Health. Clinical guidelines on the identification, evaluation, and treatement of overweight and obesity in adults. The Evidence Report, Obesity Education Initiative, DHHS; June 1998.

Download references

Acknowledgements

This research is supported in part by a grant from the National Institute on Aging (AG—113 75) to George A Kaplan.

Author information

Authors and Affiliations

Authors

Appendix

Appendix

Items contained in DSD-12 (response: yes/no, for nearly every day for past 2 weeks)

  1. 1

    Feeling sad, blue, or depressed.

  2. 2

    Loss of interest or pleasure in most things.

  3. 3

    Feeling tired out or low on energy most of the time.

  4. 4

    Loss of appetite or weight loss.

  5. 5

    Overeating or weight gain.

  6. 6

    Trouble falling asleep or staying asleep.

  7. 7

    Sleeping too much.

  8. 8

    More trouble than usual concentrating on things.

  9. 9

    Feeling down on yourself, no good, or worthless.

  10. 10

    Being so fidgety or restless that you moved around a lot more than usual.

  11. 11

    Moved or spoke so slowly that other people could have noticed.

  12. 12

    Thought about death more than usual, either your own, someone else's, or death in general.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Roberts, R., Deleger, S., Strawbridge, W. et al. Prospective association between obesity and depression: evidence from the Alameda County Study. Int J Obes 27, 514–521 (2003). https://doi.org/10.1038/sj.ijo.0802204

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.ijo.0802204

Keywords

This article is cited by

Search

Quick links