Original Article

International Journal of Obesity (2009) 33, 257–266; doi:10.1038/ijo.2008.268; published online 6 January 2009

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

G Zhao1, E S Ford1, S Dhingra1, C Li1, T W Strine1 and A H Mokdad2

  1. 1Division of Adult and Community Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
  2. 2Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA

Correspondence: Dr G Zhao, Division of Adult and Community Health, Centers for Disease Control and Prevention, 4770 Buford Hwy, Mailstop K66, Atlanta, GA 30341, USA. E-mail: GZhao@cdc.gov

Received 26 June 2008; Revised 1 November 2008; Accepted 18 November 2008; Published online 6 January 2009.

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Abstract

Background:

 

Obesity is associated with an increased risk of developing a variety of chronic diseases, most of which are associated with psychiatric disorders. We examined the associations of depression and anxiety with body mass index (BMI) after taking into consideration the obesity-related comorbidities (ORCs) and other psychosocial or lifestyle factors.

Methods:

 

We analyzed the data collected from 177 047 participants (agedgreater than or equal to18 years) in the 2006 Behavioral Risk Factor Surveillance System. Current depression was assessed by the Patient Health Questionnaire-8 diagnostic algorithm. Lifetime diagnoses of depression, anxiety and ORCs were self-reported. The prevalence of the three psychiatric disorders was age standardized to the 2000 US population. Multivariate-adjusted prevalence ratios were computed to test associations of depression and anxiety with BMI using SUDAAN software.

Results:

 

The age-adjusted prevalence of current depression, lifetime diagnosed depression and anxiety varied significantly by gender. Within each gender, the prevalence of the three psychiatric disorders was significantly higher in both men and women who were underweight (BMI<18.5 kg/m2), in women who were overweight (BMI: 25–<30 kg/m2) or obese (BMIgreater than or equal to30 kg/m2), and in men who had class III obesity (BMIgreater than or equal to40 kg/m2) than in those with a normal BMI (18.5-<25 kg/m2). After adjusting for demographics, ORCs, lifestyle or psychosocial factors, compared with men with a normal BMI, men with a BMIgreater than or equal to40 kg/m2 were significantly more likely to have current depression or lifetime diagnosed depression and anxiety; men with a BMI<18.5 kg/m2 were also significantly more likely to have lifetime diagnosed depression. Women who were either overweight or obese were significantly more likely than women with a normal BMI to have all the three psychiatric disorders.

Conclusions:

 

Our results demonstrate that disparities in the prevalence of depression and anxiety exist among people with different BMI levels independent of their disease status or other psychosocial or lifestyle factors.

Keywords:

anxiety, depression, psychiatric disorders, body mass index, obesity-related comorbidity, BRFSS

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