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
Subscribe to this journal
Receive 12 print issues and online access
$259.00 per year
only $21.58 per issue
Buy this article
- Purchase on Springer Link
- Instant access to full article PDF
Prices may be subject to local taxes which are calculated during checkout
Similar content being viewed by others
References
Reed DB . The relationship between obesity and psychological general well-being in United States women. Diss Ab Int 1985; 46: 3791.
Istavan J, Zavelta K, Weidner G . Body weight and psychological distress in NHANES 1. Int J Obes 1992; 16: 999–1003.
Ross C . Overweight and depression. J Health Soc Behav 1994; 35: 63–79.
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.
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.
Roberts RE, Kaplan GA, Shema SJ, Strawbridge WJ . Are the obese at greater risk for depression? Am J Epidemiol 2000; 152: 163–170.
Roberts RE, Strawbridge WJ, Deleger S, Kaplan GA . Are the fat more jolly? Ann Behav Med 2002; 24: 169–180.
Crisp AH, McGuiness B . Jolly fat: Relation between obesity and psychoneurosis in general population. BMJ 1975; 1: 7–9.
Crisp AH, Queenan M, Sittampaln Y, Harris G . ‘Jolly Fat’ revisited. J Psychosom Res 1980; 24: 233–241.
Hallstrom T, Noppa H . Obesity in women in relation to mental illness, social factors, and personality traits. J Psychosom Res 1981; 25: 75–82.
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.
Friedman MA, Brownell KD . Psychological correlates of obesity: moving to the next research generation. Psychol Bull 1995; 117: 3–20.
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.
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.
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.
Pi-Sunyer FX . Medical hazards of obesity. Ann Intern Med 1993; 119: 655–660.
Wurtman JJ, Brzezinski A, Wurtman RJ, Laferrere B . Effect of nutrient intake on premenstrual depression. Am J Obstet Gynecol 1989; 161: 1228–1234.
Wurtman RJ, Wurtman JJ . Carbohydrates and depression. Sci Am 1989; 260: 68–75.
Lieberman HR, Wurtman JJ, Chew B . Changes in mood after carbohydrate consumption among obese individuals. Am J Clin Nutr 1986; 44: 772–778.
Ross CE, Hayes D . Exercise and psychologic well-being in the community. Am J Epidemiol 1988; 127: 762–771.
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.
Roberts RE, Kaplan GA, Shema SJ, Strawbridge WJ . Does growing old increase risk for depression? Am J Psychiatry 1997; 154: 1384–1390.
Roberts RE, Kaplan GA, Shema SJ, Strawbridge WJ . Prevalence and correlates of depression in an aging cohort. J Gerontol B 1997; 52: S252–S258.
Kennedy GJ, Kelman HR, Thomas C . Persistence and remission of depressive symptoms in late life. Am J Psychiatry 1991; 148: 174–178.
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.
Lewinsohn PM, Rohde P, Seeley JR, Fischer SA . Age and depression: unique and shared effects. Psychol Aging 1991; 6: 247–260.
Jorm AF . The epidemiology of depressive states in the elderly: implications for recognition, intervention, and prevention. Soc Psychiatr Epidemiol 1995; 30: 53–59.
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.
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.
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.
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.
Benazzi F . Weight gain in depression remitted with anti-depressants: pharmacological or recovery effect? Psychother Psychosom 1998; 67: 270–274.
Sussman N, Ginsberg D . Rethinking side-effects of the selective serotonin reuptake inhibitors: sexual dysfunction and weight gain. Psychiatr Ann 1998; 28: 89–97.
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.
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.
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.
Brownell KD, Wadden TA . Etiology and treatment of obesity: understanding a serious, prevalent, and refractory disorder. J Consult Clin Psychol 1992; 60: 505–517.
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.
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.
Black DA, Goldstein RB, Mason EE . Prevalence of mental disorder in 88 morbidly obese bariatric clinic patients. Am J Psychiatry 1992; 149: 227–234.
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.
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
Appendix
Appendix
Items contained in DSD-12 (response: yes/no, for nearly every day for past 2 weeks)
-
1
Feeling sad, blue, or depressed.
-
2
Loss of interest or pleasure in most things.
-
3
Feeling tired out or low on energy most of the time.
-
4
Loss of appetite or weight loss.
-
5
Overeating or weight gain.
-
6
Trouble falling asleep or staying asleep.
-
7
Sleeping too much.
-
8
More trouble than usual concentrating on things.
-
9
Feeling down on yourself, no good, or worthless.
-
10
Being so fidgety or restless that you moved around a lot more than usual.
-
11
Moved or spoke so slowly that other people could have noticed.
-
12
Thought about death more than usual, either your own, someone else's, or death in general.
Rights 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
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1038/sj.ijo.0802204
Keywords
This article is cited by
-
Obesity as pleiotropic risk state for metabolic and mental health throughout life
Translational Psychiatry (2023)
-
Primary care physicians’ knowledge and attitudes about obesity, adherence to treatment guidelines and association with confidence to treat obesity: a Swedish survey study
BMC Primary Care (2022)
-
Weight changes and the incidence of depressive symptom in the middle-aged and older adults: findings from the Chinese nationwide cohort study
BMC Public Health (2022)
-
Epidemiological characteristics of different patterns of obesity among adults in rural communities of south-east Nigeria: a population-based cross-sectional study
BMC Nutrition (2022)
-
Deriving neighborhood-level diet and physical activity measurements from anonymized mobile phone location data for enhancing obesity estimation
International Journal of Health Geographics (2022)