Abstract
Background:
Obesity is a well-known cause of cardiovascular disease burden and premature death, but effects on depressive symptoms remain equivocal. Depressive symptoms may be more common among the obese individuals who perceive themselves as overweight, rather than those who perceive themselves as having an acceptable weight. Our aim was to determine whether weight status and weight perceptions are independently associated with psychological distress.
Methods:
We conducted a cross-sectional study using data from the Australian National Health Survey 2004–2005 (N=17 253). All variables were collected by self-report. Adjusted multinomial logistic regression analysis was conducted to generate prevalence odds ratios with 95% confidence intervals (95% CI) for medium (Kessler Psychological Distress Scale (K10) scores of 20–29) and high (K10 scores of 30–50) psychological distress (compared with K10 scores of 10–19 as the reference) associated with weight status (standard body mass index (BMI) cutoffs for underweight, overweight and obesity vs normal weight), weight perception (perceived underweight and overweight vs acceptable weight) and weight misperception (incorrect with BMI vs correct with BMI) adjusting for numerous important covariates.
Results:
Overweight and underweight perception increased the odds of medium (40 and 50%) and high (50 and 120%) psychological distress, whereas weight status and weight misperception were not associated with psychological distress in adjusted analysis. Gender, alcohol consumed per week and post-school education were not significant covariates (at P<0.10 level).
Conclusions:
Overweight and underweight perception rather than weight status or weight misperception are significant risk factors associated with medium and high psychological distress prevalence and effects appear to be uniform for men and women. Well-designed prospective studies are still needed to determine whether weight perceptions cause psychological distress, and if so, whether symptoms are significantly reduced following effective intervention.
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
Li TY, Rana JS, Manson JE, Willett WC, Stampfer MJ, Colditz GA et al. Obesity as compared with physical activity in predicting risk of coronary heart disease in women. Circulation 2006; 113: 499–506.
Gu D, He J, Duan X, Reynolds K, Wu X, Chen J et al. Body weight and mortality among men and women in China. JAMA 2006; 295: 776–783.
Hu G, Tuomilehto J, Silventoinen K, Barengo NC, Peltonen M, Jousilahti P . The effects of physical activity and body mass index on cardiovascular, cancer and all-cause mortality among 47 212 middle-aged Finnish men and women. Int J Obes 2005; 29: 894–902.
Simon GE, Von Korff M, Saunders K, Miglioretti DL, Crane PK, van Belle G et al. Association between obesity and psychiatric disorders in the US adult population. Arch Gen Psychiatry 2006; 63: 824–830.
Australian Bureau of Statistics. 4326.0-Mental Health and Wellbeing: Profile of Adults, Australia, 1997. Canberra: (retrieved June 2, 2006 from: http://www.abs.gov.au/AUSSTATS/abs@.nsf/DetailsPage/4326.01997?OpenDocument); 1998.
Carpenter KM, Hasin DS, Allison DB, Faith MS . Relationships 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.
Johnston E, Johnson S, McLeod P, Johnston M . The relation of body mass index to depressive symptoms. Can J Public Health 2004; 95: 179–183.
Jorm AF, Korten AE, Christensen H, Jacomb PA, Rodgers B, Parslow RA . Association of obesity with anxiety, depression and emotional well-being: a community survey. Aust N Z J Public Health 2003; 27: 434–440.
Heo M, Pietrobelli A, Fontaine KR, Sirey JA, Faith MS . Depressive mood and obesity in US adults: comparison and moderation by sex, age, and race. Int J Obes 2006; 30: 513–519.
Istvan J, Zavela K, Weidner G . Body weight and psychological distress in NHANES I. Int J Obes Relat Metab Disord 1992; 16: 999–1003.
Ladwig K-H, Marten-Mittag B, Lowel H, Doring A, Koenig W . Influence of depressive mood on the association of CRP and obesity in 3205 middle aged healthy men. Brain Behav Immun 2003; 17: 268–275.
Onyike CU, Crum RM, Lee HB, Lyketsos CG, Eaton WW . Is obesity associated with major depression? Results from the third national health and nutrition examination survey. Am J Epidemiol 2003; 158: 1139–1147.
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.
Turley M, Tobias M, Paul S . Non-fatal disease burden associated with excess body mass index and waist circumference in New Zealand adults. Aust N Z J Public Health 2006; 30: 231–237.
Herva A, Laitinen J, Miettunen J, Veijola J, Karvonen JT, Laksy K et al. Obesity and depression: results from the longitudinal Northern Finland 1966 Birth Cohort Study. Int J Obes 2006; 30: 520–527.
Roberts RE, Deleger S, Strawbridge WJ, Kaplan GA . Prospective association between obesity and depression: evidence from the Alameda County Study. Int J Obes Relat Metab Disord 2003; 27: 514–521.
Roberts RE, Strawbridge WJ, Deleger S, Kaplan GA . Are the fat more jolly? Ann Behav Med 2002; 24: 169–180.
Roberts RE, Kaplan GA, Shema SJ, Strawbridge WJ . Are the obese at greater risk for depression? Am J Epidemiol 2000; 152: 163–170.
Dixon JB, Dixon ME, O’Brien PE . Depression in association with severe obesity: changes with weight loss. Arch Intern Med 2003; 163: 2058–2065.
Karlsson J, Taft C, Sjostrom L, Torgerson JS, Sullivan M . Psychosocial functioning in the obese before and after weight reduction: construct validity and responsiveness of the Obesity-related Problems scale. Int J Obes Relat Metab Disord 2003; 27: 617–630.
Karlsson J, Taft C, Ryden A, Sjostrom L, Sullivan M . Ten-year trends in health-related quality of life after surgical and conventional treatment for severe obesity: the SOS intervention study. Int J Obes 2007; 31: 1248–1261.
Vage V, Solhaug JH, Viste A, Bergsholm P, Wahl AK . Anxiety, depression and health-related quality of life after jejunoileal bypass: a 25-year follow-up study of 20 female patients. Obes Surg 2003; 13: 706–713.
Larsen JK, Geenen R, van Ramshorst B, Brand N, de Wit P, Stroebe W et al. Psychosocial functioning before and after laparoscopic adjustable gastric banding: a cross-sectional study. Obes Surg 2003; 13: 629–636.
Rowston WM, McCluskey SE, Gazet JC, Lacey JH, Franks G, Lynch D . Eating behaviour, physical symptoms an psychological factors associated with weight reduction following the scopinaro operation as modified by gazet. Obes Surg 1992; 2: 355–360.
Schwartz MB, Vartanian LR, Nosek BA, Brownell KD . The influence of one's own body weight on implicit and explicit anti-fat bias. Obesity 2006; 14: 440–447.
Puhl RM, Brownell KD . Confronting and coping with weight stigma: an investigation of overweight and obese adults. Obesity 2006; 14: 1802–1815.
Latner JD, Stunkard AJ, Wilson GT . Stigmatized students: age, sex, and ethnicity effects in the stigmatization of obesity. Obesity Res 2005; 13: 1226–1231.
Strauss RS, Pollack HA . Social marginalization of overweight children. Arch Pediatr Adolesc Med 2003; 157: 746–752.
Xie B, Chou C-P, Spruijt-Metz D, Reynolds K, Clark F, Palmer PH et al. Weight perception, academic performance, and psychological factors in Chinese adolescents. Am J Health Behav 2006; 30: 115–124.
Xie B, Liu C, Chou CP, Xia J, Spruijt-Metz D, Gong J et al. Weight perception and psychological factors in Chinese adolescents. J Adolesc Health 2003; 33: 202–210.
Chang VW, Christakis NA . Self-perception of weight appropriateness in the United States. Am J Prev Med 2003; 24: 332–339.
Blokstra A, Burns CM, Seidell JC . Perception of weight status and dieting behaviour in Dutch men and women. Int J Obes Relat Metab Disord 1999; 23: 7–17.
Donath SM . Who's overweight? Comparison of the medical definition and community views. Med J Aust 2000; 172: 375–377.
ter Bogt TFM, van Dorsselaer SAFM, Monshouwer K, Verdurmen JEE, Engels RCME, Vollebergh WAM . Body mass index and body weight perception as risk factors for internalizing and externalizing problem behavior among adolescents. J Adolesc Health 2006; 39: 27–34.
AAPOR. Standard Definitions: Final Dispositions of cases Codes and Outcome Rates for Surveys 4th edn Lenexa, Kansas: American Association for Public Opinion Research, 2006.
Kessler RC, Andrews G, Colpe LJ, Hiripi E, Mroczek DK, Normand SLT et al. Short screening scales to monitor population prevalences and trends in non-specific psychological distress. Psychol Med 2002; 32: 959–976.
Furukawa TA, Kessler RC, Slade T, Andrews G . The performance of the K6 and K10 screening scales for psychological distress in the Australian National Survey of Mental Health and Well-Being. Psychol Med 2003; 33: 357–362.
Andrews G, Slade T . Interpreting scores on the kessler psychological distress scale (K10). Aust N Z J Public Health 2001; 25: 494–497.
Bornstein SR, Schuppenies A, Wong ML, Licinio J . Approaching the shared biology of obesity and depression: the stress axis as the locus of gene-environment interactions. Mol Psychiatry 2006; 11: 892–902.
McElroy SL, Kotwal R, Malhotra S, Nelson EB, Keck PE, Nemeroff CB . Are mood disorders and obesity related? A review for the mental health professional. J Clin Psychiatry 730 2004; 65: 634–651.
Stunkard AJ, Faith MS, Allison KC . Depression and obesity. Biol Psychiatry 2003; 54: 330–337.
Gallagher D, Heymsfield SB, Heo M, Jebb SA, Murgatroyd PR, Sakamoto Y . Healthy percentage body fat ranges: an approach for developing guidelines based on body mass index. Am J Clin Nutr 2000; 72: 694–701.
Puhl R, Brownell KD . Bias, discrimination, and obesity. Obesity Res 2001; 9: 788–805.
Flegal KM, Graubard BI, Williamson DF, Gail MH . Excess deaths associated with underweight, overweight, and obesity. JAMA 2005; 293: 1861–1867.
Katzmarzyk PT, Craig CL, Bouchard C . Original article underweight, overweight and obesity: relationships with mortality in the 13-year follow-up of the Canada Fitness Survey. J Clin Epidemiol 2001; 54: 916–920.
Atlantis E, Barnes EH, Ball K . Weight status and perception barriers to healthy physical activity and diet behavior. Int J Obes 2007 advance online publication 7 August 2007.
Ball K, Crawford D, Owen N . Too fat to exercise? Obesity as a barrier to physical activity. Aust N Z J Public Health 2000; 24: 331–333.
Australian Bureau of Statistics. How Australians Measure Up Canberra: (retrieved May 18, 2006 from: http://www.ausstats.abs.gov.au/Ausstats/subscriber.nsf/Lookup/CA25687100069892CA256889001F4A36/$File/43590_1995.pdf) 1998.
Acknowledgements
Kylie Ball is supported by a NHMRC/NHFA Career Development Award.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Atlantis, E., Ball, K. Association between weight perception and psychological distress. Int J Obes 32, 715–721 (2008). https://doi.org/10.1038/sj.ijo.0803762
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1038/sj.ijo.0803762
Keywords
This article is cited by
-
Socioeconomic position, perceived weight, lifestyle risk, and multimorbidity in young adults aged 18 to 35 years: a Multi-country Study
BMC Public Health (2023)
-
Body Mass Index and risk for onset of mood and anxiety disorders in the general population: Results from the Netherlands Mental Health Survey and Incidence Study-2 (NEMESIS-2)
BMC Psychiatry (2022)
-
Associations between depression, domain-specific physical activity, and BMI among US adults: NHANES 2011-2014 cross-sectional data
BMC Public Health (2022)
-
Assessing the importance of relative body weight in shaping life satisfaction: Evidence from 1 million Americans
Current Psychology (2022)
-
Do weight perception and bullying victimization account for links between weight status and mental health among adolescents?
BMC Public Health (2021)