Which body weight status is associated with depression? Results from a European population study

Abstract

Background: A bidirectional relationship has been reported between depression and obesity. Malta, a European small state, is a highly prevalent country for obesity making this population ideal to study this relationship. The aim of this study was to identify the adiposity characteristics of a population-based depression sub-group and explore for any relationships between depression and an increase in adiposity. Methods: A nationally representative health examination survey was conducted in Malta. Body mass index was measured while a validated questionnaire was used to establish the presence of depression and the sociodemographic characteristics of the participants. The study population was categorized into different sub-populations according to their adiposity status (normal, overweight, obese) and their self-reported depression. Multivariate logistic regression analyses were performed to identify independent adiposity status and socio-demographic factors associated with depression. Results: The prevalence of self-reported depression was 10.44% (CI 95%: 9.52 - 11.43) with a female predominance and an overweight-obese profile. Extreme obesity (>50Kg/m2) was only present in individuals without depression. Only the overweight status (OR: 1.35 CI95%: 1.03 - 1.78 p = 0.03) was statistically linked with depression along with being female, having a low education level, being unemployed or retired and being a smoker. Conclusions: The adiposity driver for the growing depression epidemic appears to be overweight rather than obesity. Stressful social determinants including unemployment, retirement, low education and being female have a role in this growing health concern. This calls for preventive action plans targeting overweight status, depression along with unfavourable sociodemographic characteristics. Key messages: Overweight status was found to be linked with depression. Targeted action plans to prevent overweight and depression should be implemented with special attention to population with unfavourable sociodemographic characteristics.