Skip to main content
SpringerLink
Log in

The Relation of Body Mass Index to Depressive Symptoms

  • Published:
Canadian Journal of Public Health Aims and scope Submit manuscript

Abstract

Objective

Data from the 1995 Nova Scotia Health Survey were analyzed to determine the relation between body mass index (BMI) and the risk of depression as measured by the Center for Epidemiological Studies Depression Scale (CES-D).

Methods

Clinical measures for height and weight and CES-D scores were available for 2,482 subjects from an initial sample of 5,578 Nova Scotians stratified probabilistically to be representative of age, gender and area of residence. BMIs were categorized according to the international standards (BMI 18.5–24.9 acceptable weight; 25–29.9 overweight; ≥ 30 obese).

Results

More men than women were classified as overweight (43.2% vs. 28.3%) but slightly more women than men were obese (25.6% vs. 23.4%). Based on the summary score of the CES-D, 14.2% were categorized as at risk for depression (≥ 16). Logistic regression indicated that lower education (p<0.001) and income (p<0.001), and BMI category (p<0.05) were all significantly related to an increased risk of depression. The odds ratio for the association between obesity and depression, after controlling for education and income, was 1.41 [95% CI = 1.07-1.86]. Discussion: More studies are needed to ascertain the mechanism by which obesity and depression could be related and the significance of this relation for the prevention and treatment of both obesity and depression. Given the effects of depression, we suggest that health professionals should assess their obese patients for risk of depression before embarking on a weight management protocol.

Résumé

Objectif

Nous avons analysé les données de l’enquête sur la santé en Nouvelle-Écosse (1995) pour déterminer la relation entre l’indice de masse corporelle (IMC) et le risque de dépression mesuré selon l’échelle de dépression du Center for Epidemiological Studies (CES-D).

Méthode

Les mesures cliniques de la taille et du poids et les scores du CES-D étaient disponibles pour 2 482 sujets d’un échantillon initial de 5 578 Néo-Écossais, stratifié selon la technique du calcul probabiliste pour être représentatif de l’âge, du sexe et de la région de résidence. Les IMC ont été catégorisés selon les normes internationales (IMC 18,5–24,9 = poids acceptable; 25–29,9 = embonpoint; ≥ 30 obésité).

Résultats

Plus d’hommes que de femmes ont été classés comme faisant de l’embonpoint (43,2 % c. 28,3 %), mais les femmes étaient un peu plus nombreuses que les hommes dans la catégorie des obèses (25,6 % c. 23,4 %). Selon le score sommaire du CES-D, 14,2 % des sujets étaient vulnérables à la dépression (≥ 16). Par régression logistique, nous avons déterminé que de faibles niveaux d’instruction (p<0,001) et de revenu (p<0,001) et la catégorie d’IMC (p<0,05) étaient trois facteurs liés de façon significative à un risque de dépression accru. Le rapport de cotes de l’association obésité-dépression, compte tenu du niveau d’instruction et du revenu, était de 1,41 (IC de 95 % = 1,07-1,86).

Discussion

Il faudrait davantage d’études pour établir avec précision le mécanisme qui relierait l’obésité à la dépression et la signification de ce lien pour la prévention et le traitement de l’obésité et de la dépression. Étant donné les effets de la dépression, nous suggérons aux professionnels de la santé d’évaluer le risque de dépression de leurs patients obèses avant d’amorcer un protocole de gestion du poids.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Field AE, Coakley EH, Must A, Spadano JL, Laird N, Dietz WH, et al. Impact of overweight on the risk of developing common chronic diseases during a 10-year period. Arch Intern Med 2001;161(13):1581–86.

    Article  CAS  PubMed  Google Scholar 

  2. Black DW, Goldstein RB, Mason, EE. Prevalence of mental disorders in 88 morbidly obese bariatric clinic patients. Am J Psychol 1992;149(2):227–34.

    Article  CAS  Google Scholar 

  3. Fitzgibbon ML, Stolley MR, Kirschenbaum, DS. Obese people who seek treatment have different characteristics than those who do not seek treatment. Health Psychol 1993;12(5):346–53.

    Article  Google Scholar 

  4. Hafner RJ, Watts JM, Rogers J. Psychological status of morbidly obese women before gastric restriction surgery. J Psychosom Res 1987; 31(5):607–12.

    Article  CAS  PubMed  Google Scholar 

  5. Wadden TA, Stunkard, AJ. Psychopathology and obesity. Ann N Y Acad Sci 1987;499:55–65.

    Article  CAS  PubMed  Google Scholar 

  6. Gilmore J. Body mass index and health. Health Rep 1999;11(1):1–43.

    Google Scholar 

  7. 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(2):251–57.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Roberts RE, Kaplan GA, Shema SJ, Strawbridge WJ. Are the obese at greater risk for depression? Am J Epidemiol 2000;152(2):163–70.

    Article  CAS  PubMed  Google Scholar 

  9. Roberts RE, Strawbridge WJ, Deleger S, Kaplan GA. Are the fat more jolly? Ann Behav Med 2002; 24(3):169–80.

    Article  PubMed  Google Scholar 

  10. Roberts RE, Deleger S, Strawbridge WJ, Kaplan GA. Prospective association between obesity and depression: Evidence from the Alameda County Study. Intern J Obesity 2003;27(4):514–21.

    Article  CAS  Google Scholar 

  11. Weissman MM, Klerman, GL. Sex differences in the epidemiology of depression. Arch Gen Psychiatry 1977;34(1):98–111.

    Article  CAS  PubMed  Google Scholar 

  12. Nolen-Hoeksema S. Sex differences in unipolar depression: Evidence and theory. Psychol Bull 1987;101(2):259–82.

    Article  CAS  PubMed  Google Scholar 

  13. Bebbington PE, Dunn G, Jenkins R, Lewis G, Brugha T, Farrell M, et al. The influence of age and sex on the prevalence of depressive conditions: Report from the National Survey of Psychiatric Morbidity. Psychol Med 1998;28(1):9–19.

    Article  CAS  PubMed  Google Scholar 

  14. Cairney J, Wade, TJ. The influence of age on gender differences in depression. Soc Psychiatry Psychiatr Epidemiol 2002;37(9):401–8.

    Article  PubMed  Google Scholar 

  15. Lorant V, Deliege D, Eaton W, Robert A, Philippot P, Ansseau M. Socioeconomic inequalities in depression: A meta-analysis. Am J Epidemiol 2003;157(2):98–112.

    Article  CAS  PubMed  Google Scholar 

  16. Statistics Canada, National Population Health Survey, 1994/95. Body mass index (BMI), international standard, by sex, household population aged 20 to 64 excluding pregnant women, Canada and provinces 1994/95-1998/99. [Retrieved from https://doi.org/www.statcan.ca/english/freepub/ 82-221-XIE/00502/tables/html/1222.htm, May 23, 2002].

    Google Scholar 

  17. Nova Scotia Department of Health and Heart Health Nova Scotia. The Nova Scotia Health Survey 1995. Halifax, 1996.

    Google Scholar 

  18. Nova Scotia Department of Health, Department of National Health and Welfare. Report of the Nova Scotia Heart Health Survey 1986. Halifax, 1987.

    Google Scholar 

  19. Carney RM, Freedland KE, Miller GE, Jaffe, AS. Depression as a risk factor for cardiac mortality and morbidity: A review of potential mechanisms. J Psychosom Res 2002;53(4):897–902.

    Article  PubMed  Google Scholar 

  20. Wing RR, Phelan S, Tate D. The role of adherence in mediating the relationship between depression and health outcomes. J Psychosom Res 2002;53(4):877–81.

    Article  PubMed  Google Scholar 

  21. Radloff, LS. The CES-D scale: A self-report depression scale for research in the general population. Appl Psychol Measurement 1977;1(3):385–401.

    Article  Google Scholar 

  22. Tabachnick BG, Fidell, LS. Using Multivariate Statistics, 4th edition. Boston: Allyn and Bacon, 2001.

    Google Scholar 

  23. Patten, SB. Descriptive epidemiology of a depressive syndrome in a western Canadian community population. Can J Public Health 2001;92(5):392–95.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  24. Kessler RC, Foster C, Webster, PS. The relationship between age and depressive symptoms in two national surveys. Psychol Aging 1992;7(1):119–26.

    Article  CAS  PubMed  Google Scholar 

  25. Mirowsky J, Ross, CE. Age and depression. J Health Social Behav 1992;33(3):187–205.

    Article  CAS  Google Scholar 

  26. 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(1):59–66.

    Article  CAS  PubMed  Google Scholar 

  27. Nakamura K, Hoshino Y, Kodama K, Yamamoto M. Reliability of self-reported body height and weight of adult Japanese women. J Biosoc Sci 1999;31(4):555–58.

    Article  CAS  PubMed  Google Scholar 

  28. Chor D, Coutinho Eda S, Laurenti R. Reliability of self-reported weight and height among state bank employees. Rev Saude Publica 1999;33(1):16–23.

    Article  CAS  PubMed  Google Scholar 

  29. Villanueva, EV. The validity of self-reported weight in US adults: A population based crosssectional study. BMC Public Health 2001;1(1):11–21.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  30. 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(1):122–26.

    Article  CAS  PubMed  Google Scholar 

  31. Hill A, Roberts J. Body mass index: A comparison between self-reported and measured height and weight. J Public Health Med 1998;20(2):206–10.

    Article  CAS  PubMed  Google Scholar 

  32. 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 Dietet Assoc 2001;101(1):28–34.

    Article  CAS  Google Scholar 

  33. Ross C. Overweight and depression. J Health Soc Behav 1994;35(1):63–79.

    Article  CAS  PubMed  Google Scholar 

  34. Friedman MA, Brownell, KD. Psychological correlates of obesity: Moving to the next research generation. Psychol Bull 1995;117(1):3–20.

    Article  CAS  PubMed  Google Scholar 

  35. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 4 ed., Text revision. Washington, DC: American Psychiatric Association, 1994.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. School of Nutrition and Dietetics, Acadia University, Wolfville, NS, B4P 2R6, Canada

    Elizabeth Johnston PhD (Director and Professor) & Shanthi Johnson PhD

  2. Department of Psychology, Acadia University, Canada

    Peter McLeod PhD

  3. Valley Regional Hospital, Kentville, NS, Canada

    Mark Johnston MD, FRCPC

Authors
  1. Elizabeth Johnston PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Shanthi Johnson PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Peter McLeod PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Mark Johnston MD, FRCPC
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Elizabeth Johnston PhD.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Johnston, E., Johnson, S., McLeod, P. et al. The Relation of Body Mass Index to Depressive Symptoms. Can J Public Health 95, 179–183 (2004). https://doi.org/10.1007/BF03403643

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF03403643

Search

Navigation