Skip to main content
PMC home page
Canadian Journal of Public Health = Revue Canadienne de Santé Publique logoLink to Canadian Journal of Public Health = Revue Canadienne de Santé Publique
. 2004 May 1;95(3):179–183. doi: 10.1007/BF03403643

The Relation of Body Mass Index to Depressive Symptoms

Elizabeth Johnston 14,✉, Shanthi Johnson 14, Peter McLeod 24, Mark Johnston 34
PMCID: PMC6976152  PMID: 15191118

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.

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. doi: 10.1001/archinte.161.13.1581. [DOI] [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. doi: 10.1176/ajp.149.2.227. [DOI] [PubMed] [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. doi: 10.1037/0278-6133.12.5.342. [DOI] [PubMed] [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. doi: 10.1016/0022-3999(87)90039-0. [DOI] [PubMed] [Google Scholar]
  • 5.Wadden TA, Stunkard AJ. Psychopathology and obesity. Ann N Y Acad Sci. 1987;499:55–65. doi: 10.1111/j.1749-6632.1987.tb36197.x. [DOI] [PubMed] [Google Scholar]
  • 6.Gilmore J. Body mass index and health. Health Rep. 1999;11(1):1–43. [PubMed] [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. doi: 10.2105/AJPH.90.2.251. [DOI] [PMC free article] [PubMed] [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. doi: 10.1093/aje/152.2.163. [DOI] [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. doi: 10.1207/S15324796ABM2403_02. [DOI] [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. doi: 10.1038/sj.ijo.0802204. [DOI] [PubMed] [Google Scholar]
  • 11.Weissman MM, Klerman GL. Sex differences in the epidemiology of depression. Arch Gen Psychiatry. 1977;34(1):98–111. doi: 10.1001/archpsyc.1977.01770130100011. [DOI] [PubMed] [Google Scholar]
  • 12.Nolen-Hoeksema S. Sex differences in unipolar depression: Evidence and theory. Psychol Bull. 1987;101(2):259–82. doi: 10.1037/0033-2909.101.2.259. [DOI] [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. doi: 10.1017/S0033291797006077. [DOI] [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. doi: 10.1007/s00127-002-0569-0. [DOI] [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. doi: 10.1093/aje/kwf182. [DOI] [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. 2002. [Google Scholar]
  • 17.Nova Scotia Department of HealthHeart Health Nova Scotia. The Nova Scotia Health Survey 1995. 1996. [Google Scholar]
  • 18.Nova Scotia Department of Health . Department of National Health and Welfare. 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. doi: 10.1016/S0022-3999(02)00311-2. [DOI] [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. doi: 10.1016/S0022-3999(02)00315-X. [DOI] [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. doi: 10.1177/014662167700100306. [DOI] [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. doi: 10.1007/BF03404989. [DOI] [PMC free article] [PubMed] [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. doi: 10.1037/0882-7974.7.1.119. [DOI] [PubMed] [Google Scholar]
  • 25.Mirowsky J, Ross CE. Age and depression. J Health Social Behav. 1992;33(3):187–205. doi: 10.2307/2137349. [DOI] [PubMed] [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. doi: 10.1016/0022-3999(95)00542-0. [DOI] [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. doi: 10.1017/S0021932099005556. [DOI] [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. doi: 10.1590/S0034-89101999000100004. [DOI] [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. doi: 10.1186/1471-2458-1-11. [DOI] [PMC free article] [PubMed] [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. doi: 10.1093/oxfordjournals.aje.a114494. [DOI] [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. doi: 10.1093/oxfordjournals.pubmed.a024744. [DOI] [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. doi: 10.1016/S0002-8223(01)00008-6. [DOI] [PubMed] [Google Scholar]
  • 33.Ross C. Overweight and depression. J Health Soc Behav. 1994;35(1):63–79. doi: 10.2307/2137335. [DOI] [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. doi: 10.1037/0033-2909.117.1.3. [DOI] [PubMed] [Google Scholar]
  • 35.American P Association. Diagnostic and Statistical Manual of Mental Disorders. 4 ed. Washington, DC: American Psychiatric Association; 1994. [Google Scholar]

Articles from Canadian Journal of Public Health = Revue Canadienne de Santé Publique are provided here courtesy of Springer

RESOURCES