The relationship between weight history and psychological health—Differences related to gender and weight loss patterns

Franziska U C E Jung; Steffi G Riedel-Heller; Claudia Luck-Sikorski

doi:10.1371/journal.pone.0281776

. 2023 Feb 13;18(2):e0281776. doi: 10.1371/journal.pone.0281776

The relationship between weight history and psychological health—Differences related to gender and weight loss patterns

Franziska U C E Jung ^1,^*, Steffi G Riedel-Heller ^1,^‡, Claudia Luck-Sikorski ^2,^‡

Editor: Meng Li³

PMCID: PMC9925088 PMID: 36780486

Abstract

Background

The prevalence and burden of obesity continues to grow worldwide. Psychological comorbidities may not only influence quality of life, but may also hinder successful weight loss. The causality between excess weight and mental health issues is still not fully understood. The aim of the study was to investigate whetherweight history parameters, (ie.age of onset) are related to psychological comorbidities.

Method

The data were derived from a representative telephone survey in Germany, collecting information on weight loss patterns and mental health outcomes among individuals with BMI>30kg/m². Overall, 787 participants were examined in terms of depressive symptoms (Patient Health Questionnaire, PHQ-9) and anxiety (Generalized Anxiety Disorder Questionnaire, GAD7). In addition, participants were asked about different aspects of their weight history (ie. weight loss patterns and trajectories) over the lifespan. The relationship between weight history and mental health was analyzed using multivariate statistics.

Results

According to regression analyses, having had more weight loss attempts, a greater weight loss being desired and being a “weight maintainer” was associated with more symptoms of depression (p < 0.001), whereas a greater desired weight loss and being categorized as a “weight maintainer” was associated with more anxiety (p < 0.001). Moroever, the prevalence of depressive symptoms was significantly higher in male individuals who desire to lose more weight or had more weight loss attempts in the past.

Conclusion

Gender-specific differences were observed in terms of weight history parameters, as well as mental health outcomes. Especially for men, weight loss patterns seem to be related to depressive symptoms. Concerning the overall results, it becomes clear that screening for weight history at the beginning of a multidisciplinary weight loss program in the context of gender-specific psychological comorbidities is important. The question remains why some aspects of weight history seem to be more important than others.

Introduction

Overweight as well as obesity continue to show rising prevalence worldwide, especially in children and adolescents [1,2]. Currently, the coronavirus disease pandemic (COVID-19) has been associated with both poor mental health as well as unfavorable weight-related health behaviors especially in people with obesity [3]. Apart from a rising prevalence, research on obesity has also focused on different facets of weight history and their impact on comorbidities and overall health, especially in terms of widespreading consequences over the lifespan. According to the life course approach, numerous biological, psychosocial, and cognitive factors can have an independent, cumulative, and interacting impact on the likelihood of developing health problems as people age [4,5]. Especially due to the complexity of obesity, patient-centered care has shown to be important to treat obesity and its comorbidities [6]. So far, a clear definition of weight history does not exist, however, it has been described as an evaluation of “historical information on a patient’s weight gain (or loss) pattern and trajectory” and may be useful to identify treatment options and health risks, for instance with regard to psychological health [7].

Epidemiological studies conclude that up to 23.2% of all women with obesity and 11.7% of all men with obesity are affected by depressive symptoms [8]. Obesity and mental disorders such as depression do not only share a high co-morbidity, but also a functional association in terms of biological pathways [8–10]. Previous studies suggest a bi-directional relationship [11]. In other words, depression may lead to obesity later on in life. On the other hand, obesity may also be a risk factor for developing symptoms of depression. In addition, it has been shown that weight management efforts are associated with long-term psychological improvements [12,13]. However, even if weight loss may have many favorable effects on health and overall well-being, weight loss patterns and trajecories over time may also be associated with negative consequences.

In general, duration of being overweight as well as time of onset has been shown to predict risks of mortality and morbidity, possibly due to long-term exposure [14]. Even if an early onset is not a preliminary factor for being obese as an adult, studies suggest that becoming obese during childhood is a risk factor for staying obese until adolescence or even adulthood [15]. So far, mental health issues have been identified as a potential consequence of childhood overweight and obesity, especially if individuals continue to have excess weight through adulthood [16]. Studies also suggest that early onset, and therefore extended duration of obesity and overweight determines the risk for other comorbidities, which may additionally increase the risk for depressive symptoms [17,18]. However, previous studies only investigated onsets in childhood or adolescence but do not consider further stages throughout adulthood (such as early or late adulthood) as a starting point for obesity. Apart from obesity onset, other aspects of weight history seem to be important as well.

The frequency of weight loss attempts may also influence psychological health, especially if constant attempts to lose weight do not lead to improvements of overall health and well-being, but result in feelings of guilt, poor self-esteem and depression. In addition to that, research has shown that weight loss cannot per se be associated with favorable psychological effects and may increase depressive symptoms [19,20]. In addition, unrealistic weight loss goals or expectations can enhance these negative effects [21]. In the past, greater weight loss desire was signficiantly associated with higher frequency of mentally and physically unhealthy days and not meeting one’s expectations with regard to weight loss may lead to psychological distress [22]. As a result, individuals’s weight history may be characterized by certain patterns including weight fluctuations, which have also been related to negative psychological outcomes [23].

Only a few studies concentrated on possible gender differences. Research suggests a tendency, that psychological health is differently influenced by weight history parameters such as onset–depending on the gender of the participants [24,25]. A recent five-year follow-up study has shown that presence of mood disorder at baseline results in later weight gain in male but not in female participants, whereas BMI at baseline was associated with higher risk for mood disorder in female, but not in male individuals [26]. However, most studies that investigated the association between weight history and mental health focused on female participants only. In addition, studies that conducted research on weight history trajectories are limited to restricted age ranges in childhood or adolescence.

To the best of our knowledge, this is the first study that focuses on male and female participants, investigating possible gender differences with regard to weight history and psychological health. In this context, the study aims to investigate the link between weight history parameters (obesity onset, frequency of weight loss attempts, weight loss patterns, greatest weight loss) and mental health outcomes (depression and anxiety) in a broad sample of individuals with obesity.

Method

Sampling procedure

Telephone interviews were sampled by a large market research institute, specialized on health care research (Forsa Institute of Social Research and Statistical Analysis, Berlin, Germany). Overall, 2,191 target households from all states in Germany were randomly contacted (sampling period: January-February 2015). Participants were selected using random digital dialing and Kish selection grid. Overall, 60.0% of these households could not be included into analysis due to refusal, drop-out during the interview or other reasons. Respondents were then interviewed by trained research interviewers using computer-assisted telephone interviews (CATI). In order to ensure representativeness, demographic weighing was applied with regard to age, gender and education. Overall, a target sample size of n = 1,000 individuals participated in the assessment. The inclusion criteria included being at least 18 years old and having a BMI greater than 30 kg/m². Of the n = 1,000 interviews, 125 (12.5%) were excluded from further analyses due to missing data on a majority of variables that were focus of this study. Furthermore, 88 participants were excluded because they stated having had metabolic surgery, which may have biased results on anxiety and depression. The conduct of this study was given approval by the Ethics Committee of the University of Leipzig (Approval No 208-14-14042014). The institute Forsa was responsible for obtaining verbal informed consent of each participant during the interview.

Instruments

Covariates

Sociodemographic and other measures such as gender, age and body mass index (BMI) were included as confounders in all analyses. Information on self-reported weight and height was used to calculate the participants’ BMI (in kg/m²) with respect to WHO standards [27]. If respondents refused to state their current weight for personal reasons, they were asked whether their weight lies within a certain range in order to categorize them to the correct BMI-category [28]. Representability of the German general public was esured by demographic weighing (including age, gender, and education).

Characteristics of weight history

Participants were asked about different aspects of their weight history as done in previous studies [29]. This included a question about the onset of obesity (“How old were you when you developed obesity?”). Based on these answers, the onset was categorized into four different groups: 1. Onset during childhood (before the age of 12), onset during adolescence (age 13–19), onset during early adulthood (age 20–40) and onset during later adulthood (age 41 or older). In addition, participants were asked about the frequency of weight loss attempts during their entire life (“How many times have you tried to lose weight?”, open question). The answers were categorized as follows due to the distribution of the data: category 1 (1–2 times), category 2 (3–5 times), category 3 (6–10 times) and category 4 (more than 10 times).

In addition to onset, weight history was analyzed with regard to the number of times participants aimed to reduce their weight and the maximum weight loss they have achieved so far. Participants were asked about their greatest weight loss and their weight before they lost it. If participants’ current weight exceeds the weight after their weight loss, they were categorized as “non-maintainers” and if their current weight was equal or lower, they were categorized as “maintainers”. Participants were also asked for their weight loss goal, defined as “desired weight loss”. Based on this information and in order to compare this in relation to their current weight, the difference between current and desired weight was calculated in percentage. A cut-off of ten percent was used as a key point, since guidelines suggest a realistic and healthy weight loss of ≤10% [6,30].

Psychological health outcomes

Depressive symptoms were assessed using the German version of the Patient Health Questionnaire (PHQ-9), containing 9 items, that have to be rated on a four-point- response scale (0 = not at all; 3 = nearly every day) [31,32]. A cut-off score of 10 or greater can be interpreted as a depressive disorder. In our sample, the internal consistency was α = 0.754.

Anxiety was assessed using the Generalized Anxiety Disorder questionnaire (GAD-7). It contains 7 items and answers are given using a four-point response scale (0 = not at all; 3 = nearly every day) [33,34]. According to the authors, a cut-off score of 10 or greater can be interpreted as an anxiety disorder. The internal consistency in this sample was α = 0.822.

Data analysis

All data were analyzed using STATA/SE 16.0 [35]. Categorical variables were analyzed using Chi²-test, continuous data were analyzed using one-way ANOVA. In addition, p-values and effect sizes (Cohen’s d or Cramer’s V were applicable) are reported. ANOVAS were also used investigating the effect of weight history variables and gender on psychological health (post-hoc: Tukey). In addition, partial correlations were part of the statistical analysis in order to investigate whether mental health outcomes and weight history parameters are related. Multivariate analysis (regression models), further investigating this relationship, include two models: Model 1 (dependent variable: symptoms of depression) and Model 2 (dependent variable: symptoms of anxiety), controlling for age, gender and current BMI. For partial correlations, the duration of being obese was included as a control variable.

Results

The overall sample included 787 participants and the majority of this sample was male (53%). Details on sociodemographic information can be found in Table 1. In this sample, 11.7% fulfilled the cut-off for clinical relevant symptoms of anxiety (GAD-7: ≥10). Similar results could be obtained for depression, here, 15.3% of participants met the PHQ-9cut-off criterion of 10 and above for depression. With regard to psychological health, associated variables and gender, female participants showed significantly more symptoms of depression (p < 0.001). Female participants in this sample reported significantly more attempts of losing weight (p = 0.042), are less likely to maintain a previous weight loss (p = 0.041) and are more likely to wish for weight loss goals greater than 10% (p < 0.001).

Table 1. Sociodemographic information for the overall sample and separated by gender.

	Overall (787)	Male (n = 417)	Female (n = 370)	p-value & effect sizes
Age	55.8 (14.7)	54.0 (14.4)	57.9 (14.9)	p<0.001, d = -0.264
Depression, PHQ-9 (0–24) M(SD) Depressive Disorder(≥ 10)	5.5 (4.2) 121 (15.3%)	4.9 (4.0) 41 (11.5%)	6.1 (4.4) 73 (19.7%)	p<0.001, d = -0.277 p = 0.002, V = 0.131
Anxiety, GAD-7 (0–21) M(SD) Anxiety Disorder(≥ 10)	4.4 (4.0) 92 (11.7%)	4.0 (3.8) 39 (9.3%)	4.9 (4.3) 53 (14.3%)	n.s. p = 0.031, V = 0.131
BMI (30–56), M(SD) Obesity Class I Obesity Class II Obesity Class III	34.4 (4.0) 521 (66.2%) 199 (25.3%) 67 (8.5%)	34.3 (3.9) 279 (66.9%) 107 (25.7%) 31 (7.4%)	34.5 (4.2) 242 (65.4%) 92 (24.9%) 36 (9.7%)	n.s.
Onset of Obesity (yrs) M(SD)	28.6 (16.0)	28.2 (16.0)	28.9 (15.9)	n.s.
Frequency of weight loss attempts (1–100) M(SD)	11.5 (18.6)	10.2 (19.1)	13.0 (18.0)	p = 0.037, d = -0.480
Desired weight loss (in %), n = 787 < 10% ≥ 10%	150 (19.1%) 634 (80.9%)	104 (25.1%) 311 (74.9%)	46 (12.5%) 323 (87.5%)	p<0.001, V = 0.160
Greatest weight loss (in kg) M(SD)	16.2 (11.1)	16.0 (11.4)	16.4 (10.8)	n.s.
Weight maintenance Maintainer Non-maintainer	193 (24.5%) 594 (75.5%)	115 (27.6%) 302 (72.4%)	78 (21.1%) 292 (78.9%)	p = 0.035, V = 0.075

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Note: Categorical variables were analyzed using Chi²-test; continuous variables were analyzed using one-way ANOVA; PHQ-9 = Patient Health Questionnaire; GAD-7 = Generalized Anxiety Disorder; BMI = Body mass Index, n.s. = not significant, M = mean, SD = standard deviation, p = statistical significance, d = Cohen’s d, V = Cramer’s V.

Weight history and psychological health

The severity of psychological factors differed between weight history categories as well as female and male participants (Figs 1 and 2).

Fig 1 demonstrates the mean scores of either depressive symptoms and symptoms of anxiety in terms of onset and frequency of weight loss attempts. With regard to onset, no significant differences could be found for female and male participants and between scores of depression or anxiety. Only in terms of number of weight loss attempts, male participants in this sample show significant differences in terms of depressive symptoms (F(3,413) = 5.33, p = 0.001), especially when comparing male participants who reported more than 10 weight loss attempts versus 1–2 attempts (p = 0.001) and versus 3–5 attempts (p = 0.019).

Similarly, Fig 2 describes psychological symptoms with regard to weight maintenance and weight loss goals. For weight loss goals, again, significant differences could only be found in male participants and with regard to depressiveness (F(1,413) = 4.02, p = 0.046), even though on average, weight loss goals that exceed 10% were associated with more symptoms of depression in men (mean PHQ-9: 5.2 vs 4.3) and in women (mean PHQ-9: 6.2 vs. 5.2).

As a forth parameter, weight maintenance was analyzed. Interestingly, male participants characterized as “weight loss maintainer” show higher scores of symptoms of anxiety (mean GAD-7: 4.7 vs. 3.8) but not depressive symptoms (mean PHQ-9: 5.4 vs. 4.8) compared to “non-maintainers” (F(1,415) = 5.48, p = 0.020), as can be seen in Fig 2. For women, no significant differences could be obtained (mean PHQ-9: 6.2 vs. 6.1; mean GAD-7: 5.8 vs. 4.8).

Partial correlation (controlling for BMI, age and gender)

Results of partial correlations are summarized in Table 2. After controlling for age, BMI and gender, symptoms of depression were significantly correlated with anxiety, weight loss attempts and desired weight loss. In other words, the greater the number of weight loss attempts and the higher the desired weight loss, the more symptoms of depression can be found.

Table 2. Partial correlations for psychological and weight history variables (controlling for age, gender and BMI).

	Depression (PHQ-9)	Anxiety (GAD-7)	Onset	Weight loss attempts	Desired weight loss	Greatest weight loss
Depression (PHQ-9)
Anxiety (GAD-7)	.769^***
Onset ¹	-.046	-.035
Weight loss attempts ¹	.123^***	.037	-.095^**
Desired weight loss ¹	.180^***	.151^***	.060	.085^*
Greatest weight loss ¹	.045	-.006	-.233^***	.091^*	.066
Weight maintenance ²	-.053	-.100^**	.019	.030	.097^**	.125^***

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Note

*** Significant at .001 alpha level

** Significant at .01 alpha level

* Significant at .05 alpha level

¹ = continuous

² = dichotomous (0 = maintainer, 1 = non-maintainer); PHQ-9 = Patient Health Questionnaire; GAD-7 = Generalized Anxiety Disorder.

Anxiety was significantly correlated with desired weight loss and weight loss maintenance, meaning that greater symptoms of anxiety can be found in participants that have a higher desired weight loss goal and, interestingly, are categorized as weight maintainer.

Regression analysis

In order to further investigate the influence of weight history factors on psychological health, multiple regression analysis was conducted (Table 3). Model 1 (dependent variable: depressive symptoms, PHQ-9) shows that having had more weight loss attempts, a greater weight loss being desired and being a “weight maintainer” can be associated with more symptoms of depression (F(10,776) = 6.10, p < 0.001, R² = 0.071, Eta² = 0.074). Model 2 (dependent variable: symptoms of anxiety, GAD-7) shows that a greater desired weight loss and being categorized as a “weight maintainer” can be linked to more anxiety (F(10,776) = 4.82, p < 0.001, R² = 0.078, Eta² = 0.059).

Table 3. Multiple regression analysis with depression (Model 1) and anxiety (Model 2) as dependent variables.

	Model 1: Depression, PHQ-9	Model 2: Anxiety, GAD-7
Onset¹ (ref. late adulthood) Childhood Adolescence Early adulthood	-.589 -.643 -.622	-.285 -.384 -.382
Frequency Weight Loss Attempts²	-.025^**	.005
Desired weight loss²	.094^***	.083^***
Greatest weight loss²	.003	-.012
Weight Maintenance (ref.: maintainer)	-.880^*	-1.285^**
Age	.003	-.034^*
Gender (ref.: male)	.892^**	1.031^**
BMI	-.078	-.117^*

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Note

*** Significant at .001 alpha level

** Significant at .01 alpha level

* Significant at .05 alpha level; PHQ-9 = Patient Health Questionnaire; GAD-7 = Generalized Anxiety Disorder

¹ = categorical

² = continuous.

Discussion

Early onset of obesity and overweight has been shown to act as predictors for morbidity, increasing the risk for comorbidities and premature mortality, even after controlling for body mass index during adulthood [36,37]. The aim of this study was to investigate whether certain characteristics of weight history, such as frequency of weight loss attempts, weight maintenance, desired weight loss and onset of obesity are related to differences in psychological health. Moreover, since most studies that cover this research area are based on female-only samples, another aim was to investigate whether gender-differences may influence this association.

With regard to psychological health, the mean score of symptoms of anxiety in this sample is higher compared to the general population [38]. Similarly, depressive symptoms in this broad sample are greater compared to other studies including individuals with normal weight [39], but slightly lower compared to other samples [40,41]. In general, female individuals in our sample exhibited more symptoms of both depression and anxiety compared to their male counterparts. These findings are similar to previous research, indicating that gender may be an important mediator in the relationship between excess weight and psychological health [42]. With regard to weight history, female participants in this study report significantly more weight loss attempts, similar to what can be found in previous studies [43,44]. In addition, female participants are also more likely to have greater weight loss desires (i.e. want to reduce more weight relative to their current weight) and are less likely to maintain their weight loss compared to men. Again, these findings go align with the results of other studies that focus on gender differences in weight management [45–47].

The main focus of this study was to investigate whether weight history parameters are related to psychological health. Overall, regression analysis showed that the number of weight loss attempts, the desired weight loss as well as weight maintenance can be associated with symptoms of depression, whereas, desired weight loss and weight maintenance influence the severity of anxiety symptoms. In our study, significant effects can only be found for men. Even if it has been suggested that the burden of psychological co-morbidities is associated with the duration (and hence onset) of obesity and overweight [48], our results do not verify this assumption. In other words, the association between onset and psychological health (depression and anxiety) was not significant. For depressive symptoms, it has been shown that the earlier depression is diagnosed, the greater the BMI increase in later life [49]. Another study has found that the bi-directional association between obesity and depression was stronger for females in young adulthood than in late adolescence and that obese adolescents have a 40% greater risk of being depressed [50]. In contrast, studies investigating treatment-seeking samples suggest that age of onset of obesity may not be associated with increased risk of psychopathology or negatively affect psychological health in general [51,52], which may explain the results of the current study.

In our study, the prevalence of depressive symptoms was significantly higher in male individuals who desire to lose more weight compared to individuals that wish to achieve a weight loss up to 10% a recommended by medical guidelines. Having a weight loss goal that may be unrealistic or exceeds medical recommendations may increase disappointment, increase pressure to lose weight and therefore negatively influence psychological distress [22,53,54]. Especially the fact that only men were significantly affected is an interesting finding, as recent literature so far only suggests that higher weight loss goals may be negatively associated with mental health in women [22,55]. It underlines the importance of male participants with obesity as an understudied group. Additionally, this finding may also explain the link between number of weight loss attempts and depressive symptoms in men. In this context, higher frequency of weight loss attempts (i.e. more than 10 times) was significantly related to a higher score of depression in men, but not in women. Therefore, the reason for more frequent attempts may be explained by the greater weight loss desire.

In the current study, weight maintenance in men is also related to mental health, showing that symptoms of anxiety are more common among individuals that can be categorized as weight maintainers (i.e. being able to maintain or further reduce weight that has been lost in the past). This is similar to previous research showing that weight loss per se may not only be mentally satisfying, especially if the original weight loss goal was rather unrealistic to achieve as pointed out before. Achieved weight loss may–for example–increase the pressure to keep this weight loss and therefore negatively impact psychological health by increasing distress. Similarly, several studies indicate that weight loss or weight maintenance may be related to negatives consequences with regard to psychosocial and mental health issues [20,56,57].

Overall, the fact that male participants in this study were significantly affected by weight loss history parameters compared to female participants highlights the importance of including and separately analyzing results with particular attention to gender differences. Since the relationship between obesity and mental health in men has often been overlooked by researchers, eliminating additional variables and confounders such as somatic conditions, that may moderate this relationship in men and explain higher rates of mental health problems in some cases [58,59].

Data were based on self-reports, which may have biased the results for instance due to underreporting weight or incorrectly remembering the age of onset. Previous research demonstred that individuals tend to over- or underreport their own weight and height–depending on gender and age [60]. Another limitation is related to weight maintenance. From our data, we can only categorize individuals as maintainer or non-maintainer based on the information, that they have been able to maintain a weight loss that has been lost in the past. However, we are not able to deduce what happened between this weight loss and the time of study conductance. Individuals, categorized as weight maintainers, may still show (unfavorable) weight cycling, even if they managed to maintain or even reduce their weight.

Conclusion

Psychological comorbidities and their role in determining well-being and weight status are of great relevance. Our studies reveals that depression and anxiety are related to weight maintenance, weight loss goals as well as attempts. Therefore, weight history characteristics should be included within clinical decision-making as part of multi-modal obesity management programs. The results of this study do not only underlie why these patient-specific parameters are essential, as the severity of mental health issues in individuals with obesity may depend on certain weight trajectories, there may also be differences for male and female patients which should not be left out of focus. Future research should also focus on male participants, in order to identify risk groups that may suffer from mental health problems related to weight history.

Data Availability

The data that support the findings are available on figshare: DOI 10.6084/m9.figshare.21581754.

Funding Statement

This work was supported by the Federal Ministry of Education and Research (BMBF), Germany, FKZ: 01EO1501 and supported by Open Access Publishing Fund of Leipzig University. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

References

1.World Health Organization. Obesity and overweight. 2021. [cited 21 Apr 2022]. Available from: https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight. [Google Scholar]
2.Buoncristiano M, Spinelli A, Williams J, Nardone P, Rito AI, García-Solano M, et al. Childhood overweight and obesity in Europe: Changes from 2007 to 2017. Obes Rev. 2021; 22 Suppl 6:e13226. Epub 2021/08/10. doi: 10.1111/obr.13226 . [DOI] [PubMed] [Google Scholar]
3.Jones RA, Lawlor ER, Birch JM, Patel MI, Werneck AO, Hoare E, et al. The impact of adult behavioural weight management interventions on mental health: A systematic review and meta-analysis. Obes Rev. 2021; 22:e13150. Epub 2020/10/25. doi: 10.1111/obr.13150 . [DOI] [PMC free article] [PubMed] [Google Scholar]
4.Halfon N, Forrest CB. Handbook of Life Course Health Development. The Emerging Theoretical Framework of Life Course Health Development. 2018. doi: 10.1007/978-3-319-47143-3_2 [DOI] [PubMed] [Google Scholar]
5.Wethington E. An Overview of the Life Course Perspective: Implications for Health and Nutrition. Journal of Nutrition Education and Behavior. 2005; 37:115–20. doi: 10.1016/s1499-4046(06)60265-0 [DOI] [PubMed] [Google Scholar]
6.Durrer Schutz D, Busetto L, Dicker D, Farpour-Lambert N, Pryke R, Toplak H, et al. European Practical and Patient-Centred Guidelines for Adult Obesity Management in Primary Care. Obes Facts. 2019; 12:40–66. doi: 10.1159/000496183 . [DOI] [PMC free article] [PubMed] [Google Scholar]
7.Kushner RF, Batsis JA, Butsch WS, Davis N, Golden A, Halperin F, et al. Weight History in Clinical Practice: The State of the Science and Future Directions. Obesity (Silver Spring). 2020; 28:9–17. doi: 10.1002/oby.22642 . [DOI] [PubMed] [Google Scholar]
8.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 (Lond). 2006; 30:513–9. doi: 10.1038/sj.ijo.0803122 . [DOI] [PubMed] [Google Scholar]
9.Stunkard AJ, Faith MS, Allison KC. Depression and obesity. Biol Psychiatry. 2003; 54:330–7. doi: 10.1016/s0006-3223(03)00608-5 . [DOI] [PubMed] [Google Scholar]
10.de Wit L, Luppino F, van Straten A, Penninx B, Zitman F, Cuijpers P. Depression and obesity: a meta-analysis of community-based studies. Psychiatry Res. 2010; 178:230–5. Epub 2010/05/13. doi: 10.1016/j.psychres.2009.04.015 . [DOI] [PubMed] [Google Scholar]
11.Luppino FS, Wit LM de, Bouvy PF, Stijnen T, Cuijpers P, Penninx BWJH, et al. Overweight, obesity, and depression: a systematic review and meta-analysis of longitudinal studies. Arch Gen Psychiatry. 2010; 67:220–9. doi: 10.1001/archgenpsychiatry.2010.2 . [DOI] [PubMed] [Google Scholar]
12.Gill H, Kang S, Lee Y, Rosenblat JD, Brietzke E, Zuckerman H, et al. The long-term effect of bariatric surgery on depression and anxiety. J Affect Disord. 2019; 246:886–94. Epub 2018/12/28. doi: 10.1016/j.jad.2018.12.113 . [DOI] [PubMed] [Google Scholar]
13.Fabricatore AN, Wadden TA, Higginbotham AJ, Faulconbridge LF, Nguyen AM, Heymsfield SB, et al. Intentional weight loss and changes in symptoms of depression: a systematic review and meta-analysis. Int J Obes (Lond). 2011; 35:1363–76. Epub 2011/02/22. doi: 10.1038/ijo.2011.2 . [DOI] [PMC free article] [PubMed] [Google Scholar]
14.Borgeraas H, Barstad LH, Størdal Lund R, Fredheim JM, Hertel JK, Hjelmesæth J. Association of time of obesity onset with comorbidities in treatment-seeking men and women with severe obesity. Obes Sci Pract. 2018; 4:427–36. doi: 10.1002/osp4.298 . [DOI] [PMC free article] [PubMed] [Google Scholar]
15.Geserick M, Vogel M, Gausche R, Lipek T, Spielau U, Keller E, et al. Acceleration of BMI in Early Childhood and Risk of Sustained Obesity. N Engl J Med. 2018; 379:1303–12. doi: 10.1056/NEJMoa1803527 . [DOI] [PubMed] [Google Scholar]
16.Sanderson K, Patton GC, McKercher C, Dwyer T, Venn AJ. Overweight and obesity in childhood and risk of mental disorder: a 20-year cohort study. Aust N Z J Psychiatry. 2011; 45:384–92. doi: 10.3109/00048674.2011.570309 . [DOI] [PubMed] [Google Scholar]
17.Hu Y, Bhupathiraju SN, de Koning L, Hu FB. Duration of obesity and overweight and risk of type 2 diabetes among US women. Obesity (Silver Spring). 2014; 22:2267–73. doi: 10.1002/oby.20851 . [DOI] [PMC free article] [PubMed] [Google Scholar]
18.Labad J, Price JF, Strachan MWJ, Fowkes FGR, Ding J, Deary IJ, et al. Symptoms of depression but not anxiety are associated with central obesity and cardiovascular disease in people with type 2 diabetes: the Edinburgh Type 2 Diabetes Study. Diabetologia. 2010; 53:467–71. Epub 2009/12/10. doi: 10.1007/s00125-009-1628-9 . [DOI] [PMC free article] [PubMed] [Google Scholar]
19.Wooley SC, Garner DM. Obesity treatment: the high cost of false hope. J Am Diet Assoc. 1991; 91:1248–51. [PubMed] [Google Scholar]
20.Jackson SE, Steptoe A, Beeken RJ, Kivimaki M, Wardle J. Psychological changes following weight loss in overweight and obese adults: a prospective cohort study. PLoS ONE. 2014; 9:e104552. doi: 10.1371/journal.pone.0104552 . [DOI] [PMC free article] [PubMed] [Google Scholar]
21.Jung F, Spahlholz J, Hilbert A, Riedel-Heller SG, Luck-Sikorski C. Impact of Weight-Related Discrimination, Body Dissatisfaction and Self-Stigma on the Desire to Weigh Less. Obes Facts. 2017; 10:139–51. doi: 10.1159/000468154 . [DOI] [PMC free article] [PubMed] [Google Scholar]
22.Muennig P, Jia H, Lee R, Lubetkin E. I think therefore I am: perceived ideal weight as a determinant of health. Am J Public Health. 2008; 98:501–6. doi: 10.2105/AJPH.2007.114769 . [DOI] [PMC free article] [PubMed] [Google Scholar]
23.Foreyt JP, Brunner RL, Goodrick GK, Cutter G, Brownell KD, St Jeor ST. Psychological correlates of weight fluctuation. Int J Eat Disord. 1995; 17:263–75. doi: [DOI] [PubMed] [Google Scholar]
24.Venn AJ, Thomson RJ, Schmidt MD, Cleland VJ, Curry BA, Gennat HC, et al. Overweight and obesity from childhood to adulthood. A follow‐up of participants in the 1985 Australian Schools Health and Fitness Survey. Medical Journal of Australia. 2007; 186:458–60. doi: 10.5694/j.1326-5377.2007.tb00997.x [DOI] [PubMed] [Google Scholar]
25.Hajek A, König H-H. Asymmetric effects of obesity on loneliness among older Germans. Longitudinal findings from the Survey of Health, Ageing and Retirement in Europe. Aging Ment Health. 2021; 25:2293–7. Epub 2020/09/22. doi: 10.1080/13607863.2020.1822285 . [DOI] [PubMed] [Google Scholar]
26.Sahle BW, Breslin M, Sanderson K, Patton G, Dwyer T, Venn A, et al. Association between depression, anxiety and weight change in young adults. BMC Psychiatry. 2019; 19:398. Epub 2019/12/16. doi: 10.1186/s12888-019-2385-z . [DOI] [PMC free article] [PubMed] [Google Scholar]
27.WHO. Preventing and managing the global epidemic. Report of a WHO consultation on obesity. Genf; 1998. [PubMed] [Google Scholar]
28.Benecke A VH. Overweight and Obesity. Berlin; 2003. [Google Scholar]
29.Latner JD, Ciao AC. Weight-loss history as a predictor of obesity treatment outcome: prospective, long-term results from behavioral, group self-help treatment. J Health Psychol. 2014; 19:253–61. doi: 10.1177/1359105312468191 . [DOI] [PubMed] [Google Scholar]
30.Interdisziplinäre Leitlinie der Qualität S3 zur „Prävention und Therapie der Adipositas“. 2nd ed.; 2014. [Google Scholar]
31.Löwe B., Spitzer R.L., Zipfel S., Herzog W. PHQ-D. Gesundheitsfragebogen fuer Patienten [German version of the patient health questionnaire].; 2002. [Google Scholar]
32.Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001; 16:606–13. doi: 10.1046/j.1525-1497.2001.016009606.x . [DOI] [PMC free article] [PubMed] [Google Scholar]
33.Löwe B. Gesundheitsfragebogen für Patienten (GAD-7). [Generalizied Anxiety Disorder Scale-7 (GAD-7). Universitätsklinikum Hamburg-Eppendorf; 2015. [Google Scholar]
34.Spitzer RL, Kroenke K, Williams JBW, Löwe B. A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med. 2006; 166:1092–7. doi: 10.1001/archinte.166.10.1092 . [DOI] [PubMed] [Google Scholar]
35.STATA Statistical Software. TX: StataCorp LLC: StataCorp; 2019. [Google Scholar]
36.Inge TH, King WC, Jenkins TM, Courcoulas AP, Mitsnefes M, Flum DR, et al. The effect of obesity in adolescence on adult health status. Pediatrics. 2013; 132:1098–104. doi: 10.1542/peds.2013-2185 . [DOI] [PMC free article] [PubMed] [Google Scholar]
37.Llewellyn A, Simmonds M, Owen CG, Woolacott N. Childhood obesity as a predictor of morbidity in adulthood: a systematic review and meta-analysis. Obes Rev. 2016; 17:56–67. doi: 10.1111/obr.12316 . [DOI] [PubMed] [Google Scholar]
38.Hinz A, Klein AM, Brähler E, Glaesmer H, Luck T, Riedel-Heller SG, et al. Psychometric evaluation of the Generalized Anxiety Disorder Screener GAD-7, based on a large German general population sample. J Affect Disord. 2017; 210:338–44. doi: 10.1016/j.jad.2016.12.012 . [DOI] [PubMed] [Google Scholar]
39.Kocalevent R-D, Hinz A, Brähler E. Standardization of the depression screener patient health questionnaire (PHQ-9) in the general population. Gen Hosp Psychiatry. 2013; 35:551–5. doi: 10.1016/j.genhosppsych.2013.04.006 . [DOI] [PubMed] [Google Scholar]
40.Hawkins MAW, Goldstein CM, Dolansky MA, Gunstad J, Redle JD, Josephson R, et al. Depressive symptoms are associated with obesity in adults with heart failure: An analysis of gender differences. Eur J Cardiovasc Nurs. 2015; 14:516–24. Epub 2014/07/16. doi: 10.1177/1474515114542558 . [DOI] [PMC free article] [PubMed] [Google Scholar]
41.Schwenke M, Löbner M, Riedel-Heller S, Luppa M. Adipositas und Depression in der Primärversorgung. Psychiatr Prax. 2020. doi: 10.1055/a-1144-7035 [DOI] [PubMed] [Google Scholar]
42.Rajan TM, Menon V. Psychiatric disorders and obesity: A review of association studies. J Postgrad Med. 2017; 63:182–90. doi: 10.4103/jpgm.JPGM_712_16 . [DOI] [PMC free article] [PubMed] [Google Scholar]
43.Lemon SC, Rosal MC, Zapka J, Borg A, Andersen V. Contributions of weight perceptions to weight loss attempts: differences by body mass index and gender. Body Image. 2009; 6:90–6. doi: 10.1016/j.bodyim.2008.11.004 . [DOI] [PMC free article] [PubMed] [Google Scholar]
44.Tsai SA, Lv N, Xiao L, Ma J. Gender Differences in Weight-Related Attitudes and Behaviors Among Overweight and Obese Adults in the United States. Am J Mens Health. 2016; 10:389–98. doi: 10.1177/1557988314567223 . [DOI] [PubMed] [Google Scholar]
45.Foster GD, Wadden TA, Phelan S, Sarwer DB, Sanderson RS. Obese patients’ perceptions of treatment outcomes and the factors that influence them. Arch Intern Med. 2001; 161:2133–9. doi: 10.1001/archinte.161.17.2133 . [DOI] [PubMed] [Google Scholar]
46.Bhogal MS, Langford R. Gender differences in weight loss; evidence from a NHS weight management service. Public Health. 2014; 128:811–3. doi: 10.1016/j.puhe.2014.06.019 . [DOI] [PubMed] [Google Scholar]
47.Masheb RM, Grilo CM. Weight loss expectations in patients with binge-eating disorder. Obes Res. 2002; 10:309–14. doi: 10.1038/oby.2002.44 . [DOI] [PubMed] [Google Scholar]
48.Marmorstein NR, Lacono WG, Legrand L. Obesity and depression in adolescence and beyond: reciprocal risks. Int J Obes (Lond). 2014; 38:906–11. doi: 10.1038/ijo.2014.19 . [DOI] [PMC free article] [PubMed] [Google Scholar]
49.Anderson SE, Cohen P, Naumova EN, Must A. Association of depression and anxiety disorders with weight change in a prospective community-based study of children followed up into adulthood. Arch Pediatr Adolesc Med. 2006; 160:285–91. doi: 10.1001/archpedi.160.3.285 . [DOI] [PubMed] [Google Scholar]
50.Mannan M, Mamun A, Doi S, Clavarino A. Prospective Associations between Depression and Obesity for Adolescent Males and Females- A Systematic Review and Meta-Analysis of Longitudinal Studies. PLoS ONE. 2016; 11:e0157240. doi: 10.1371/journal.pone.0157240 . [DOI] [PMC free article] [PubMed] [Google Scholar]
51.Mustillo S, Worthman C, Erkanli A, Keeler G, Angold A, Costello EJ. Obesity and psychiatric disorder: developmental trajectories. Pediatrics. 2003; 111:851–9. doi: 10.1542/peds.111.4.851 . [DOI] [PubMed] [Google Scholar]
52.Petroni ML, Villanova N, Avagnina S, Fusco MA, Fatati G, Compare A, et al. Psychological distress in morbid obesity in relation to weight history. Obes Surg. 2007; 17:391–9. doi: 10.1007/s11695-007-9069-3 . [DOI] [PubMed] [Google Scholar]
53.Foster GD, Wadden TA, Vogt RA, Brewer G. What is a reasonable weight loss? Patients’ expectations and evaluations of obesity treatment outcomes. Journal of Consulting and Clinical Psychology. 1997; 65:79–85. doi: 10.1037//0022-006x.65.1.79 [DOI] [PubMed] [Google Scholar]
54.Siervo M, Montagnese C, Muscariello E, Evans E, Stephan BCM, Nasti G, et al. Weight loss expectations and body dissatisfaction in young women attempting to lose weight. J Hum Nutr Diet. 2014; 27 Suppl 2:84–9. doi: 10.1111/jhn.12078 . [DOI] [PubMed] [Google Scholar]
55.Provencher V, Bégin C, Gagnon-Girouard M-P, Gagnon HC, Tremblay A, Boivin S, et al. Defined weight expectations in overweight women: anthropometrical, psychological and eating behavioral correlates. Int J Obes (Lond). 2007; 31:1731–8. doi: 10.1038/sj.ijo.0803656 . [DOI] [PubMed] [Google Scholar]
56.Booth AO, Wang X, Turner AI, Nowson CA, Torres SJ. Diet-Induced Weight Loss Has No Effect on Psychological Stress in Overweight and Obese Adults: A Meta-Analysis of Randomized Controlled Trials. Nutrients. 2018; 10. doi: 10.3390/nu10050613 . [DOI] [PMC free article] [PubMed] [Google Scholar]
57.Hayes JF, Hoggatt KJ, Breland JY. Mental Health Diagnostic Patterns in Behavioral Weight Loss Program Attendees. Mil Med. 2020. doi: 10.1093/milmed/usaa046 . [DOI] [PMC free article] [PubMed] [Google Scholar]
58.Tronieri JS, Wurst CM, Pearl RL, Allison KC. Sex Differences in Obesity and Mental Health. Curr Psychiatry Rep. 2017; 19:29. doi: 10.1007/s11920-017-0784-8 . [DOI] [PubMed] [Google Scholar]
59.Hach I, Ruhl UE, Klose M, Klotsche J, Kirch W, Jacobi F. Obesity and the risk for mental disorders in a representative German adult sample. Eur J Public Health. 2007; 17:297–305. doi: 10.1093/eurpub/ckl227 . [DOI] [PubMed] [Google Scholar]
60.Merrill RM, Richardson JS. Validity of self-reported height, weight, and body mass index: findings from the National Health and Nutrition Examination Survey, 2001–2006. [PMC free article] [PubMed] [Google Scholar]

PLoS One. doi: 10.1371/journal.pone.0281776.r001

Decision Letter 0

Meng Li

2 Nov 2022

PONE-D-22-11713The relationship between obesity, weight history and psychological health – are there differences related to gender?PLOS ONE

Dear Dr. Jung,

Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process.

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Meng Li

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PLOS ONE

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Reviewer #1: Yes

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2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

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Reviewer #1: No

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Reviewer #1: Yes

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5. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: Reviewer comments PONE D 22 11713

This paper describes an observational cohort study of the associations between anxiety and depression scores and obesity onset, weight loss goals and weight loss attempts in adults with obesity. The study is potentially important and valuable and the authors have a great opportunity to make a major contribution to the filed with the large amount of data they have collected. However, I have a number of comments to make about the paper, offered in a constructive spirit.

From the outset, there is an overwhelming sense of vagueness to the paper that pervades every part of it. The title is vague and does not adequately convey what the hypothesis is. What is the study design? What are the specific outcomes? In the abstract, the methods aren’t at all clear, the aims aren’t consistent with the title and the results just don’t make sense. Why the F statistic in the abstract results? This is unconventional.

The authors need to revise STROBE (or similar) guidelines and adhere to these in revising their paper.

Also it is worth noting that the formatting is not of a sufficiently high standard – taking the abstract as but one example.

The introduction is not adequately focussed on the hypothesis in hand. Arguably, the first two paragraphs could be deleted conmpletely and the paper would look much more succinct and focussed. The consideration of childhood obesity “tracking” into adulthood is to me totally irrelevant to this paper and just distracts from a consideration of the frankly really interesting findings that people with obesity who have a desire to lose a greater amount of weight tend to have higher levels of anxiety and depression,

Stop referring to the cohort as “non-clinical” – it diminishes the credibility of the paper.

How was BMI measured by phone? Have the authors considered the challenges this poses in terms of the reliability of the data? Is tehre a precedent for large studies using self reported weight and height? If so, it would be good for the authors to demonstrate an awareness of this.

The term “weight history” is vague. So is psychological health. Be specific about what these are much earlier and throughout the paper.

The failure to include error bars in figures 1 and 2 is a major omission.

The paper needs to be much shorter and more focussed and specific, especially the discussion and the introduction. Then the authors will have an important contribution to the literature.

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Reviewer #1: Yes: Francis M Finucane

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PLoS One. 2023 Feb 13;18(2):e0281776. doi: 10.1371/journal.pone.0281776.r002

Author response to Decision Letter 0

18 Nov 2022

Dear Prof. Li,

We would hereby like to re-submit our manuscript (PONE-D-22-11713).

First of all, we revised the manuscript according to the jounral requirements mentioned in your Decision letter:

1. Style requirements were adjusted

2. Details were added with regard to participant consent

3. With regard to the funding, the following applies: “The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.”

4. The funding-related text was removed from the manuscript. We apologize for this misunderstanding. In addition, due to the agreement between PLOS and my institution (Leipzig University), I had to change the funding information in the online system.

5. / 6. : the minimal anonymized data set will be available here: DOI 10.6084/m9.figshare.21581754

7. I am affiliated with Leipzig University. Please let me know if you need any proofs.

In addition, we thank the Reviewer for these helpful comments and revised the manuscript accordingly. Especially the main focus of the study was concretized by adding more information and defining the construct of “weight history” as this may have caused confusion. The manuscript was also revised with regard to STROBE guidelines and the figures and tables were adjusted. More information on this can be found in the file uploaded (Response to Reviewer).

The final version of this article was read and approved by all mentioned authors

We would be very grateful, if you could re-consider our manuscript for publication. If there are any further questions, please do not hesitate to contact us.

Yours sincerely,

Franziska Jung

Attachment

Submitted filename: Responds to Reviewer.docx

Click here for additional data file.^{(16KB, docx)}

PLoS One. doi: 10.1371/journal.pone.0281776.r003

Decision Letter 1

Meng Li

4 Jan 2023

PONE-D-22-11713R1The relationship between weight history and psychological health – Differences related to gender and weight loss patternsPLOS ONE

Dear Dr. Jung,

One of the original reviewers recommended rejecting this paper and the other reviewer recommended major revision. Usually, I would reject a paper in this type of situation. However, I'd like to give this paper another chance. Please address ALL comments to the best you can. In your response to reviewers' comments letter, please quote the revised manuscript section instead of saying "revisions have been made". This will make it easier for the reviewers as they do not have to read your response letter and the revised manuscript side by side.

Please submit your revised manuscript by Feb 18 2023 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file.

Please include the following items when submitting your revised manuscript:

A rebuttal letter that responds to each point raised by the academic editor and reviewer(s). You should upload this letter as a separate file labeled 'Response to Reviewers'.
A marked-up copy of your manuscript that highlights changes made to the original version. You should upload this as a separate file labeled 'Revised Manuscript with Track Changes'.
An unmarked version of your revised paper without tracked changes. You should upload this as a separate file labeled 'Manuscript'.

We look forward to receiving your revised manuscript.

Kind regards,

Meng Li

Academic Editor

PLOS ONE

[Note: HTML markup is below. Please do not edit.]

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation.

Reviewer #1: (No Response)

Reviewer #2: (No Response)

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2. Is the manuscript technically sound, and do the data support the conclusions?

Reviewer #1: Partly

Reviewer #2: Partly

**********

3. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #2: Yes

**********

4. Have the authors made all data underlying the findings in their manuscript fully available?

Reviewer #1: Yes

Reviewer #2: Yes

**********

5. Is the manuscript presented in an intelligible fashion and written in standard English?

Reviewer #1: Yes

Reviewer #2: Yes

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6. Review Comments to the Author

Reviewer #1: Having carefully revised the amended version of the manuscript and the responses to my previous comments, I think that the overall quality of the writing and the adequacy of the consideration of those comments fall below an acceptable level. The changes have been minimal. The consideration of, for example, the methodological limitations with self-reported weights and heights obtained by phone (comment/ response 5) has been inadequate. F statistics remain in the abstract.

Reviewer #2: The authors conducted a phone interview study collecting information on weight loss patterns and history and mental health outcomes among individuals with obesity. I have some comments and suggestions to enhance the clarity of the manuscript.

1. In the Abstract’s Methods section (line 22): Please specify the study design in the first sentence.

2. In the Abstract’s Methods section: Please include what analyses were done (the Results section mentions “regression analyses” for the first time. What regression analyses the authors used needs to be explained briefly in the Methods.

3. In the Abstract’s Conclusion section (line 35): The Results section in the abstract does not include any gender-specific findings. The conclusion seems to be irrelevant in the abstract. Please rewrite accordingly.

5. In the Method’s Sampling Procedure section: When was this data collection via phone interviews done and for how long (study date and period)?

6. In the Method’s Sampling Procedure section: Please indicate the age inclusion criteria of participants (e.g., Were they individuals of all ages? Or individuals of X years and older? Adults?)

8. In the Method’s Data Analysis section: Please explain partial correlation and multi-variable regression models in more detail and their objectives (Currently, the authors only explain what was done for each analysis in the Results section. This information should be addressed upfront in the Methods).

9. In the Results (the use of “onset”): The authors mention that they calculated the duration by subtracting the age of onset from the age at the interview. However, it is not clear which value the authors used in the analyses (was the duration used in the analyses at all?).

a. Table 1: Does the variable “Onset of obesity” mean the age of onset of the duration of obesity?

b. Table 2: Similar here. What does the variable “Onset” mean?

c. In Regression Analysis section: It seems the models only include the age of onset (in 3 categories). Would it be meaningful to also include the duration of obesity in the models?

10. In the Discussion section (line 254): What does it mean by “clinical samples”? Those with obesity? Please specify.

Thank you.

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PLoS One. 2023 Feb 13;18(2):e0281776. doi: 10.1371/journal.pone.0281776.r004

Author response to Decision Letter 1

26 Jan 2023

Reviewer Comment Reply

Reviewer 1 Having carefully revised the amended version of the manuscript and the responses to my previous comments, I think that the overall quality of the writing and the adequacy of the consideration of those comments fall below an acceptable level. The changes have been minimal. The consideration of, for example, the methodological limitations with self-reported weights and heights obtained by phone (comment/ response 5) has been inadequate.

1. F statistics remain in the abstract.

2. From the outset, there is an overwhelming sense of vagueness to the paper that pervades every part of it. The title is vague and does not adequately convey what the hypothesis is. What is the study design? What are the specific outcomes? In the abstract, the methods aren’t at all clear, the aims aren’t consistent with the title and the results just don’t make sense. Why the F statistic in the abstract results? This is unconventional.

We thank the reviewer for this comment and revised the abstract accordingly.

Background

The prevalence and burden of obesity continues to grow worldwide. Psychological comorbidities may not only influence quality of life, but may also hinder successful weight loss. The causality between excess weight and mental health issues is still not fully understood. The aim of the study was to investigate whether weight history parameters, (ie.age of onset) are related to psychological comorbidities.

Method

The data were derived from a representative telephone survey in Germany, collecting information on weight loss patterns and mental health outcomes among individuals with BMI>30kg/m2. Overall, 787 participants were examined in terms of depressive symptoms (Patient Health Questionnaire, PHQ-9) and anxiety (Generalized Anxiety Disorder Questionnaire, GAD7). In addition, participants were asked about different aspects of their weight history (ie. weight loss patterns and trajectories) over the lifespan. The relationship between weight history and mental health was analyzed using multivariate statistics.

Results

Conclusion

3. The authors need to revise STROBE (or similar) guidelines and adhere to these in revising their paper. Also it is worth noting that the formatting is not of a sufficiently high standard – taking the abstract as but one example. We agree with the reviewer and revised the manuscript and abstract with regard to the format and the specifications given by reviewer 2.

4. The introduction is not adequately focussed on the hypothesis in hand. Arguably, the first two paragraphs could be deleted conmpletely and the paper would look much more succinct and focussed. The consideration of childhood obesity “tracking” into adulthood is to me totally irrelevant to this paper and just distracts from a consideration of the frankly really interesting findings that people with obesity who have a desire to lose a greater amount of weight tend to have higher levels of anxiety and depression, We apologize for this misunderstanding. The consideration of childhood obesity tracking into adulthood was added as part of the introduction, because it reflects the main focus of this paper (“weight history”) and underlines the importance of tracking BMI and other weight-related parameters as part of successuful weight managament over the life course – as suggested by others (e.g. Berry et al., 2022; Kushner et al., 2020; Ekberg et al., 2012; Ryder et al., 2019). The finding that people with obesity who have a desire to lose a greater amount of weight tend to have higher levels of anxiety and depression was not the main focus of this study. However, we think that the structure of the introduction may have caused confusing, therefore we revised this section thoughtfully.

Please see changes throughout the manuscript, for example:

Page 3, line 70-77:

So far, mental health issues have been identified as a potential consequence of childhood overweight and obesity, especially if individuals continue to have excess weight through adulthood [18]. Studies also suggest that early onset, and therefore extended duration of obesity and overweight determines the risk for other comorbidities such as Type 2 diabetes and cardiovascular disease, which may additionally increase the risk for depressive symptoms [19,20]. However, previous studies did not clearly show how different timepoints of onset (ie. childhod vs. early adulthood) may lead to differences in severity of depression or anxiety across the lifespan. In addition, other aspects of weight history seem to be important as well.

Page 3, line 83-87:

In the past, greater weight loss desire was signficiantly associated with higher frequency of mentally and physically unhealthy days and not meeting one’s expectations with regard to weight loss may lead to psychological distress [24,25]. As a result, individuals’s weight history may be characterized by weight fluctuations, which have been associated with negative psychological outcomes, therefore, there may be differences between weight-maintainers and non-maintainers [26].

5. Stop referring to the cohort as “non-clinical” – it diminishes the credibility of the paper.

We apologize for this misunderstanding. The aim was to make clear that we did not recruit patients from a hospital or GP practice like other studies. In other words, participants in our study may or may not be under treatment at the time of the data collection. We now changed this according to the reviewers’ comment. For example on Page 4, line 100.

6. How was BMI measured by phone? Have the authors considered the challenges this poses in terms of the reliability of the data? Is tehre a precedent for large studies using self reported weight and height? If so, it would be good for the authors to demonstrate an awareness of this.

We apologize for this misunderstanding. BMI was not “measured” by phone. Participants were asked to state their weight and height and BMI was then calculated from their response according to the formula provided by the WHO. In order to avoid missing values, participants who refused to provide information on weight were given a specific weight range, being able to assign them to one of the BMI categories (see Benecke, 2003 for more information). We are aware of the issues associated with self-reported weight and height, therefore we added this to the limitation section.

Page 5, line 123-127:

Information on self-reported weight and height was used to calculate the participants' BMI (in kg/m2) with respect to WHO standards [30]. If respondents refused to state their current weight for personal reasons, they were asked whether their weight lies within a certain range in order to categorize them to the correct BMI-category [31] . Representability of the German general public was esured by demographic weighing (including age, gender, and education).

Page 13, line 310-312:

7. The term “weight history” is vague. So is psychological health. Be specific about what these are much earlier and throughout the paper.

We thank the reviewer for this comment. “Weight history” and “psychological health” have now been described in greater detail throughout the manuscript.

Page 2, line 50-57:

According to the life course approach, numerous biological, psychosocial, and cognitive factors can have an independent, cumulative, and interacting impact on the likelihood of developing health problems as people age [4,5]. Especially due to the complexity of obesity, patient-centered care has shown to be important to treat obesity and its comorbidities [6]. So far, a clear definition of weight history does not exist, however, it has been described as an evaluation of “historical information on a patient’s weight gain (or loss) pattern and trajectory” and may be useful to identify treatment options and health risks, for instance with regard to psychological health [7].

8. The failure to include error bars in figures 1 and 2 is a major omission.

We apologize for this mistake. Error bars have now been added to the figures.

9. The paper needs to be much shorter and more focussed and specific, especially the discussion and the introduction. Then the authors will have an important contribution to the literature.

We agree with the reviewer and revised the introduction and discussion section.

Reviewer 2 1. In the Abstract’s Methods section (line 22): Please specify the study design in the first sentence.

The data were derived from a representative telephone survey in Germany, collecting information on weight loss patterns and mental health outcomes among individuals with BMI>30kg/m2. Overall, 787 participants were examined in terms of depressive symptoms (Patient Health Questionnaire, PHQ-9) and anxiety (Generalized Anxiety Disorder Questionnaire, GAD7). In addition, participants were asked about different aspects of their weight history (ie. weight loss patterns and trajectories) over the lifespan. The relationship between weight history and mental health was analyzed using multivariate statistics.

Results

Conclusion

4. In the Introduction section (lines 98-99): Please define what “four stages of onset” and “variety of parameters” are upfront in the Introduction for a clearer understanding. The current objective can sound quite vague. We agree with the reviewer that this may have caused confusion and clearly defined the objective of the study by re-phrasing this sentences.

Page 4, line 101-103

In this context, the study aims to investigate the link between weight history parameters (obesity onset, frequency of weight loss attempts, weight loss patterns, greatest weight loss) and mental health outcomes (depression and anxiety) in a broad sample of individuals with obesity.

The four stages of onset (childhood, adolescence, early and late adulthood) are further described in the method section (page 5).

Page 3, line 75-77

However, previous studies only investigated onsets in childhood or adolescence but do not consider further stages throughout adulthood (such as early or late adulthood) as a starting point for obesity.

5. In the Method’s Sampling Procedure section: When was this data collection via phone interviews done and for how long (study date and period)? We thank the reviewer for this comment and added this information to the manuscript.

Page 4, line 107-108

Overall, 2,191 target households from all states in Germany were randomly contacted (sampling period: January-February 2015).

6. In the Method’s Sampling Procedure section: Please indicate the age inclusion criteria of participants (e.g., Were they individuals of all ages? Or individuals of X years and older? Adults?) Again, we thank the reviewer for this comment and added this information to the method section.

Page 5, line 113-114

The inclusion criteria included being at least 18 years old and having a BMI greater than 30 kg/m2.

7. In the Method’s Characteristics of Weight History section: Were the participants asked to count all the weight loss attempts “during their entire life (ever since the obesity onset)”? Please specify such information. In consultation with a native speaker, we re-phrased the translation of this item. The question related to the weight loss attempts during their entire life and participants were given an answering scheme including the categories (1-2x, 3-5x, 6-10x), therefore, this was not an open question. Please see changes on page 6 (line 137-140).

In addition, participants were asked about the frequency of weight loss attempts during their entire life (“How many times have you tried to lose weight?”, open question). The answers were categorized as follows due to the distribution of the data: category 1 (1-2 times), category 2 (3-5 times), category 3 (6-10 times) and category 4 (more than 10 times).

We agree with the reviewer and added more information on the data analysis section

Page 7, line 166-170

In addition, partial correlations were part of the statistical analysis in order to investigate whether mental health outcomes and weight history parameters are related. Multivariate analysis (regression models), further investigating this relationship, include two models: Model 1 (dependent variable: symptoms of depression) and Model 2 (dependent variable: symptoms of anxiety), controlling for age, gender and current BMI. For partial correlations, the duration of being obese was included as a control variable.

a. Table 1: Does the variable “Onset of obesity” mean the age of onset of the duration of obesity?

b. Table 2: Similar here. What does the variable “Onset” mean?

c. In Regression Analysis section: It seems the models only include the age of onset (in 3 categories). Would it be meaningful to also include the duration of obesity in the models?

We apologize for this mistake, the duration was not part of the current analyses (it was skipped after previous revision, because one cannot know what happened in between, e.g. change from obesity to overweight or normalweight). Therefore this sentences on page 5 was deleted from the manuscript.

a. “Onest of obesity” in Tab. 1 means the age at which a BMI over 30 was first observed/reached. Please see details in the method section (Item obesity onset: How old were you when you developed obesity”?)

b. Same here (therefore we indicated it as a continuous variable in Tab. 2)

c. Tab. 3 includes three age categories, because the forth category (late adulthood) was used as the reference category in this regression analyses. We therefore added this information to Tab. 3. If the reviewer thinks that it would make our results more comprehensible, it would also be possible to add another table with onset as a continuous variable instead. However, we did so due to the distribution of the data and in order to make it comparable to other studies that differentiate between age categories rather than using onset as a continous variable.

10. In the Discussion section (line 254): What does it mean by “clinical samples”? Those with obesity? Please specify. By “Clinical samples” we mean samples derived from intervention studies or data collected in clinical settings, such as hospitals. It was not the focus of our study to ask participants whether they were currently under treatment, therefore we wanted to explain why results with regard to depressive symptoms in our sample are different to other samples that included patients with obesity, recruited in health care settings.

As this was also mentioned by Reviewer 1, be deleted this in order to avoid any misunderstandings (please see page 11, line 260-261).

11. In the Discussion section: Maybe also compare the current results with previous studies about the consistently higher prevalence of anxiety and depression in women regardless of their weight loss attempts, goals, and weight maintenance. We agree with the reviewer and think that it is important to mention this within the discussion section eventhough the main focus was on the relationship between weight history and mental health.

The following has been added to the manuscript:

Page 11, line 260-264

In general, female individuals in our sample exhibited more symptoms of both depression and anxiety compared to their male counterparts. These findings are similar to previous research , indicating that gender may be an important mediator in the relationship between excess weight and psychological health [45].

Attachment

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PLoS One. doi: 10.1371/journal.pone.0281776.r005

Decision Letter 2

Meng Li

1 Feb 2023

The relationship between weight history and psychological health – Differences related to gender and weight loss patterns

PONE-D-22-11713R2

Dear Dr. Jung,

We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements.

Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication.

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Additional Editor Comments (optional):

Reviewers' comments:

PLoS One. doi: 10.1371/journal.pone.0281776.r006

Acceptance letter

Meng Li

3 Feb 2023

PONE-D-22-11713R2

The relationship between weight history and psychological health – Differences related to gender and weight loss patterns

Dear Dr. Leipzig:

I'm pleased to inform you that your manuscript has been deemed suitable for publication in PLOS ONE. Congratulations! Your manuscript is now with our production department.

If your institution or institutions have a press office, please let them know about your upcoming paper now to help maximize its impact. If they'll be preparing press materials, please inform our press team within the next 48 hours. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information please contact onepress@plos.org.

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on behalf of

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Associated Data

This section collects any data citations, data availability statements, or supplementary materials included in this article.

Supplementary Materials

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Data Availability Statement

The data that support the findings are available on figshare: DOI 10.6084/m9.figshare.21581754.

[pone.0281776.ref001] 1.World Health Organization. Obesity and overweight. 2021. [cited 21 Apr 2022]. Available from: https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight. [Google Scholar]

[pone.0281776.ref002] 2.Buoncristiano M, Spinelli A, Williams J, Nardone P, Rito AI, García-Solano M, et al. Childhood overweight and obesity in Europe: Changes from 2007 to 2017. Obes Rev. 2021; 22 Suppl 6:e13226. Epub 2021/08/10. doi: 10.1111/obr.13226 . [DOI] [PubMed] [Google Scholar]

[pone.0281776.ref003] 3.Jones RA, Lawlor ER, Birch JM, Patel MI, Werneck AO, Hoare E, et al. The impact of adult behavioural weight management interventions on mental health: A systematic review and meta-analysis. Obes Rev. 2021; 22:e13150. Epub 2020/10/25. doi: 10.1111/obr.13150 . [DOI] [PMC free article] [PubMed] [Google Scholar]

[pone.0281776.ref004] 4.Halfon N, Forrest CB. Handbook of Life Course Health Development. The Emerging Theoretical Framework of Life Course Health Development. 2018. doi: 10.1007/978-3-319-47143-3_2 [DOI] [PubMed] [Google Scholar]

[pone.0281776.ref005] 5.Wethington E. An Overview of the Life Course Perspective: Implications for Health and Nutrition. Journal of Nutrition Education and Behavior. 2005; 37:115–20. doi: 10.1016/s1499-4046(06)60265-0 [DOI] [PubMed] [Google Scholar]

[pone.0281776.ref006] 6.Durrer Schutz D, Busetto L, Dicker D, Farpour-Lambert N, Pryke R, Toplak H, et al. European Practical and Patient-Centred Guidelines for Adult Obesity Management in Primary Care. Obes Facts. 2019; 12:40–66. doi: 10.1159/000496183 . [DOI] [PMC free article] [PubMed] [Google Scholar]

[pone.0281776.ref007] 7.Kushner RF, Batsis JA, Butsch WS, Davis N, Golden A, Halperin F, et al. Weight History in Clinical Practice: The State of the Science and Future Directions. Obesity (Silver Spring). 2020; 28:9–17. doi: 10.1002/oby.22642 . [DOI] [PubMed] [Google Scholar]

[pone.0281776.ref008] 8.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 (Lond). 2006; 30:513–9. doi: 10.1038/sj.ijo.0803122 . [DOI] [PubMed] [Google Scholar]

[pone.0281776.ref009] 9.Stunkard AJ, Faith MS, Allison KC. Depression and obesity. Biol Psychiatry. 2003; 54:330–7. doi: 10.1016/s0006-3223(03)00608-5 . [DOI] [PubMed] [Google Scholar]

[pone.0281776.ref010] 10.de Wit L, Luppino F, van Straten A, Penninx B, Zitman F, Cuijpers P. Depression and obesity: a meta-analysis of community-based studies. Psychiatry Res. 2010; 178:230–5. Epub 2010/05/13. doi: 10.1016/j.psychres.2009.04.015 . [DOI] [PubMed] [Google Scholar]

[pone.0281776.ref011] 11.Luppino FS, Wit LM de, Bouvy PF, Stijnen T, Cuijpers P, Penninx BWJH, et al. Overweight, obesity, and depression: a systematic review and meta-analysis of longitudinal studies. Arch Gen Psychiatry. 2010; 67:220–9. doi: 10.1001/archgenpsychiatry.2010.2 . [DOI] [PubMed] [Google Scholar]

[pone.0281776.ref012] 12.Gill H, Kang S, Lee Y, Rosenblat JD, Brietzke E, Zuckerman H, et al. The long-term effect of bariatric surgery on depression and anxiety. J Affect Disord. 2019; 246:886–94. Epub 2018/12/28. doi: 10.1016/j.jad.2018.12.113 . [DOI] [PubMed] [Google Scholar]

[pone.0281776.ref013] 13.Fabricatore AN, Wadden TA, Higginbotham AJ, Faulconbridge LF, Nguyen AM, Heymsfield SB, et al. Intentional weight loss and changes in symptoms of depression: a systematic review and meta-analysis. Int J Obes (Lond). 2011; 35:1363–76. Epub 2011/02/22. doi: 10.1038/ijo.2011.2 . [DOI] [PMC free article] [PubMed] [Google Scholar]

[pone.0281776.ref014] 14.Borgeraas H, Barstad LH, Størdal Lund R, Fredheim JM, Hertel JK, Hjelmesæth J. Association of time of obesity onset with comorbidities in treatment-seeking men and women with severe obesity. Obes Sci Pract. 2018; 4:427–36. doi: 10.1002/osp4.298 . [DOI] [PMC free article] [PubMed] [Google Scholar]

[pone.0281776.ref015] 15.Geserick M, Vogel M, Gausche R, Lipek T, Spielau U, Keller E, et al. Acceleration of BMI in Early Childhood and Risk of Sustained Obesity. N Engl J Med. 2018; 379:1303–12. doi: 10.1056/NEJMoa1803527 . [DOI] [PubMed] [Google Scholar]

[pone.0281776.ref016] 16.Sanderson K, Patton GC, McKercher C, Dwyer T, Venn AJ. Overweight and obesity in childhood and risk of mental disorder: a 20-year cohort study. Aust N Z J Psychiatry. 2011; 45:384–92. doi: 10.3109/00048674.2011.570309 . [DOI] [PubMed] [Google Scholar]

[pone.0281776.ref017] 17.Hu Y, Bhupathiraju SN, de Koning L, Hu FB. Duration of obesity and overweight and risk of type 2 diabetes among US women. Obesity (Silver Spring). 2014; 22:2267–73. doi: 10.1002/oby.20851 . [DOI] [PMC free article] [PubMed] [Google Scholar]

[pone.0281776.ref018] 18.Labad J, Price JF, Strachan MWJ, Fowkes FGR, Ding J, Deary IJ, et al. Symptoms of depression but not anxiety are associated with central obesity and cardiovascular disease in people with type 2 diabetes: the Edinburgh Type 2 Diabetes Study. Diabetologia. 2010; 53:467–71. Epub 2009/12/10. doi: 10.1007/s00125-009-1628-9 . [DOI] [PMC free article] [PubMed] [Google Scholar]

[pone.0281776.ref019] 19.Wooley SC, Garner DM. Obesity treatment: the high cost of false hope. J Am Diet Assoc. 1991; 91:1248–51. [PubMed] [Google Scholar]

[pone.0281776.ref020] 20.Jackson SE, Steptoe A, Beeken RJ, Kivimaki M, Wardle J. Psychological changes following weight loss in overweight and obese adults: a prospective cohort study. PLoS ONE. 2014; 9:e104552. doi: 10.1371/journal.pone.0104552 . [DOI] [PMC free article] [PubMed] [Google Scholar]

[pone.0281776.ref021] 21.Jung F, Spahlholz J, Hilbert A, Riedel-Heller SG, Luck-Sikorski C. Impact of Weight-Related Discrimination, Body Dissatisfaction and Self-Stigma on the Desire to Weigh Less. Obes Facts. 2017; 10:139–51. doi: 10.1159/000468154 . [DOI] [PMC free article] [PubMed] [Google Scholar]

[pone.0281776.ref022] 22.Muennig P, Jia H, Lee R, Lubetkin E. I think therefore I am: perceived ideal weight as a determinant of health. Am J Public Health. 2008; 98:501–6. doi: 10.2105/AJPH.2007.114769 . [DOI] [PMC free article] [PubMed] [Google Scholar]

[pone.0281776.ref023] 23.Foreyt JP, Brunner RL, Goodrick GK, Cutter G, Brownell KD, St Jeor ST. Psychological correlates of weight fluctuation. Int J Eat Disord. 1995; 17:263–75. doi: [DOI] [PubMed] [Google Scholar]

[pone.0281776.ref024] 24.Venn AJ, Thomson RJ, Schmidt MD, Cleland VJ, Curry BA, Gennat HC, et al. Overweight and obesity from childhood to adulthood. A follow‐up of participants in the 1985 Australian Schools Health and Fitness Survey. Medical Journal of Australia. 2007; 186:458–60. doi: 10.5694/j.1326-5377.2007.tb00997.x [DOI] [PubMed] [Google Scholar]

[pone.0281776.ref025] 25.Hajek A, König H-H. Asymmetric effects of obesity on loneliness among older Germans. Longitudinal findings from the Survey of Health, Ageing and Retirement in Europe. Aging Ment Health. 2021; 25:2293–7. Epub 2020/09/22. doi: 10.1080/13607863.2020.1822285 . [DOI] [PubMed] [Google Scholar]

[pone.0281776.ref026] 26.Sahle BW, Breslin M, Sanderson K, Patton G, Dwyer T, Venn A, et al. Association between depression, anxiety and weight change in young adults. BMC Psychiatry. 2019; 19:398. Epub 2019/12/16. doi: 10.1186/s12888-019-2385-z . [DOI] [PMC free article] [PubMed] [Google Scholar]

[pone.0281776.ref027] 27.WHO. Preventing and managing the global epidemic. Report of a WHO consultation on obesity. Genf; 1998. [PubMed] [Google Scholar]

[pone.0281776.ref028] 28.Benecke A VH. Overweight and Obesity. Berlin; 2003. [Google Scholar]

[pone.0281776.ref029] 29.Latner JD, Ciao AC. Weight-loss history as a predictor of obesity treatment outcome: prospective, long-term results from behavioral, group self-help treatment. J Health Psychol. 2014; 19:253–61. doi: 10.1177/1359105312468191 . [DOI] [PubMed] [Google Scholar]

[pone.0281776.ref030] 30.Interdisziplinäre Leitlinie der Qualität S3 zur „Prävention und Therapie der Adipositas“. 2nd ed.; 2014. [Google Scholar]

[pone.0281776.ref031] 31.Löwe B., Spitzer R.L., Zipfel S., Herzog W. PHQ-D. Gesundheitsfragebogen fuer Patienten [German version of the patient health questionnaire].; 2002. [Google Scholar]

[pone.0281776.ref032] 32.Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001; 16:606–13. doi: 10.1046/j.1525-1497.2001.016009606.x . [DOI] [PMC free article] [PubMed] [Google Scholar]

[pone.0281776.ref033] 33.Löwe B. Gesundheitsfragebogen für Patienten (GAD-7). [Generalizied Anxiety Disorder Scale-7 (GAD-7). Universitätsklinikum Hamburg-Eppendorf; 2015. [Google Scholar]

[pone.0281776.ref034] 34.Spitzer RL, Kroenke K, Williams JBW, Löwe B. A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med. 2006; 166:1092–7. doi: 10.1001/archinte.166.10.1092 . [DOI] [PubMed] [Google Scholar]

[pone.0281776.ref035] 35.STATA Statistical Software. TX: StataCorp LLC: StataCorp; 2019. [Google Scholar]

[pone.0281776.ref036] 36.Inge TH, King WC, Jenkins TM, Courcoulas AP, Mitsnefes M, Flum DR, et al. The effect of obesity in adolescence on adult health status. Pediatrics. 2013; 132:1098–104. doi: 10.1542/peds.2013-2185 . [DOI] [PMC free article] [PubMed] [Google Scholar]

[pone.0281776.ref037] 37.Llewellyn A, Simmonds M, Owen CG, Woolacott N. Childhood obesity as a predictor of morbidity in adulthood: a systematic review and meta-analysis. Obes Rev. 2016; 17:56–67. doi: 10.1111/obr.12316 . [DOI] [PubMed] [Google Scholar]

[pone.0281776.ref038] 38.Hinz A, Klein AM, Brähler E, Glaesmer H, Luck T, Riedel-Heller SG, et al. Psychometric evaluation of the Generalized Anxiety Disorder Screener GAD-7, based on a large German general population sample. J Affect Disord. 2017; 210:338–44. doi: 10.1016/j.jad.2016.12.012 . [DOI] [PubMed] [Google Scholar]

[pone.0281776.ref039] 39.Kocalevent R-D, Hinz A, Brähler E. Standardization of the depression screener patient health questionnaire (PHQ-9) in the general population. Gen Hosp Psychiatry. 2013; 35:551–5. doi: 10.1016/j.genhosppsych.2013.04.006 . [DOI] [PubMed] [Google Scholar]

[pone.0281776.ref040] 40.Hawkins MAW, Goldstein CM, Dolansky MA, Gunstad J, Redle JD, Josephson R, et al. Depressive symptoms are associated with obesity in adults with heart failure: An analysis of gender differences. Eur J Cardiovasc Nurs. 2015; 14:516–24. Epub 2014/07/16. doi: 10.1177/1474515114542558 . [DOI] [PMC free article] [PubMed] [Google Scholar]

[pone.0281776.ref041] 41.Schwenke M, Löbner M, Riedel-Heller S, Luppa M. Adipositas und Depression in der Primärversorgung. Psychiatr Prax. 2020. doi: 10.1055/a-1144-7035 [DOI] [PubMed] [Google Scholar]

[pone.0281776.ref042] 42.Rajan TM, Menon V. Psychiatric disorders and obesity: A review of association studies. J Postgrad Med. 2017; 63:182–90. doi: 10.4103/jpgm.JPGM_712_16 . [DOI] [PMC free article] [PubMed] [Google Scholar]

[pone.0281776.ref043] 43.Lemon SC, Rosal MC, Zapka J, Borg A, Andersen V. Contributions of weight perceptions to weight loss attempts: differences by body mass index and gender. Body Image. 2009; 6:90–6. doi: 10.1016/j.bodyim.2008.11.004 . [DOI] [PMC free article] [PubMed] [Google Scholar]

[pone.0281776.ref044] 44.Tsai SA, Lv N, Xiao L, Ma J. Gender Differences in Weight-Related Attitudes and Behaviors Among Overweight and Obese Adults in the United States. Am J Mens Health. 2016; 10:389–98. doi: 10.1177/1557988314567223 . [DOI] [PubMed] [Google Scholar]

[pone.0281776.ref045] 45.Foster GD, Wadden TA, Phelan S, Sarwer DB, Sanderson RS. Obese patients’ perceptions of treatment outcomes and the factors that influence them. Arch Intern Med. 2001; 161:2133–9. doi: 10.1001/archinte.161.17.2133 . [DOI] [PubMed] [Google Scholar]

[pone.0281776.ref046] 46.Bhogal MS, Langford R. Gender differences in weight loss; evidence from a NHS weight management service. Public Health. 2014; 128:811–3. doi: 10.1016/j.puhe.2014.06.019 . [DOI] [PubMed] [Google Scholar]

[pone.0281776.ref047] 47.Masheb RM, Grilo CM. Weight loss expectations in patients with binge-eating disorder. Obes Res. 2002; 10:309–14. doi: 10.1038/oby.2002.44 . [DOI] [PubMed] [Google Scholar]

[pone.0281776.ref048] 48.Marmorstein NR, Lacono WG, Legrand L. Obesity and depression in adolescence and beyond: reciprocal risks. Int J Obes (Lond). 2014; 38:906–11. doi: 10.1038/ijo.2014.19 . [DOI] [PMC free article] [PubMed] [Google Scholar]

[pone.0281776.ref049] 49.Anderson SE, Cohen P, Naumova EN, Must A. Association of depression and anxiety disorders with weight change in a prospective community-based study of children followed up into adulthood. Arch Pediatr Adolesc Med. 2006; 160:285–91. doi: 10.1001/archpedi.160.3.285 . [DOI] [PubMed] [Google Scholar]

[pone.0281776.ref050] 50.Mannan M, Mamun A, Doi S, Clavarino A. Prospective Associations between Depression and Obesity for Adolescent Males and Females- A Systematic Review and Meta-Analysis of Longitudinal Studies. PLoS ONE. 2016; 11:e0157240. doi: 10.1371/journal.pone.0157240 . [DOI] [PMC free article] [PubMed] [Google Scholar]

[pone.0281776.ref051] 51.Mustillo S, Worthman C, Erkanli A, Keeler G, Angold A, Costello EJ. Obesity and psychiatric disorder: developmental trajectories. Pediatrics. 2003; 111:851–9. doi: 10.1542/peds.111.4.851 . [DOI] [PubMed] [Google Scholar]

[pone.0281776.ref052] 52.Petroni ML, Villanova N, Avagnina S, Fusco MA, Fatati G, Compare A, et al. Psychological distress in morbid obesity in relation to weight history. Obes Surg. 2007; 17:391–9. doi: 10.1007/s11695-007-9069-3 . [DOI] [PubMed] [Google Scholar]

[pone.0281776.ref053] 53.Foster GD, Wadden TA, Vogt RA, Brewer G. What is a reasonable weight loss? Patients’ expectations and evaluations of obesity treatment outcomes. Journal of Consulting and Clinical Psychology. 1997; 65:79–85. doi: 10.1037//0022-006x.65.1.79 [DOI] [PubMed] [Google Scholar]

[pone.0281776.ref054] 54.Siervo M, Montagnese C, Muscariello E, Evans E, Stephan BCM, Nasti G, et al. Weight loss expectations and body dissatisfaction in young women attempting to lose weight. J Hum Nutr Diet. 2014; 27 Suppl 2:84–9. doi: 10.1111/jhn.12078 . [DOI] [PubMed] [Google Scholar]

[pone.0281776.ref055] 55.Provencher V, Bégin C, Gagnon-Girouard M-P, Gagnon HC, Tremblay A, Boivin S, et al. Defined weight expectations in overweight women: anthropometrical, psychological and eating behavioral correlates. Int J Obes (Lond). 2007; 31:1731–8. doi: 10.1038/sj.ijo.0803656 . [DOI] [PubMed] [Google Scholar]

[pone.0281776.ref056] 56.Booth AO, Wang X, Turner AI, Nowson CA, Torres SJ. Diet-Induced Weight Loss Has No Effect on Psychological Stress in Overweight and Obese Adults: A Meta-Analysis of Randomized Controlled Trials. Nutrients. 2018; 10. doi: 10.3390/nu10050613 . [DOI] [PMC free article] [PubMed] [Google Scholar]

[pone.0281776.ref057] 57.Hayes JF, Hoggatt KJ, Breland JY. Mental Health Diagnostic Patterns in Behavioral Weight Loss Program Attendees. Mil Med. 2020. doi: 10.1093/milmed/usaa046 . [DOI] [PMC free article] [PubMed] [Google Scholar]

[pone.0281776.ref058] 58.Tronieri JS, Wurst CM, Pearl RL, Allison KC. Sex Differences in Obesity and Mental Health. Curr Psychiatry Rep. 2017; 19:29. doi: 10.1007/s11920-017-0784-8 . [DOI] [PubMed] [Google Scholar]

[pone.0281776.ref059] 59.Hach I, Ruhl UE, Klose M, Klotsche J, Kirch W, Jacobi F. Obesity and the risk for mental disorders in a representative German adult sample. Eur J Public Health. 2007; 17:297–305. doi: 10.1093/eurpub/ckl227 . [DOI] [PubMed] [Google Scholar]

[pone.0281776.ref060] 60.Merrill RM, Richardson JS. Validity of self-reported height, weight, and body mass index: findings from the National Health and Nutrition Examination Survey, 2001–2006. [PMC free article] [PubMed] [Google Scholar]

PERMALINK

The relationship between weight history and psychological health—Differences related to gender and weight loss patterns

Franziska U C E Jung

Steffi G Riedel-Heller

Claudia Luck-Sikorski

Roles

Abstract

Background

Method

Results

Conclusion

Introduction

Method

Sampling procedure

Instruments

Covariates

Characteristics of weight history

Psychological health outcomes

Data analysis

Results

Table 1. Sociodemographic information for the overall sample and separated by gender.

Weight history and psychological health

Fig 1. Onset of obesity and weight loss attempts associated with psychological health for male and female participants (for depression: Mean PHQ-9 score, for anxiety mean GAD-7 score).

Fig 2. Weight maintenance after greatest weight loss and desired weight loss associated with psychological health for male and female participants (for depression: Mean PHQ-9 score, for anxiety mean GAD-7 score).

Partial correlation (controlling for BMI, age and gender)

Table 2. Partial correlations for psychological and weight history variables (controlling for age, gender and BMI).

Regression analysis

Table 3. Multiple regression analysis with depression (Model 1) and anxiety (Model 2) as dependent variables.

Discussion

Conclusion

Data Availability

Funding Statement

References

Decision Letter 0

Meng Li

Roles

Author response to Decision Letter 0

Decision Letter 1

Meng Li

Roles

Author response to Decision Letter 1

Decision Letter 2

Meng Li

Roles

Acceptance letter

Meng Li

Roles

Associated Data

Supplementary Materials

Data Availability Statement

ACTIONS

PERMALINK

RESOURCES

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