Depression and anxiety among US adults: associations with body mass index
Abstract
Background Obesity is associated with an increased risk of developing a variety of chronic diseases, most of which are associated with psychiatric disorders. We examined the associations of depression and anxiety with body mass index (BMI) after taking into consideration the obesity-related comorbidities (ORCs) and other psychosocial or lifestyle factors.Methods We analyzed the data collected from 177,047 participants (aged>or=18 years) in the 2006 Behavioral Risk Factor Surveillance System. Current depression was assessed by the Patient Health Questionnaire-8 diagnostic algorithm. Lifetime diagnoses of depression, anxiety and ORCs were self-reported. The prevalence of the three psychiatric disorders was age standardized to the 2000 US population. Multivariate-adjusted prevalence ratios were computed to test associations of depression and anxiety with BMI using SUDAAN software.Results The age-adjusted prevalence of current depression, lifetime diagnosed depression and anxiety varied significantly by gender. Within each gender, the prevalence of the three psychiatric disorders was significantly higher in both men and women who were underweight (BMI<18.5 kg/m(2)), in women who were overweight (BMI: 25-<30 kg/m(2)) or obese (BMI>or=30 kg/m(2)), and in men who had class III obesity (BMI>or=40 kg/m(2)) than in those with a normal BMI (18.5-<25 kg/m(2)). After adjusting for demographics, ORCs, lifestyle or psychosocial factors, compared with men with a normal BMI, men with a BMI>or=40 kg/m(2) were significantly more likely to have current depression or lifetime diagnosed depression and anxiety; men with a BMI<18.5 kg/m(2) were also significantly more likely to have lifetime diagnosed depression. Women who were either overweight or obese were significantly more likely than women with a normal BMI to have all the three psychiatric disorders.Conclusions Our results demonstrate that disparities in the prevalence of depression and anxiety exist among people with different BMI levels independent of their disease status or other psychosocial or lifestyle factors.
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Overweight/obesity and depression/anxiety very often overlap.
“Very often these conditions overlap”
From Mobile Apps for the Management of Comorbid Overweight/Obesity and Depression/Anxiety: A Systematic Review (2020) · cites this paper as [15]
Depression and anxiety have a marked association with overweight/obesity.
“depression and anxiety stand out, not only for their higher prevalence but also for their marked association with overweight/obesity [13–15]”
From Mobile Apps for the Management of Comorbid Overweight/Obesity and Depression/Anxiety: A Systematic Review (2020) · cites this paper as [15]
Obesity heightens the odds of anxiety symptoms by 40%.
“A similar positive relationship is observed with anxiety: obesity heightens the odds of an anxiety disorder or anxiety symptoms (e.g., dread, unease) by 30% and 40%, respectively [1,20].”
From The menace of obesity to depression and anxiety prevalence (2022) · cites this paper as [1]
Elevated body mass index is predictive of a chronic course of depressive and anxiety symptoms.
“An elevated body mass index (BMI) is predictive of a chronic course of depressive and anxiety symptoms [1,2].”
From The menace of obesity to depression and anxiety prevalence (2022) · cites this paper as [1]
Obesity heightens the odds of an anxiety disorder by 30%.
“A similar positive relationship is observed with anxiety: obesity heightens the odds of an anxiety disorder or anxiety symptoms (e.g., dread, unease) by 30% and 40%, respectively [1,20].”
From The menace of obesity to depression and anxiety prevalence (2022) · cites this paper as [1]
There is a stronger relationship between severe obesity (BMI ≥ 35) and anxiety.
“Indeed, there is a stronger relationship between severe obesity (BMI ≥ 35) and anxiety [1].”
From The menace of obesity to depression and anxiety prevalence (2022) · cites this paper as [1]
The frequency of depression and anxiety disorder diagnoses is approximately double for obese women as compared with obese men.
“The frequency of depression and anxiety disorder diagnoses are approximately double for obese women as compared with obese men [1,157], a divergence that corresponds with lifetime prevalence independent of body weight.”
From The menace of obesity to depression and anxiety prevalence (2022) · cites this paper as [1]
The sex distinction in incidence of depression and anxiety narrows considerably in conditions of severe obesity (BMI ≥ 40).
“This sex distinction in incidence narrows considerably in conditions of severe obesity (BMI ≥ 40) [1].”
From The menace of obesity to depression and anxiety prevalence (2022) · cites this paper as [1]
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- Authors
- Zhao, G., Ford, E. S., Dhingra, S., Li, C., Strine, T. W., & Mokdad, A. H.
- Affiliations
- Centers for Disease Control and Prevention (US)
- University of Washington (US)
- Corresponding author
- Zhao, G
- Venue
- International Journal of Obesity
- Published
- 2009-01-06
- Volume
- 33
- Issue
- 2
- Pages
- 257-266
- ISSN
- 0307-0565 (ISSN-L)
- 1476-5497
- OpenAlex
- W2088968814
- Cited by
- 423
- References
- 63
- Citations by year
- 2026: 14 · 2025: 24 · 2024: 28 · 2023: 32 · 2022: 24 · 2021: 25 · 2020: 33 · 2019: 27 · 2018: 17 · 2017: 16 · 2016: 33 · 2015: 32 · 2014: 36 · 2013: 19 · 2012: 15
- FWCI
- 21.18
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- International Journal of Obesity (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Keywords
- depression, anxiety, body mass index, obesity, underweight, overweight, obesity-related comorbidities, mental illness, sex differences, prevalence, Behavioral Risk Factor Surveillance System, PHQ-8
- MeSH terms
- Adolescent, Adult, Aged, Anxiety Disorders, Depressive Disorder, Female, Health Status, Humans, Male, Middle Aged, Obesity, Quality of Life, Surveys and Questionnaires, Risk Factors, Socioeconomic Factors, Thinness, United States, Body Mass Index, Prevalence, Overweight, Young Adult
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