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Cited by 59Treatment of Major DepressionEating Disorders and BehaviorsAnxiety, Depression, Psychometrics, Treatment, Cognitive Processes

Relationship Between Obesity and Depression: Characteristics and Treatment Outcomes With Antidepressant Medication

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Toups, Marisa S.P., Myers, Alyson K., Wisniewski, Stephen R., Kurian, Benji, Morris, David W., Rush, Augustus John, Fava, Maurizio, Trivedi, Madhukar H.·2013·Psychosomatic Medicine
DOI 10.1097/psy.0000000000000000PMC PMC3905462
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Abstract

OBJECTIVE: Obesity and major depressive disorder often co-occur. However, differences between obese and normal-weight depressed patients and the moderating effect of obesity on antidepressant treatment outcome are not well studied. METHODS: Adults (n = 662) with major depressive disorder in the Combining Medications to Enhance Depression Outcomes study were randomized to treatment with escitalopram plus placebo, bupropion plus escitalopram, or venlafaxine plus mirtazapine for a 12-week primary treatment phase and 16-week follow-up. Body mass index (BMI) was calculated at baseline and categorized according to World Health Organization criteria: normal or low weight (NW), overweight, Obese I and Obese II+. A repeated-effects model, unadjusted and adjusted for baseline variables, assessed outcomes. RESULTS: Obesity was common (46.2%), only 25.5% were NW. Higher BMI was associated with greater medical illness (p < .001), social phobia (p = .003), and bulimia (p = .026). Lower BMI was associated with more frequent post-traumatic stress disorder (p = .002) and drug abuse (p < .001). Treatment outcomes did not differ including Week 12 remission rates (NW 36%, overweight 40%, Obese I 43%, Obese II+ 37%; p = .69). Lower BMI was associated with more frequent (p = .024 [unadjusted] and .053 [adjusted]) and more severe (p = .008 [unadjusted] and .053 [adjusted]) adverse effects. CONCLUSIONS: BMI was related to clinical presentation and prevalence of comorbidities, but not antidepressant outcomes. Lower BMI classes had more psychiatric comorbidities, potentially obscuring the relationship between BMI and antidepressant effects. Trial Registration ClinicalTrials.gov identifier: NCT00590863.

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Authors
Toups, M. S. P., Myers, A. K., Wisniewski, S. R., Kurian, B., Morris, D. W., Rush, A. J., Fava, M., & Trivedi, M. H.
Affiliations
  • The University of Texas Southwestern Medical Center (US)
  • University of Pittsburgh (US)
Corresponding author
Trivedi, Madhukar H.
ORCID
Venue
Psychosomatic Medicine
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2013-11
Volume
75
Issue
9
Pages
863-872
ISSN
0033-3174 (ISSN-L)
DOI
10.1097/psy.0000000000000000
PMC
PMC3905462
OpenAlex
W2026923692
Cited by
59
References
35
Citations by year
2026: 2 · 2025: 5 · 2023: 10 · 2022: 3 · 2021: 8 · 2020: 6 · 2019: 3 · 2018: 4 · 2017: 2 · 2016: 9 · 2015: 5 · 2014: 2
FWCI
3.92
Type
journal article
Language
en
Open access
Locations
  • Psychosomatic Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
  • National University of Singapore (submittedVersion)
Funders
  • National Institutes of Health (n01mh90003-26-0-0)
  • National Institute of Mental Health (N01‐MH‐90003, N01 MH090003, T32MH067543)
Topics
  • Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
  • Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Keywords
obesity, major depressive disorder, body mass index, antidepressant treatment outcome, antidepressant side effects, psychiatric comorbidity, escitalopram, bupropion, venlafaxine, mirtazapine, depression remission, drug abuse, post-traumatic stress disorder, social anxiety disorder, bulimia nervosa
MeSH terms
Adolescent, Adult, Aged, Antidepressive Agents, Major Depressive Disorder, Drug Therapy, Combination, Female, Humans, Male, Middle Aged, Obesity, Risk Factors, United States, Models, Statistical, Comorbidity, Body Mass Index, Prevalence, Single-Blind Method, Treatment Outcome, Young Adult, Depressive Disorder, Treatment-Resistant

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