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Bidirectional association between depression and obesity in middle-aged and older women

International Journal of Obesity volume 36, pages 595–602 (2012)Cite this article

Abstract

Objective:

Although it has been hypothesized that the depression–obesity relation is bidirectional, few studies have addressed this hypothesis in a prospective setting. We aimed to examine the bidirectional relationship in middle-aged and elderly women.

Subjects:

A total of 65 955 women aged 54–79 years in the Nurses’ Health Study were prospectively followed from 1996 to 2006 with updated information on body weight, depression status and various covariates every 2 years. Depression was defined as self-report of physician-diagnosed depression and/or antidepressant use. Obesity was defined as a BMI ⩾30.0 kg m−2. The first three waves (1996–2000) were used as the baseline period and the last three waves (2002–2006) were used as the follow-up period.

Results:

After adjusting for baseline age, physical activity, comorbidities, BMI and other covariates, depression at the baseline period was associated with an increased risk of obesity at the follow-up period in all women (multivariate-adjusted odds ratio (OR), 1.38; 95% confidence interval (95% CI), 1.24–1.53) and baseline non-obese women (OR, 1.51; 95% CI, 1.36–1.67). In the opposite direction, after adjusting for baseline age, physical activity, comorbidities, depression status and other covariates, obese women at baseline had a moderately increased risk of depression at the follow-up period compared with normal-weight women (OR, 1.11; 95% CI, 1.03–1.18), and this association was similar for new onset of depression (OR for obese versus normal weight women, 1.10; 95% CI, 1.02–1.20).

Conclusions:

Our results suggest a bidirectional association between depression and obesity in middle-aged and elderly women. Future studies are needed to confirm our findings in different populations, and investigate the potential mechanisms underlying this association. Our results underscore the importance of early detection and proper behavioral modifications to lower the burden of both conditions.

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Acknowledgements

We are indebted to the participants in the Nurses’ Health Study for their continuing outstanding support and the co-workers in these studies for their valuable help. The study was supported by the National Institutes of Health Grant DK58845 and P30 DK46200. Dr Ascherio received a grant from the National Alliance for Research on Schizophrenia & Depression (Project ID: 5048070-01). Dr Sun was supported by a career development award K99HL098459 from the National Heart, Lung, and Blood Institute. Dr Lucas received a postdoctoral fellowship from the Fonds de recherche en santé du Québec (FRSQ). Dr Kivimaki is supported by the NIH (HL036310-20A2 from National Heart, Lung, and Blood Institute, and AG034454 from National Institute of Aging) and the BUPA Foundation, UK. Dr Okereke was supported by the NIH (career development award K08AG029813 from National Institute of Aging, and R01MH091448 from the National Institute of Mental Health). The funding sources were not involved in data collection, data analysis, manuscript writing and publication.

Author information

Authors and Affiliations

  1. Department of Nutrition, Harvard School of Public Health, Boston, MA, USA

    A Pan, Q Sun, M Lucas, A Ascherio & F B Hu

  2. Department of Medicine, Channing Laboratory, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA

    Q Sun, O I Okereke, A Ascherio & F B Hu

  3. Department of Public Health, Hôpital Avicenne and University Paris 13, Bobigny, France

    S Czernichow

  4. Nutritional Epidemiology Research Unit—UMR U557 INSERM, U1125 INRA, CNAM, Paris 13 University, Bobigny, France

    S Czernichow

  5. Department of Epidemiology and Public Health, University College London, London, UK

    M Kivimaki

  6. Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA

    O I Okereke, J E Manson, A Ascherio & F B Hu

  7. Department of Psychiatry, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA

    O I Okereke

  8. Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA

    J E Manson

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  1. A Pan
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Correspondence to F B Hu.

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Pan, A., Sun, Q., Czernichow, S. et al. Bidirectional association between depression and obesity in middle-aged and older women. Int J Obes 36, 595–602 (2012). https://doi.org/10.1038/ijo.2011.111

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