Overweight, Obesity, and Depression: A Systematic Review and Meta-analysis of Longitudinal Studies

Context: Association between obesity and depression
has repeatedly been established. For treatment and prevention
purposes, it is important to acquire more insight
into their longitudinal interaction.
Objective: To conduct a systematic review and metaanalysis
on the longitudinal relationship between depression,
overweight, and obesity and to identify possible
influencing factors.
Data Sources: Studies were found using PubMed,
PsycINFO, and EMBASE databases and selected on several
criteria.
Study Selection: Studies examining the longitudinal
bidirectional relation between depression and overweight
(body mass index 25-29.99) or obesity (body mass
index ≥30) were selected.
Data Extraction: Unadjusted and adjusted odds ratios
(ORs) were extracted or provided by the authors.
Data Synthesis: Overall, unadjusted ORs were calculated
and subgroup analyses were performed for the 15
included studies (N=58 745) to estimate the effect of possible
moderators (sex, age, depression severity). Obesity
at baseline increased the risk of onset of depression
at follow-up (unadjusted OR, 1.55; 95% confidence interval
[CI], 1.22-1.98; Ppronounced among Americans than among Europeans
(P=.05) and for depressive disorder than for depressive
symptoms (P=.05). Overweight increased the risk of onset
of depression at follow-up (unadjusted OR, 1.27; 95%
CI, 1.07-1.51; Psignificant among adults (aged 20-59 years and≥360 years)
but not among younger persons (ageddepression (symptoms and disorder) was not predictive
of overweight over time. However, depression increased
the odds for developing obesity (OR, 1.58; 95%
CI, 1.33-1.87; Pspecific moderators of the association.
Conclusions: This meta-analysis confirms a reciprocal link
between depression and obesity. Obesity was found to increasetheriskofdepression,
mostpronouncedamongAmericansandfor
clinicallydiagnoseddepression. In addition,depression
was found to be predictive of developing obesity.