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Overweight, obesity, and individual symptoms of depression: A multicohort study with replication in UK Biobank

Frank, P; Jokela, M; Batty, GD; Lassale, C; Steptoe, A; Kivimäki, M; (2022) Overweight, obesity, and individual symptoms of depression: A multicohort study with replication in UK Biobank. Brain, Behavior, and Immunity , 105 pp. 192-200. 10.1016/j.bbi.2022.07.009. Green open access

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Abstract

Objectives: Obesity is associated with increased risk of depression, but the extent to which this association is symptom-specific is unknown. We examined the associations of overweight and obesity with individual depressive symptoms. / Methods: We pooled data from 15 population-based cohorts comprising 57,532 individuals aged 18 to 100 years at study entry. Primary analyses were replicated in an independent cohort, the UK Biobank study (n = 122,341, age range 38 to 72). Height and weight were assessed at baseline and body mass index (BMI) was computed. Using validated self-report measures, 24 depressive symptoms were ascertained once in 16 cross-sectional, and twice in 7 prospective cohort studies (mean follow-up 3.2 years). / Results: In the pooled analysis of the primary cohorts, 22,045 (38.3 %) participants were overweight (BMI between 25 and 29.9 kg/m2), 12,025 (20.9 %) class I obese (BMI between 30 and 34.9 kg/m2), 7,467 (13.0 %) class II-III obese (BMI ≥ 35 kg/m2); and 7,046 (12.3 %) were classified as depressed. After multivariable adjustment, obesity class I was cross-sectionally associated with 1.11-fold (95 % confidence interval 1.01–1.22), and obesity class II-III with 1.31-fold (1.16–1.49) higher odds of overall depression. In symptom-specific analyses, robust associations were apparent for 4 of the 24 depressive symptoms (‘could not get going/lack of energy’, ‘little interest in doing things’, ‘feeling bad about yourself, and ‘feeling depressed’), with confounder-adjusted odds ratios of having 3 or 4 of these symptoms being 1.32 (1.10–1.57) for individuals with obesity class I, and 1.70 (1.34–2.14) for those with obesity class II-III. Elevated C-reactive protein and 21 obesity-related diseases explained 23 %-31 % of these associations. Symptom-specific associations were confirmed in longitudinal analyses where obesity preceded symptom onset, were stronger in women compared with men, and were replicated in UK Biobank. / Conclusions: Obesity is associated with a distinct set of depressive symptoms. These associations are partially explained by systemic inflammation and obesity-related morbidity. Awareness of this obesity-related symptom profile and its underlying biological correlates may inform better targeted treatments for comorbid obesity and depression.

Type: Article
Title: Overweight, obesity, and individual symptoms of depression: A multicohort study with replication in UK Biobank
Location: Netherlands
Open access status: An open access version is available from UCL Discovery
DOI: 10.1016/j.bbi.2022.07.009
Publisher version: https://doi.org/10.1016/j.bbi.2022.07.009
Language: English
Additional information: Copyright © 2022 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
Keywords: Depression, Multicohort study, Obesity, Overweight, Symptoms of depression, UK Biobank
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health > Epidemiology and Public Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health > Behavioural Science and Health
URI: https://discovery.ucl.ac.uk/id/eprint/10153105
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