Increasing weight or persistent overweight status from childhood to adulthood is associated with a higher risk for depression, according to the results published by Obesity Reviews.
Researchers conducted a systematic review of the MEDLINE, PsychINFO, Embase, Cumulative Index to Nursing and Allied Health Literature, and Scopus databases for studies with a longitudinal design that assessed weight change from childhood to adulthood that were associated with depression and anxiety. A total of 17 studies were included in the final review.
A meta-analysis could not be performed due to a high level of heterogeneity observed across all the studies. The Newcastle-Ottawa scale was used to assess and rate the quality of included studies. The researchers found that 11 studies were determined to be of moderate quality, and the remaining 6 were considered high quality.
Of the 17 studies, 11 defined weight change between 2 points in time, and the remaining articles defined weight change based on 3 or more documented weights. Weight status was measured using body mass index (BMI) or BMI z-scores in 14 studies. The remaining articles used retrospective measures to define weight status. Depression outcomes were evaluated in 13 studies, and only one evaluated anxiety as the sole outcome. The remaining 5 studies evaluated a composite risk of anxiety and depression.
Depression outcomes were measured as depressive symptoms in 4 studies. Among of the 2 studies that observed BMI change as a continuous variable, one study reported a significant association with depressive symptoms (P <.01). Of the 2 studies that utilized BMI categories to measure weight change, 1 found that there was no association of overweight status changes and depressive symptoms whereas the other study observed the opposite outcome; participants obesity was associated with more severe depressive symptoms (P <.001).
Of the studies that defined depression as a confirmed diagnosis, 4 studies used BMI categories to assess weight change. One of the studies, in particular, found that in an all-women cohort, persistent obesity (odds ratio [OR], 2.0; 95% CI, 1.2-3.3) and the development of obesity from previously nonoverweight individuals (OR, 2.1; 95% CI, 1.1-3.8) are associated with a greater risk for new-onset adult depression. A separate all-women cohort found that obese women who were overweight during childhood had a higher risk for depression (relative risk, 2.0; 95% CI, 1.2-3.7).
The 2 articles which assessed weight change between separate time points had conflicting results. Of the studies that used 3 or more BMI or body size measures, 1 study found that obesity in late adolescence was a predictor of depression in young adulthood (OR, 2.8; 95% CI, 1.3-6.1). The other 3 studies with the same weight change measures observed that a rapid increase in weight from puberty to adulthood was associated with a higher risk for depression (OR, 4.5; 95% CI, 2.1-18.4).
Regarding the only study with anxiety as the primary outcome, the authors found that a change in overweight status was not associated with anxiety during adulthood. However, an association was detected in women who were persistently overweight (OR, 1.5; 95% CI, 1.0-2.5).
Of the 5 studies with a composite outcome of anxiety and depression, there were 3 that used BMI categories to assess weight change and demonstrated mixed results. Of the 2 studies that assessed weight status with 3 or more BMI measures, 1 found no association between overweight status and depression- or anxiety-related hospitalizations. The other study found that young men with increasing weight status experienced a more favorable mental health status.
Limitations of this study include that fact that several of the studies included in this analysis did not exclude patients with a prior history of depression; depression may have preceded weight gain, which can contribute to potential bias.
The study authors conclude, “[P]ersistent and/or increasing adiposity from childhood to adulthood is associated with an increased risk [for] depression in adulthood, particularly in women.”
This article originally appeared on Endocrinology Advisor
Gallagher C, Waidyatillake N, Pirkis J, et al. The effects of weight change from childhood to adulthood on depression and anxiety risk in adulthood: a systematic review. Obes Rev. Published online: April 16, 2023. doi:10.1111/obr.13566.