Mood Disorder, Obesity Associated With Poorer Physical, Mental Outcomes
Future studies should examine the cost of obesity and its consequences in individuals with mood disorders.
The co-occurrence of mood disorders and obesity may be associated with poorer physical and psychological health, as well as more frequent consultations with healthcare professionals, according to the review of cross-sectional study data published in the Journal of Affective Disorders.
Investigators collected data from the 2007-2008 Canadian Community Health Survey, which provides information on health status, healthcare utilization, and health determinants of inhabitants of the Quebec province. For the present analyses, the response data included were from adults (aged >18 years) with obesity (body mass index [BMI] ≥30 kg/m2). The presence of mood disorder was defined as a past or current diagnosis by a healthcare professional of depression, bipolar disorder, mania, or dysthymia. Psychological well-being was assessed using several self-reported indicators: the presence of a major depressive episode, anxiety disorder, and/or psychological distress; quality of life; perceived global and mental health; and satisfaction with life in general. Health behaviors assessed included physical activity, fruit and vegetable consumption, and tobacco use. To capture the use of healthcare services, participants were asked to if they had consulted with any healthcare professional over the past year. Logistic regression analyses were performed to examine associations among the data.
A total of 1298 individuals were included in the study; 47.1% were women, mean body mass index (BMI) was 33.9±3.9 kg/m2, and the majority (70.6%) were aged >30 years. The prevalence of individuals with both obesity and mood disorder was 7.7%, primarily (65%) women. In comparison, the group of obese individuals without reported mood disorder was composed of mostly men (54.3%). No significant differences between obese individuals without mood disorder and individuals with obesity and mood disorder were identified according to educational level or BMI, although the obesity and mood disorder group had a greater percentage of women (P <.001) and individuals aged ≥65 years (P =.02).
The prevalence of most physical comorbidities was significantly higher in the obesity and mood disorder group compared with the group of obese individuals without mood disorder, although no differences were observed for type 2 diabetes or heart disease. Specifically, odds ratios (ORs) ranged from 1.8 (95% CI, 1.1-2.8) for hypertension to 2.8 (95% CI, 1.3-6.0) for stomach ulcer. The total number of reported chronic diseases was also higher in the obesity and mood disorder group compared with the group of obese individuals without mood disorder (P <.0001).
Individuals with obesity and mood disorder reported poorer psychological well-being and more consultations with healthcare professionals compared with obese individuals without mood disorder. Specifically, the ORs of poor psychological outcomes ranged from 2.1 (95% CI, 1.4-3.3) for stress to 25.6 (95% CI, 14.7-45.0) for poor perceived mental health.
Regarding healthcare consultations, ORs ranged from 1.9 (95% CI, 1.0-3.5) for consultations with physicians to 7.7 (95% CI, 4.2-14.3) for consultations with psychologists. Individuals with obesity and mood disorder reported fewer healthy behaviors, with an OR of 2.1 (95% CI, 1.3-3.3) for tobacco use.
The cross-sectional study design limits any conclusions about causality or temporality. Even so, these associations indicate a significant association between the co-occurrence of mood disorder and obesity and poorer health in several areas. Interventions to prevent or manage obesity in mood disorders would therefore be beneficial.
Romain AJ, Marleau J, Baillot A. Impact of obesity and mood disorders on physical comorbidities, psychological well-being, health behaviours and use of health services. J Affect Disord. 2018;225:381-388.