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Obesity and psychopathology in women: a three decade prospective study

International Journal of Obesity volume 32, pages 558–566 (2008)Cite this article

Abstract

Objective:

To evaluate prospective associations between elevations in body mass index (BMI) at average age 27 and generalized anxiety disorder (GAD) and major depressive disorder (MDD) at average age 59 in a community sample of women.

Design:

Three waves of data collected over three decades were drawn from mothers in the Children in the Community (CIC) Study. Binary logistic regression was used to estimate predictive effects of two BMI cutpoints (⩾30 and ⩾25) on GAD and MDD independent of other risks for psychopathology.

Subjects:

The 544 mothers who were interviewed in the original wave of the CIC Study in 1975 and in the first and most recent follow-up waves in 1983 and 2002–2005.

Measurements:

Information about height and weight was obtained by self-report in face-to-face interviews. GAD and MDD were assessed by structured interview covering DSM-IV diagnostic criteria. Other potential risk factors examined included age, race, education, prior depressive symptoms and marital status, chronic disease, social support and financial strain concurrent with GAD and MDD.

Results:

A baseline BMI ⩾30 significantly increased the odds for subsequent GAD and MDD by 6.27 and 5.25 times, respectively, after adjusting for other significant risk factors. Odds of GAD also increased significantly given a baseline BMI ⩾25 (by 2.44 times); however this association was not independent of other significant risk factors. Predictive associations between a baseline BMI ⩾30 and MDD were not attenuated by attained BMI assessed at outcome.

Conclusion:

Findings extend existing evidence of the mental health consequences of obesity in a representative sample of mothers, and suggest that obesity may have long-term implications for mental distress in women at a clinical level over the adult years.

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References

  1. Crisp AH, McGuiness B . Jolly fat: relationship between obesity and psychoneurosis in the general population. BMJ 1976; 1: 7–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  2. Crisp AH, Queenan M, Sittampain Y, Harris G . ‘Jolly fat’ revisited. J Psychosom Res 1980; 24: 233–241.

    Article  CAS  PubMed  Google Scholar 

  3. Hällström T, Noppa H . Obesity in women in relation to mental illness, social factors and personality traits. J Psychosom Res 1981; 25: 75–82.

    Article  PubMed  Google Scholar 

  4. John U, Meyer C, Rumpf H-J, Hapke U . Relationships of psychiatric disorders with overweight and obesity in an adult general population. Obes Res 2005; 13: 101–109.

    Article  PubMed  Google Scholar 

  5. Palinkas LA, Wingard DL, Barrett-Connor E . Depressive symptoms in overweight and obese older adults: a test of the ‘jolly fat’ hypothesis. J Psychosom Res 1996; 40: 59–66.

    Article  CAS  PubMed  Google Scholar 

  6. Han TS, Tijhuis MAR, Lean MEJ, Seidell JC . Quality of life in relation to overweight and body fat distribution. Am J Public Health 1998; 88: 1814–1820.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Heo M, Pietrobelli A, Fontaine KR, Sirey JA, Faith MS . Depressive mood and obesity in US adults: comparison and moderation by sex, age, and race. Int J Obes 2006; 30: 513–519.

    Article  CAS  Google Scholar 

  8. Istvan J, Zavela K, Weidner G . Body weight and psychological distress in NHANES I. Int J Obes 1992; 16: 999–1003.

    CAS  Google Scholar 

  9. Johnston E, Johnson S, McLeod P, Johnston M . The relation of body mass index to depressive symptoms. Can J Public Health 2004; 95: 175–183.

    Google Scholar 

  10. Jorm AF, Korten AE, Christensen H, Jacomb PA, Ridgers P, Parslow RA . Association of obesity with anxiety, depression, and emotional well-being: a community survey. Aus N Z J Public Health 2003; 27: 434–440.

    Article  Google Scholar 

  11. Carpenter KM, Hasin DS, Allison DB, Faith MS . Relationships between obesity and DSM-IV major depressive disorder, suicide ideation, and suicide attempts: results from a general population study. Am J Public Health 2000; 90: 251–257.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Simon GE, Von Korff M, Saunders K, Miglioretti DL, Crane PK, van Belle G et al. Association between obesity and psychiatric disorders in the US adult population. Arch Gen Psychiatry 2006; 63: 824–830.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Onyike CU, Crum RA, Lee HB, Lyketsos CG, Eaton WW . Is obesity associated with major depression? Results from the Third National Health and Nutrition Examination Survey. Am J Epidemiol 2003; 158: 1139–1147.

    Article  PubMed  Google Scholar 

  14. Herva A, Laitinen J, Miettunen J, Veijola J, Karvonen JT, Läksy K et al. Obesity and depression: results from the longitudinal Northern Finland 1966 Birth Cohort Study. Int J Obes 2006; 30: 520–527.

    Article  CAS  Google Scholar 

  15. Anderson SE, Cohen P, Naumova E, Jacques PF, Must A . Adolescent overweight and risk for subsequent major depressive disorder and anxiety disorder: prospective evidence. Psychosomatic Med 2007; 69 (in press).

  16. Mustillo S, Worthman C, Erkanli A, Keeler G, Angold A, Costello EJ . Obesity and psychiatric disorder: developmental trajectories. Pediatrics 2003; 111: 851–859.

    Article  PubMed  Google Scholar 

  17. Roberts RE, Deleger S, Strawbridge WJ, Kaplan GA . Prospective association between obesity and depression: evidence from the Alameda County Study. Int J Obes 2003; 27: 514–521.

    Article  CAS  Google Scholar 

  18. Bryan J, Tiggemann M . The effect of weight-loss dieting on cognitive performance and psychological well-being in overweight women. Appetite 2001; 36: 147–156.

    Article  CAS  PubMed  Google Scholar 

  19. Klem ML, Wing RR, McGuire MT, Seagle HM, Hill JO . Psychological symptoms in individuals successful at long-term maintenance of weight loss. Health Psychol 1998; 17: 336–345.

    Article  CAS  PubMed  Google Scholar 

  20. Dixon JB, Dixon ME, O’Brien P . Depression in association with severe obesity. Arch Intern Med 2003; 163: 2058–2065.

    Article  PubMed  Google Scholar 

  21. van Gemert WG, Severeijins RM, Greve JW, Groenman N, Soeters PB . Psychological functioning of morbidly obese patients after surgical treatment. Int J Obes 1998; 22: 393–398.

    Article  CAS  Google Scholar 

  22. Friedman MA, Brownell KD . Psychological correlates of obesity: moving to the next research generation. Psychol Bull 1995; 117: 3–20.

    Article  CAS  PubMed  Google Scholar 

  23. Ogden CL, Carroll MD, Curtin LR, McDowell MA, Tabak CJ, Flegal KM . Prevalence of overweight and obesity in the United States, 1999–2004. JAMA 2006; 295: 1549–1555.

    Article  CAS  PubMed  Google Scholar 

  24. Foreyt JP, Goodrick GK . The ultimate triumph of obesity. Lancet 1995; 346: 134–135.

    Article  CAS  PubMed  Google Scholar 

  25. Kotke TE, Wu LA, Hoffman RS . Economic and psychological implications of the obesity epidemic. Mayo Clin Proc 2003; 78: 92.

    Article  Google Scholar 

  26. Wyatt SB, Winters KP, Dubbert PM . Overweight and obesity: prevalence, consequences, and causes of a growing public health problem. Am J Med Sci 2006; 331: 166–174.

    Article  PubMed  Google Scholar 

  27. Calle EE, Thun MJ, Petrelli JM, Rodriguez C, Heath Jr CW . Body mass index and mortality in a prospective cohort of U.S. adults. N Engl J Med 1999; 391: 1097–1105.

    Article  Google Scholar 

  28. Fontaine KR, Redden DT, Wang C, Westfall AO, Allison DB . Years of life lost due to obesity. JAMA 2003; 289: 187–193.

    Article  PubMed  Google Scholar 

  29. Mokdad AH, Bowman BA, Ford ES, Vinicor F, Marks JS, Koplan JP . The continuing epidemics of obesity and diabetes in the United States. JAMA 2001; 286: 1195–1200.

    Article  CAS  PubMed  Google Scholar 

  30. Must A, Spadano J, Coakley EH, Field AE, Colditz G, Dietz WH . The disease burden associated with overweight and obesity. JAMA 1999; 282: 1523–1529.

    Article  CAS  PubMed  Google Scholar 

  31. Pi-Sunyer FX . Medical hazards of obesity. Ann Intern Med 1993; 119: 655–660.

    Article  CAS  PubMed  Google Scholar 

  32. Horwath E, Cohen RS, Weissman MM . Epidemiology of depressive and anxiety disorders. In: Tsuang MT, Tohen M (eds). Textbook in Psychiatric Epidemiology, (2nd edn). Wiley-Liss: New York, 2002, pp 389–426.

    Chapter  Google Scholar 

  33. National Heart, Blood, and Lung Institute. Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults: The Evidence Report 1998. National Institutes of Health Publication 98–4083. National Institutes of Health: Bethesda, MD.

  34. Blazer DG, Kessler RC, McGonagle KA, Swartz MS . The prevalence and distribution of major depression in a national community sample: the National Comorbidity Survey. Am J Psychiatry 1994; 151: 979–986.

    Article  CAS  PubMed  Google Scholar 

  35. Kessler RC . The effects of stressful life events on depression. Annu Rev Psychol 1997; 48: 191–214.

    Article  CAS  PubMed  Google Scholar 

  36. Kessler RC . Stress, social status, and psychological distress. J Health Soc Behav 1979; 20: 259–272.

    Article  CAS  PubMed  Google Scholar 

  37. Roberts RE, Kaplan GA, Shema SJ, Strawbridge WJ . Prevalence and correlates of depression in an aging cohort: the Alameda County Study. J Gerontol B Psychol Sci Soc Sci 1997; 52: S252–S258.

    Article  CAS  PubMed  Google Scholar 

  38. Roberts RE, Kaplan GA, Shema SJ, Strawbridge WJ . Are the obese at greater risk for depression? Am J Epidemiol 2000; 152: 163–170.

    Article  CAS  PubMed  Google Scholar 

  39. Roberts RE, Strawbridge WJ, Deleger S, Kaplan GA . Are the fat more jolly? Ann Behav Med 2002; 24: 169–180.

    Article  PubMed  Google Scholar 

  40. Bromberger JT, Harlow S, Avis N, Kravitz HM, Cordal A . Racial/ethnic differences in the prevalence of depressive symptoms among middle-aged women: the study of women's health across the nation (SWAN). Am J Public Health 2004; 94: 1378–1385.

    Article  PubMed  PubMed Central  Google Scholar 

  41. Cohen P, Cohen J . Life Values and Adolescent Mental Health. Lawrence Erlbaum Associates: Mahwah, NJ, 1996.

    Google Scholar 

  42. Kogan LS, Smith J, Jenkins S . Ecological validity of indicator data as predictors of survey findings. J Soc Serv Res 1977; 1: 117–132.

    Article  Google Scholar 

  43. Derogatis LR, Lipman RS, Rickels K, Uhlenhuth EH, Covi L . The Hopkins Symptom Checklist (HSCL): a self-report inventory. Behav Sci 1974; 19: 1–15.

    Article  CAS  PubMed  Google Scholar 

  44. Kasen S, Cohen P, Chen H, Castille D . Depression in adult women: age changes and cohort effects. Am J Public Health 2003; 93: 2061–2066.

    Article  PubMed  PubMed Central  Google Scholar 

  45. Kasen S, Cohen P, Berenson K, Chen H, Dufur R . Dual work and family roles and depressive symptoms in two birth cohorts of women. Soc Psychiatry Psychiatr Epidemiol 2005; 40: 300–307.

    Article  PubMed  Google Scholar 

  46. Chen H, Cohen P, Kasen S . Cohort differences in self-rated health: evidence from a three-decade community-based, longitudinal study of women. Am J Epidemiol 2007; 166: 439–446.

    Article  PubMed  Google Scholar 

  47. Sneed JR, Kasen S, Cohen P . Early life risk factors of late-onset depression. Int J Geriatr Psychiatry 2007; 22: 663–667.

    Article  PubMed  Google Scholar 

  48. SPSS, Inc. SPSS 15.0 Base User's Guide. Prentice-Hall: Chicago, IL, 2006.

  49. Hosmer DW, Lemeshow S . Applied Logistic Regression. Wiley: New York, 1989.

    Google Scholar 

  50. Fabricatore AN, Wadden T . Psychological aspects of obesity. Clin Dermatol 2004; 22: 332–337.

    Article  PubMed  Google Scholar 

  51. Viner RM, Cole TJ . Adult socioeconomic, educational, social, and psychological outcomes of childhood obesity: a national birth cohort study. BMJ doi:10.1136/bmj.38453.422049.EO (published online 17 May 2005).

  52. Pagoto SL, Spring B, Cook JW, McChargue D, Schneider K . High BMI and reduced engagement and enjoyment of pleasant events. Pers Individ Dif 2006; 40: 1421–1431.

    Article  Google Scholar 

  53. Puhl R, Brownell KD . Bias, discrimination, and obesity. Obes Res 2001; 9: 788–805.

    Article  CAS  PubMed  Google Scholar 

  54. Puhl RM, Brownell KD . Confronting and coping with weight stigma: an investigation of overweight and obese adults. Obesity 2006; 14: 1802–1815.

    Article  PubMed  Google Scholar 

  55. Wang SS, Brownell KD, Wadden TA . The influence of stigma of obesity on overweight individuals. Int J Obes 2004; 28: 1333–1337.

    Article  CAS  Google Scholar 

  56. Eaton WW . Studying the natural history of psychopathology. In: Tsuang MT, Tohen M, Zanner GEP (eds). Textbook in Psychiatric Epidemiology. Wiley-Liss: New York, 1995. pp 157–177.

    Google Scholar 

  57. Stevens J, Keil JE, Waid LR, Gazes PC . Accuracy of current, 4-year, and 28-year body weight in an elderly population. Am J Epidemiol 1990; 132: 1156–1163.

    Article  CAS  PubMed  Google Scholar 

  58. Rowland ML . Reporting bias in height and weight data. Statist Bull 1989; 70: 2–12.

    CAS  Google Scholar 

  59. Stunkard AJ, Albaum JM . The accuracy of self-reported weights. Am J Clin Nutr 1981; 34: 1593–1599.

    Article  CAS  PubMed  Google Scholar 

  60. Casey VA, Dwyer JT, Coleman JT, Krall EA, Gardner J, Valadian I . Accuracy of recall by middle-aged participants in a longitudinal study of their body size and indices of maturation earlier in life. Ann Hum Biol 1991; 18: 155–166.

    Article  CAS  PubMed  Google Scholar 

  61. Casey VA, Dwyer JT, Berkey CS, Coleman JT, Gardner J, Valadian I . Long-term memory of body weight and past weight satisfaction: a longitudinal follow-up study. Am J Clin Nutr 991; 53: 1492–1498.

    Google Scholar 

  62. Norgan NG, Cameron G . The accuracy of body weight and height recall in middle-aged men. Int J Obes 2000; 24: 1695–1698.

    Article  CAS  Google Scholar 

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Acknowledgements

This study was supported by grant funds from the National Institute of Child Health and Human Development HD-40685. The research was approved by the New York State Psychiatric Institute Institutional Review Board. Members of the sample participated under conditions of informed consent in adherence to institutional guidelines.

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Authors and Affiliations

  1. Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY, USA

    S Kasen, P Cohen & H Chen

  2. Department of Epidemiology, New York State Psychiatric Institute, New York, NY, USA

    S Kasen, P Cohen & H Chen

  3. Department of Public Health and Family Medicine, Tufts University School of Medicine, Boston, MA, USA

    A Must

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Correspondence to S Kasen.

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Kasen, S., Cohen, P., Chen, H. et al. Obesity and psychopathology in women: a three decade prospective study. Int J Obes 32, 558–566 (2008). https://doi.org/10.1038/sj.ijo.0803736

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