The association between obesity and depression in adults: a meta-review

AimsObesity and depression are increasing in prevalence and have become key issues in the public health of the modern day. We performed a meta-review to summarise the association between obesity and depression in adults.MethodA systematic literature search was undertaken on MEDLINE, PsychINFO, EMBASE and Web of Science for systematic reviews (SRs) with or without meta-analyses (MA) on the association between obesity and depression in adults (>18 years) published before 18 September 2018. Any approach to define depressive disorders (e.g. via structured interview or code in medical file) was accepted. Likewise, any method to assess obesity was accepted. Screening, data extraction and quality assessment was completed by two reviewers independently, with a third reviewer to arbitrate any disagreement. AMSTAR 2 tool was used to assess the methodological quality and risk of bias of the pertinent SRs/MAs.ResultAfter duplicate removal, we identified 6007 potentially pertinent citations. Following, title, abstract and full-text screening, 10 studies were included in the review; nine SRs with MAs and one SR. A statistically significant association between obesity and depression was reported in all nine SRs with MAs, with odds ratios ranging from 1.18 (95% CI = 1.11-1.26) to 1.57 (95% CI = 1.53-2.01). Increased severity of obesity (body mass index over 40) was associated with a greater odds of becoming depressed. Odds of developing depression were greater for obese females, compared to obese males, but this difference was not statistically significant. Depression was shown to be a significant risk factor for future obesity in all four relevant MAs with odds ratios ranging from 1.18 (95% CI = 1.13-1.23) to 1.40 (95% CI = 1.14-1.71) . Depressed adolescent females had the highest odds of becoming obese, significantly more so than depressed adolescent males and depressed adults. The quality of the included studies were mixed with five scoring moderate quality, three low quality and two critically low quality.ConclusionThe findings suggest a reciprocal association between depression and obesity, which may be modulated by age and gender. Future research should assess the potential effect of obesity and depression severity more carefully while also exploring the underlying mechanisms. These results warrant the investigation of the effect of obesity or depression intervention on the outcomes of the other.FUNDINGThis research received no financial sponsorship.

Depressive Disorders

Depressive disorders onset early in development. Depression during childhood and adolescence is associated with serious disruptions in emotional, social, and occupational functioning into adulthood and a high likelihood of recurrence. This chapter discusses clinical manifestations, prevalence, and course of depression presenting in early childhood (ages 3–6), middle childhood/preadolescence (ages 7–12), and adolescence (13–18). An overview is presented of standardized interviews and questionnaires for clinical assessment of depression in children and adolescents; the chapter summarizes research on empirically supported treatments for youth depression. Also included is a case study of a depressed adolescent with treatment plans formulated from both cognitive behavior therapy and interpersonal psychotherapy perspectives. Future directions for research on depressive disorders in youths are discussed, including neuroimaging research using ecologically valid stimuli, empirically supported interventions for younger children and preadolescents, and personalization of psychosocial treatment to youth’s profiles of risk and protective factors to increase effectiveness.