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Introduction: Obesity and depression contribute to the global burden of economic cost, morbidity, and mortality. Nevertheless, not all people with obesity develop depression. Objective: To determine the factors associated with depressive symptoms among people aged 15 or older with obesity from the National Demographic and Family Health Survey (ENDES in Spanish 2019–2021). Methods: Cross-sectional analytical study. The outcome of interest was the presence of depressive symptoms, assessed using the Patient Health Questionnaire-9 (PHQ-9). Crude (cPR) and adjusted (aPR) prevalence ratios were estimated using GLM Poisson distribution with robust variance estimates. Results: The prevalence of depression symptoms was 6.97%. In the multivariate analysis, a statistically significant association was found between depressive symptoms and female sex (PRa: 2.59; 95% CI 1.95–3.43); mountain region (PRa: 1.51; 95% CI 1.18–1.92); wealth index poor (PRa: 1.37; 95% CI 1.05–1.79, medium (PRa: 1.49; 95% CI 1.11–2.02), and rich (PRa: 1.65; 95% CI 1.21–2.26); daily tobacco use (PRa: 2.05, 95% CI 1.09–3.87); physical disability (PRa: 1.96, 95% CI 1.07–3.57); and a history of arterial hypertension (PRa: 2.05; 95% CI 1.63–2.55). Conclusion: There are several sociodemographic factors (such as being female and living in the Andean region) and individual factors (daily use of tobacco and history of hypertension) associated with depressive symptoms in Peruvian inhabitants aged 15 or older with obesity. In this study, the COVID-19 pandemic was associated with an increase in depressive symptoms.

Background: The association between obesity and depression has been frequently reported. However, it still remains unclear which anthropometric indicators for obesity could be the best measure to explain its linkage with depressive symptoms. Methods: This is a cross-sectional analytical study. Secondary data was analyzed using information from the Demographic and Health Survey of Peru (ENDES in Spanish). Data from the years 2018 to 2021 were reviewed. The outcome of interest was the presence of depressive symptoms, assessed with the Patient Health Questionnaire-9 (PHQ-9). The exposure variable was the presence of obesity, which was evaluated by body mass index (BMI) and abdominal circumference. Crude and adjusted odds ratios (cOR and aOR) were calculated using logistic regression. Both prevalence and association measures were presented with 95% confidence intervals (95% CI). Results: A total of 141,134 subjects were included in the study. Depression was present in 2.51% (95% CI 2.38–2.65). Obesity according to BMI was present in 25.42% (95% CI 24.97–25.88), while abdominal obesity was shown in 41.67% (95% CI 41.19–42.15). In the multivariate analysis, a statistically significant association was found in regard to symptoms of depression in patients with abdominal obesity (aOR: 1.13; 95% CI 1.03–1.24), while no association was found with obesity according to BMI. Conclusions: Abdominal circumference could be a better anthropometric measure than BMI to evaluate the association between obesity and depressive symptoms in the Peruvian population.