Emotional states of different obesity phenotypes: A sex-specific results in a west-Asian population

Abstract

Background The present study aimed to investigate the relationship of obesity phenotypes with depression, anxiety, and stress of the adult participants in Tehran Lipid and Glucose Study (TLGS). Methods Depression, anxiety, and stress levels of 2469 adult participants aged > 19 (1158 men and 1311 women) from Tehran Lipid and Glucose Study were examined among different obesity phenotypes in the current study. Weight, height, and waist circumferences of participants were measured by trained personnel. Obesity was defined as BMI ≥ 30 kg/m², and metabolically unhealthy status based on having metabolic syndrome (MetS) or diabetes type 2. Finally, four obesity phenotypes were defined: 1) Metabolically Healthy Non-Obese (MHNO), 2) Metabolically Healthy Obese (MHO) 3) Metabolically Unhealthy Non-Obese (MUNO), and 4) Metabolically Unhealthy Obese (MUO). Ordinal logistic regression analysis was used to compare sex-specific odds ratios. Results The mean age of 2469 men and women was 46.2 ± 15.9 and 45.6 ± 14.7, respectively. In total, women were more likely to experience different levels of depression (30.5%), anxiety (44.2%), and stress (43.5%). After adjusting for potential confounders, the odds of experiencing higher levels of anxiety were significantly greater in metabolically unhealthy men whether they were obese (OR: 1.78, 95% CI: 1.25–2.54; P = < 0.001) or non-obese (OR: 1.61, 95% CI: 1.17–2.21; P = < 0.001), and also in MUO women (OR: 1.73, 95% CI: 1.28–2.34; P = < 0.001) comparing to their MHNO counterparts. Moreover, the odds of experiencing higher levels of stress were significantly greater in MUNO men (OR: 1.40, 95% CI: 1.02–1.90; P = 0.04), and in MUO women (OR: 1.45, 95% CI: 1.07–1.96; P = 0.02) comparing to their MHNO counterparts. No difference in having higher levels of depression was observed in both genders. Conclusions Compared to MHNO individuals, MUO women and all metabolically unhealthy men reported higher levels of anxiety and stress. The obesity phenotypes were by no means associated with depression in men and women.