Symptoms of depression and changes in body weight from adolescence to mid-life

Abstract

OBJECTIVE: To investigate the relationship of symptoms of depression to weight changes in healthy individuals of normal weight across a follow-up of over 20 y. PARTICIPANTS AND DESIGN: College students (3885 men and 841 women) were administered a self-report depression measure in the mid-1960s. Their baseline body mass index (BMI) was calculated from their college medical records. Participants were contacted by mail in the late 1980s and asked to report their current height and weight as well as their smoking and exercise habits. Another measure of depressive symptoms was obtained from 3560 individuals at follow-up. Multiple regression models were used to relate changes in weight to depression scores while controlling for background (gender, baseline BMI and the gender by BMI interaction) and behavioral (exercise and smoking) predictors. RESULTS: The relationship between depressive symptoms and body weight change took the form of an interaction with baseline BMI (P`0.001). Those with high baseline depression scores gained less weight than their nondepressed counterparts if they were initially lean, but more if they were initially heavy. This trend was especially strong in those with high depression scores at both baseline and follow-up. CONCLUSIONS: The ®ndings support the hypothesis that depression exaggerates pre-existing weight change tendencies. This pattern would not have been detected by an examination of main effects alone, illustrating the need to move toward more complicated interactive models in the study of psychological factors and weight. Keywords: depression; longitudinal studies; body weight IntroductionSymptoms of depression have a number of physiological and behavioral concomitants, including altered neuroendocrine functioning, 1 smoking, 2 alcohol consumption 3 and physical inactivity. 4 A number of studies have examined the associations of depression and other forms of psychological distress with body weight, but their results do not present a consistent or clear picture. Some of these investigations have examined the prevalence of clinical depression and other psychopathologies in obese individuals and have found little evidence to suggest that they have unusually high rates of these disorders. 5 Studies that have investigated associations of milder forms of psychological distress to body mass have had mixed results (for example, see Refs 6±10). Some of the inconsistencies may be the result of the use of crosssectional designs that create interpretive ambiguities, because it is plausible that psychological distress could be a consequence of being overweight, 6 as well as a precursor of body weight change.11 Prospective studies are necessary to address questions regarding causal directionality.One of the most promising lines of investigation deals with depression and depressive symptomatology as precursors of body weight change. Noppa and Ha Èllstro Èm 12 found that depression in middle-aged women was associated with subsequent weight gain. DiPietro et al 11 examined depressive symptoms as pre...

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