Association Between Obesity and Psychiatric Disorders in the US Adult Population | Anxiety Disorders | JAMA Psychiatry | JAMA Network
[Skip to Navigation]
Access to paid content on this site is currently suspended due to excessive activity being detected from your IP address 34.226.234.102. Please contact the publisher to request reinstatement.
1.
Flegal  KMCarroll  MDOgden  CLJohnson  CL Prevalence and trends in obesity among US adults: 1999-2000.  JAMA 2002;2881723- 1727PubMedGoogle ScholarCrossref
2.
Hedley  AAOgden  CLJohnson  CLCarroll  MDCurtin  LRFlegal  KM Prevalence of overweight and obesity among US children, adolescents, and adults: 1999-2002.  JAMA 2004;2912847- 2850PubMedGoogle ScholarCrossref
3.
Olshansky  SJPassaro  DJHershow  RCLayden  JCarnes  BABordy  JHawflick  LButler  RNAllison  DBLudwig  DS A potential decline in life expectancy in the United States in the 21st century.  N Engl J Med 2005;3521138- 1145PubMedGoogle ScholarCrossref
4.
Drewnowski  ASpecter  S Povery and obesity: the role of energy density and energy costs.  Am J Clin Nutr 2004;796- 16PubMedGoogle Scholar
5.
Zhang  QWang  Y Trends in association between obesity and socioeconomic status in US adults: 1971-2000.  Obes Res 2004;121622- 1632PubMedGoogle ScholarCrossref
6.
Sarlio-Lahteenkorva  SSilventoinen  KLahelma  E Relative weight and income at different levels of socioeconomic status.  Am J Public Health 2004;94468- 472PubMedGoogle ScholarCrossref
7.
Pereira  MAKartashov  AIEbbeling  CBVan Horn  LSlattery  MLJacobs  DR  JrLudwig  DS Fast-food habits, weight gain, and insulin resistance (the CARDIA study): 15-year prospective analysis.  Lancet 2005;36536- 42PubMedGoogle ScholarCrossref
8.
Block  JPScribner  RADeSalvo  KB Fast food, race/ethnicity, and income: a geographic analysis.  Am J Prev Med 2004;27211- 217PubMedGoogle Scholar
9.
Frank  LDAndresen  MASchmid  TL Obesity relationships with community design, physical activity, and time spent in cars.  Am J Prev Med 2004;2787- 96PubMedGoogle ScholarCrossref
10.
Vandegrift  DYoked  T Obesity rates, income, and suburban sprawl: an analysis of US states.  Health Place 2004;10221- 229PubMedGoogle ScholarCrossref
11.
Stunkard  AJFaith  MSAllison  KC Depression and obesity.  Biol Psychiatry 2003;54330- 337PubMedGoogle ScholarCrossref
12.
Faith  MSMatz  PEJorge  MA Obesity-depression associations in the population.  J Psychosom Res 2002;53935- 942PubMedGoogle ScholarCrossref
13.
Johnston  EJohnston  SMcLeod  PJohnston  M The relation of body mass index to depressive symptoms.  Can J Public Health 2004;95179- 183PubMedGoogle Scholar
14.
Heo  MPietrobelli  AFontaine  KRSirey  JAFaity  MS Depressive mood and obesity in US adults: comparison and moderation by sex, age, and race.  Int J Obes (Lond) 2006;30513- 519Google ScholarCrossref
15.
Dong  CSanchez  LPrice  R Relationship of obesity to depression: a family-based study.  Int J Obes Relat Metab Disord 2004;28790- 795PubMedGoogle ScholarCrossref
16.
Roberts  REStrawbridge  WJDeleger  SKaplan  GA Are the fat more jolly?  Ann Behav Med 2002;24169- 180PubMedGoogle ScholarCrossref
17.
Palinkas  LAWingard  DLBarrett-Connor  E Depressive symptoms in overweight and obese older adults: a test of the “jolly fat” hypothesis.  J Psychosom Res 1996;4059- 66PubMedGoogle ScholarCrossref
18.
Istvan  JZavela  KWeidner  G Body weight and psychological distress in NHANES I.  Int J Obes Relat Metab Disord 1992;16999- 1003PubMedGoogle Scholar
19.
Carpenter  KMHasin  DSAllison  DBFaith  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;90251- 257PubMedGoogle ScholarCrossref
20.
Onyike  CUCrum  RMLee  HBLyketsos  CGEaton  WW Is obesity associated with major depression? results from the Third National Health and Nutrition Examination Survey.  Am J Epidemiol 2003;1581139- 1147PubMedGoogle ScholarCrossref
21.
Moore  MEStunkard  ASrole  L Obesity, social class, and mental illness.  JAMA 1962;181962- 966PubMedGoogle ScholarCrossref
22.
Li  ZBHo  SYChan  WMHo  KSLi  MPLeung  GMLam  TH Obesity and depressive symptoms in Chinese elderly.  Int J Geriatr Psychiatry 2004;1968- 74PubMedGoogle ScholarCrossref
23.
Jasienska  GZiomkiewicz  AGorkiewicz  MPajak  A Body mass, depressive symptoms, and menopausal status: an examination of the “jolly fat” hypothesis.  Womens Health Issues 2005;15145- 151PubMedGoogle ScholarCrossref
24.
Hasler  GPine  DSGamma  AMilos  GAjdacic  VEich  DRossler  WAngst  J The associations between psychopathology and being overweight: a 20-year prospective study.  Psychol Med 2004;341047- 1057PubMedGoogle ScholarCrossref
25.
Goodman  EWhitaker  R A prospective study of the role of depression in the development and persistence of adolescent obesity.  Pediatrics 2002;110497- 504PubMedGoogle ScholarCrossref
26.
Roberts  REDeleger  SStrawbridge  WJKaplan  GA Prospective association between obesity and depression: evidence from the Alameda County Study.  Int J Obes Relat Metab Disord 2003;27514- 521PubMedGoogle ScholarCrossref
27.
Dixon  JBDixon  MEO'Brien  PE Depression in association with severe obesity: changes with weight loss.  Arch Intern Med 2003;1632058- 2065PubMedGoogle ScholarCrossref
28.
Linde  JAJeffery  RWLevy  RLSherwood  NEUtter  JPronk  NPBoyle  RG Binge eating disorder, weight control self-efficacy, and depression in overweight men and women.  Int J Obes Relat Metab Disord 2004;28418- 425PubMedGoogle ScholarCrossref
29.
McGuire  MTWing  RRKlem  MLLang  WHill  JO What predicts weight regain in a group of successful weight losers?  J Consult Clin Psychol 1999;67177- 185PubMedGoogle ScholarCrossref
30.
Jorm  AFKorten  AEChristensen  HJacomb  PARidgers  BParslow  RA Association of obesity with anxiety, depression, and emotional well-being: a community survey.  Aust N Z J Public Health 2003;27434- 440PubMedGoogle ScholarCrossref
31.
Cilli  MDe Rosa  RPandolfi  CVacca  KCugini  PCeni  ZhBella  S Quantification of sub-clinical anxiety and depression in essentially obese patients and normal-weight health subjects.  Eat Weight Disord 2003;8319- 320PubMedGoogle ScholarCrossref
32.
Davis  EMRovi  SJohnson  MS Mental health, family function and obesity in African-American women.  J Natl Med Assoc 2005;97478- 482PubMedGoogle Scholar
33.
John  UMeyer  CRumpf  HHapke  U Relationships of psychiatric disorders with overweight and obesity in an adult general population.  Obes Res 2005;13101- 109PubMedGoogle ScholarCrossref
34.
Kessler  RCMerikangass  KR The National Comorbidity Survey Replication (NCS-R): background and aims.  Int J Methods Psychiatr Res 2004;1360- 68PubMedGoogle ScholarCrossref
35.
Kessler  RCBerglund  PChiu  WTDemler  OHerringa  SHiripi  EJin  RPennell  BEWalters  EEZaslavsky  AZheng  H The US National Comorbidity Survey Replication (NCS-R): design and field procedures.  Int J Methods Psychiatr Res 2004;1369- 92PubMedGoogle ScholarCrossref
36.
Kessler  RCUstun  TB The World Mental Health (WMH) Survey Initiative version of the World Health Organization (WHO) Composite International Diagnostic Interview (CIDI).  Int J Methods Psychiatr Res 2004;1393- 121PubMedGoogle ScholarCrossref
37.
Stevens  JKeil  JWaid  LGazes  P Accuracy of current, 4-year, and 28-year self-reported body weight in an elderly population.  Am J Epidemiol 1990;1321156- 1163PubMedGoogle Scholar
38.
Kuczmarski  MFKuczmarski  RJNajjar  M Effect of age on validity of self-reported height, weight, and body mass index: findings from the Third National Health and Nutrition Examination Survey: 1988-1994.  J Am Diet Assoc 2001;10128- 34PubMedGoogle ScholarCrossref
39.
Niedhammer  IBugel  IBonenfant  SGoldberg  MLeclerc  A Validity of self-reported weight and height in the French GAZE cohort.  Int J Obes Relat Metab Disord 2000;241111- 1118PubMedGoogle ScholarCrossref
40.
Flood  VWebb  KLazarus  RPang  G Use of self-report to monitor overweight and obesity in populations: some issues for consideration.  Aust N Z J Public Health 2000;2496- 99PubMedGoogle ScholarCrossref
41.
Roberts  RJ Can self-reported data accurately describe the prevalence of overweight?  Public Health 1995;109275- 284PubMedGoogle ScholarCrossref
42.
McElroy  SLKotwal  RMalhotra  SNelson  ENKeck  PENemeroff  CB Are mood disorders and obesity related? a review for the mental health professional.  J Clin Psychiatry 2004;65634- 651PubMedGoogle ScholarCrossref
43.
Stunkard  AJFernstrom  MHPrice  AFrank  EKupfer  DJ Direction of weight gain in recurrent depression: consistency across episodes.  Arch Gen Psychiatry 1990;47857- 860PubMedGoogle ScholarCrossref
44.
Carter  FABulik  CMJoyce  PR Direction of weight change in depression.  J Affect Disord 1994;3057- 60PubMedGoogle ScholarCrossref
45.
Cassidy  KKotynia-English  RAcres  JFlicker  LLautenshlager  NAlmeida  O Association between lifestyle factors and mental health measures among community-dwelling older women.  Aust N Z J Psychiatry 2004;38940- 947PubMedGoogle ScholarCrossref
46.
Sherwood  NEJeffery  RWWing  RR Binge status as a predictor of weight loss treatment outcome.  Int J Obes Relat Metab Disord 1999;23485- 493PubMedGoogle ScholarCrossref
47.
French  SAJeffery  RWSherwood  NENeumark-Sztainer  D Prevalence and correlates of binge eating in a nonclinical sample of women enrolled in a weight gain prevention program.  Int J Obes Relat Metab Disord 1999;23576- 585PubMedGoogle ScholarCrossref
48.
Musante  GJCostanzo  PRFriedman  KE The comorbidity of depression and eating dysregulation processes in a diet-seeking obese population: a matter of gender specificity.  Int J Eat Disord 1998;2365- 75PubMedGoogle ScholarCrossref
49.
Schwartz  TLNihalani  NJindal  SVirk  SJones  N Psychiatric medication-induced obesity: a review.  Obes Rev 2004;5115- 121PubMedGoogle ScholarCrossref
50.
Myers  ARosen  J Obesity stigmatization and coping: relation to mental health symptoms, body image, and self-esteem.  Int J Obes Relat Metab Disord 1999;23221- 230PubMedGoogle ScholarCrossref
51.
Puhl  RMBrownell  KD Psychosocial origins of obesity stigma: toward changing a powerful and pervasive bias.  Obes Rev 2003;4213- 227PubMedGoogle ScholarCrossref
52.
Gustafson  TBSarwer  DB Childhood sexual abuse and obesity.  Obes Rev 2004;5129- 135PubMedGoogle ScholarCrossref
53.
Murphy  JMHorton  NJMonson  RRLaird  NMSobol  AMLeighton  AH Cigarette smoking in relation to depression: historical trends from the Stirling County Study.  Am J Psychiatry 2003;1601663- 1669PubMedGoogle ScholarCrossref
54.
Stevens  JKumanyika  SKeil  J Attitudes toward body size and dieting: differences between elderly black and white women.  Am J Public Health 1994;841322- 1325PubMedGoogle ScholarCrossref
55.
Paeratakul  SWhite  MWilliamson  DRyan  DBray  G Sex, race/ethnicity, socioeconomic status, and BMI in relation to self-perception of overweight.  Obes Res 2002;10345- 350PubMedGoogle ScholarCrossref
56.
Latner  JDStunkard  AJWilson  GT Stigmatized students: age, sex, and ethnicity effects in the stigmatization of obesity.  Obes Res 2005;131226- 1231PubMedGoogle ScholarCrossref
57.
Becker  DMYanek  LRKoffman  DMBronner  YC Body image preferences among urban African Americans and whites from low income communities.  Ethn Dis 1999;9377- 386PubMedGoogle Scholar
58.
Averett  SKorenman  S Black-white differences in social and economic consequences of obesity.  Int J Obes Relat Metab Disord 1999;23166- 173PubMedGoogle ScholarCrossref
59.
Carr  DFriedman  M Is obesity stigmatizing? body weight, perceived discrimination, and psychological well-being in the United States.  J Health Soc Behav 2005;46244- 259PubMedGoogle ScholarCrossref
Original Article
July 2006

Association Between Obesity and Psychiatric Disorders in the US Adult Population

Author Affiliations

Author Affiliations: Center for Health Studies, Group Health Cooperative (Drs Simon, Von Korff, Saunders, and Miglioretti), Department of Medicine, University of Washington School of Medicine (Dr Crane), and Department of Biostatistics, University of Washington School of Public Health and Community Medicine (Drs Miglioretti and van Belle), Seattle; and Department of Health Care Policy, Harvard Medical School, Boston, Mass (Dr Kessler).

Arch Gen Psychiatry. 2006;63(7):824-830. doi:10.1001/archpsyc.63.7.824
Abstract

Background  Epidemiologic data suggest an association between obesity and depression, but findings vary across studies and suggest a stronger relationship in women than men.

Objective  To evaluate the relationship between obesity and a range of mood, anxiety, and substance use disorders in the US general population.

Design  Cross-sectional epidemiologic survey.

Setting  Nationally representative sample of US adults.

Participants  A total of 9125 respondents who provided complete data on psychiatric disorder, height, and weight. Response rate was 70.9%.

Main Outcome Measures  Participants completed an in-person interview, including assessment of a range of mental disorders (assessed using the World Health Organization Composite International Diagnostic Interview) and height and weight (by self-report).

Results  Obesity (defined as body mass index [calculated as weight in kilograms divided by the square of height in meters] of ≥30) was associated with significant increases in lifetime diagnosis of major depression (odds ratio [OR], 1.21; 95% confidence interval [CI], 1.09-1.35), bipolar disorder (OR, 1.47; 95% CI, 1.12-1.93), and panic disorder or agoraphobia (OR, 1.27; 95% CI, 1.01-1.60). Obesity was associated with significantly lower lifetime risk of substance use disorder (OR, 0.78; 95% CI, 0.65-0.93). Subgroup analyses found no difference in these associations between men and women, but the association between obesity and mood disorder was strongest in non-Hispanic whites (OR, 1.38; 95% CI, 1.20-1.59) and college graduates (OR, 1.44; 95% CI, 1.14-1.81).

Conclusions  Obesity is associated with an approximately 25% increase in odds of mood and anxiety disorders and an approximately 25% decrease in odds of substance use disorders. Variation across demographic groups suggests that social or cultural factors may moderate or mediate the association between obesity and mood disorder.

×