Major depression, antidepressant medication and the risk of obesity

Cross-sectional studies have reported an association between major depressive episode (MDE) and obesity. The objective of this longitudinal analysis was to determine whether MDE increase the risk of becoming obese over a 10-year period.

We used data from the Canadian National Population Health Survey (NPHS), a longitudinal study of a representative cohort of household residents in Canada. The incidence of obesity, defined as a body mass index (BMI) of > or =30, was evaluated in respondents who were 18 years or older at the time of a baseline interview in 1994. MDE was assessed using a brief diagnostic instrument.

The risk of obesity was not elevated in association with MDE, either in unadjusted or covariate-adjusted analyses. The strongest predictor of obesity was a BMI in the overweight (but not obese) range. Effects were also seen for (younger) age, (female) sex, a sedentary activity pattern, low income and exposure to antidepressant medications. Unexpectedly, significant effects were seen for serotonin-reuptake-inhibiting antidepressants and venlafaxine, but neither for tricyclic antidepressants nor antipsychotic medications.

MDE does not appear to increase the risk of obesity. The cross-sectional associations that have been reported, albeit inconsistently, in the literature probably represent an effect of obesity on MDE risk. Pharmacologic treatment with antidepressants may be associated with an increased risk of obesity, and strategies to offset this risk may be useful in clinical practice.