Association between body fat percentage and depression: A cross-sectional study of NHANES

Obesity and depression often co-occur and are interdependent. However, evidence regarding the association between body fat percentage in different regions and depression is scarce. Additionally, the impacts of sex-specific and BMI-stratified differences on the relationship between body fat percentage and depression remain unclear.

Data were drawn from the NHANES for the years 2005-2006 and 2011-2018. Body fat percentage was assessed using dual-energy X-ray absorptiometry (DXA). Depression was evaluated using the Patient Health Questionnaire-9 (PHQ-9). Survey-weighted binary logistic regression analyses were employed to investigate the relationship between body fat percentage and depression. Stratification analysis were stratified by sex and BMI.

This study comprised 10,694 participants. Controlling confounders, the higher quartile of total body fat percentage was associated with increased OR for depression (Q4 vs Q1: OR, 1.46; 95 % CI, 1.04-2.05) as well as for leg (Q4 vs Q1: OR, 1.48; 95 % CI, 1.07-2.05), gynoid (Q4 vs Q1: OR, 1.51; 95 % CI, 1.11-2.05), subtotal (Q4 vs Q1: OR, 1.47; 95 % CI, 1.06-2.03) and head (Q3 vs Q1: OR, 1.30; 95 % CI, 1.00-1.68). In stratification analysis by sex and BMI, body fat percentage seemed to be more closely associated with depression in males or in the underweight and overweight groups.

Cross-sectional study design and self-reported depression.

Elevated body fat percentage was strongly associated with higher prevalence of depression, especially in males or in the underweight and overweight groups.