Weight control methods and risk of generalized anxiety disorder (GAD-7) among Korean adults

Weight control methods may impact anxiety symptoms, yet few studies have examined these associations among Korean adults.

Using nationally representative 2022 Korea National Health and Nutrition Examination Survey (KNHANES) data from 3251 non-pregnant adults aged 19-80 years, we analyzed associations between GAD-7 scores and (1) individual weight control methods, (2) total number of methods used, and (3) latent classes derived from latent class analysis (LCA), stratified by sex and weight status. In addition, we examined longitudinal prevalence trends in weight control methods and GAD-7 from 1998 to 2023. Models were adjusted for demographic and health factors including drinking alcohol, smoking, hypertension, high cholesterol, and diabetes.

A dose-response relationship was observed between the number of weight control methods used and GAD-7 scores across most subgroups. Specific methods-including fasting, over-the-counter pills, dietary supplements and mono diets-were significantly associated with elevated GAD-7 risk, particularly among underweight or normal-weight groups. LCA revealed four subgroups (diet-focused healthy control group, exercise-focused healthy control group, mixed diet and medication group, and skipping meals-centered group), with those centered on skipping meals showing a higher risk of anxiety among men, whereas those using mixed diet and medication weight control methods exhibited a lower risk among women and underweight individuals.

This study's comprehensive, stratified approach and subgroup identification provide novel insights into the complex interplay between specific weight control methods and GAD risk among Korean adults. The findings underscore the importance of tailored public health interventions addressing both physical and mental health in weight management.