Bidirectional Associations Between Obesity and Depressive Symptoms: Results From the Multiethnic Postmenopausal
Nicole P Yuan1, Hamza Butt1, Jordan F Karp1
1Department of Health Promotion Sciences (NPY, EI, JWB), Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ; Department of Epidemiology and Biostatistics (HB, CH, ZC), Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ; Department of Psychiatry (JFK), College of Medicine, University of Arizona, Tucson, AZ; Herbert Wertheim School of Public Health and Human Longevity Science and Division of Geriatrics (AHS), Gerontology, and Palliative Care, Department of Medicine, University of California San Diego, La Jolla, CA; VA Palo Alto Health Care System (JCW), Palo Alto, CA; Department of Psychiatry and Behavioral Sciences, and, by Courtesy, Obstetrics and Gynecology (JCW), Stanford University School of Medicine, Stanford CA; Clinical Sciences Department (NS), College of Medicine, Sulaiman AlRajhi University, Al-Qassim, Saudi Arabia; Department of Preventive Medicine (PAR, MC), The University of Tennessee Health Science Center, Memphis, TN; Department of Epidemiology and Population Health (SF), School of Medicine, Stanford University, Stanford, CA; and the Mount Sinai - Morningside/West Psychiatry Residency (TJ), Icahn School of Medicine at Mount Sinai, New York, NY. Send correspondence and reprint requests to: Nicole P. Yuan, PhD, MPH, Department of Health Promotion Sciences, University of Arizona, 1295 North Martin Avenue, PO Box 245219, Tucson, AZ 85724.
Objectives:
Although obesity and depression are prevalent among postmenopausal women, few cohort studies have examined the association between obesity and depression among this population. We examined longitudinal and bidirectional associations between obesity and depressive symptoms among U. S. postmenopausal women.
Design:
We analyzed data from Women's Health Initiative (WHI) study.
Participants:
Sample consisted of 95,238 postmenopausal women, aged 50-79, from the WHI study who had obesity and depression data at baseline and 3-year follow-up.
Measurements:
The dataset included anthropometric measurements of height and weight and the Burnam self-report screening instrument for depression. We conducted logistic regression analyses to assess the bidirectional association between obesity and depressive symptoms, adjusting for confounding factors, including age, race, ethnicity, years since menopause, marital status, education, employment status, and family income.
Results:
At baseline, 11.3% of the women reported depressive symptoms and 25% were categorized as obese (body mass index ≥ 30 kg/m2). Women who were obese at baseline were significantly more likely to report depressive symptoms at 3-year follow-up (OR = 1.26, 95% CI: 1.19-1.34) compared to women who were not obese. Women who reported depressive symptoms at baseline had higher odds of being obese at 3-year follow-up (OR = 1.33, 95% CI: 1.20-1.46) compared to women who did not. Age, race, ethnicity, and years since menopause did not modify the associations.
Conclusions:
Our findings of longitudinal and bidirectional associations between obesity and depressive symptoms highlight the importance of addressing both diseases among postmenopausal women in the U.S.
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