Are mood disorders and obesity related? A review for the mental health professional.
OBJECTIVE
We reviewed evidence regarding a possible relationship between mood disorders and obesity to better inform mental health professionals about their overlap.


METHODS
We performed a MEDLINE search of the English-language literature for the years 1966-2003 using the following terms: obesity, overweight, abdominal, central, metabolic syndrome, depression, mania, bipolar disorder, binge eating, morbidity, mortality, cardiovascular, diabetes, cortisol, hypertriglyceridemia, sympathetic, family history, stimulant, sibutramine, antiobesity, antidepressant, topiramate, and zonisamide. We evaluated studies of obesity (and related conditions) in persons with mood disorders and of mood disorders in persons with obesity. We also compared studies of obesity and mood disorders regarding phenomenology, comorbidity, family history, biology, and pharmacologic treatment response.


RESULTS
The most rigorous clinical studies suggest that (1). children and adolescents with major depressive disorder may be at increased risk for developing overweight; (2). patients with bipolar disorder may have elevated rates of overweight, obesity, and abdominal obesity; and (3). obese persons seeking weight-loss treatment may have elevated rates of depressive and bipolar disorders. The most rigorous community studies suggest that (1). depression with atypical symptoms in females is significantly more likely to be associated with overweight than depression with typical symptoms; (2). obesity is associated with major depressive disorder in females; and (3). abdominal obesity may be associated with depressive symptoms in females and males; but (4). most overweight and obese persons in the community do not have mood disorders. Studies of phenomenology, comorbidity, family history, biology, and pharmacologic treatment response of mood disorders and obesity show that both conditions share many similarities along all of these indices.


CONCLUSIONS
Although the overlap between mood disorders and obesity may be coincidental, it suggests the two conditions may be related. Clinical and theoretical implications of this overlap are discussed, and further research is called for.
McElroy
Susan L
SL
Psychopharmacology Research and Eating Disorders and Obesity Research and Treatment Programs, University of Cincinnati College of Medicine, Cincinnati, Ohio 45267-0559, USA. susan.mcelroy@uc.edu
Kotwal
Renu
R
Malhotra
Shishuka
S
Nelson
Erik B
EB
Keck
Paul E
PE
Nemeroff
Charles B
CB
D000293:Adolescent; D000367:Age Factors; D000928:Antidepressive Agents / Q000627:therapeutic use; D000697:Central Nervous System Stimulants / Q000627:therapeutic use; D002648:Child; D015897:Comorbidity; D003866:Depressive Disorder / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008954:Models, Biological; D019964:Mood Disorders / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D009765:Obesity / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D012307:Risk Factors; D012737:Sex Factors; D016896:Treatment Outcome; D015430:Weight Gain
D000928:Antidepressive Agents; D000697:Central Nervous System Stimulants