Association between obesity and psychiatric disorders in the US adult population.
BACKGROUND
Epidemiologic data suggest an association between obesity and depression, but findings vary across studies and suggest a stronger relationship in women than men.


OBJECTIVE
To evaluate the relationship between obesity and a range of mood, anxiety, and substance use disorders in the US general population.


METHODS
Cross-sectional epidemiologic survey.


METHODS
Nationally representative sample of US adults.


METHODS
A total of 9125 respondents who provided complete data on psychiatric disorder, height, and weight. Response rate was 70.9%.


METHODS
Participants completed an in-person interview, including assessment of a range of mental disorders (assessed using the World Health Organization Composite International Diagnostic Interview) and height and weight (by self-report).


RESULTS
Obesity (defined as body mass index [calculated as weight in kilograms divided by the square of height in meters] of > or =30) was associated with significant increases in lifetime diagnosis of major depression (odds ratio [OR], 1.21; 95% confidence interval [CI], 1.09-1.35), bipolar disorder (OR, 1.47; 95% CI, 1.12-1.93), and panic disorder or agoraphobia (OR, 1.27; 95% CI, 1.01-1.60). Obesity was associated with significantly lower lifetime risk of substance use disorder (OR, 0.78; 95% CI, 0.65-0.93). Subgroup analyses found no difference in these associations between men and women, but the association between obesity and mood disorder was strongest in non-Hispanic whites (OR, 1.38; 95% CI, 1.20-1.59) and college graduates (OR, 1.44; 95% CI, 1.14-1.81).


CONCLUSIONS
Obesity is associated with an approximately 25% increase in odds of mood and anxiety disorders and an approximately 25% decrease in odds of substance use disorders. Variation across demographic groups suggests that social or cultural factors may moderate or mediate the association between obesity and mood disorder.
Simon
Gregory E
GE
Center for Health Studies, Group Health Cooperative, Seattle, WA 98101, USA. simon.g@ghc.org
Von Korff
Michael
M
Saunders
Kathleen
K
Miglioretti
Diana L
DL
Crane
Paul K
PK
van Belle
Gerald
G
Kessler
Ronald C
RC
D000328:Adult; D001008:Anxiety Disorders / Q000175:diagnosis / Q000453:epidemiology; D001714:Bipolar Disorder / Q000175:diagnosis / Q000453:epidemiology; D015992:Body Mass Index; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology*; D008875:Middle Aged; D009765:Obesity / Q000175:diagnosis / Q000453:epidemiology*; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D012737:Sex Factors; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000453:epidemiology; D014481:United States / Q000453:epidemiology