title: Relationship between obesity, depression, and disability in middle-aged women.
abstract: CONCLUSIONS
  
  
  
  BACKGROUND
  Obesity and depression are closely linked, and each has been associated with disability. However, few studies have assessed inter-relationships between these conditions.
  
  
  METHODS
  In this study, 4641 women aged 40-65 completed a structured telephone interview including self-reported height and weight, the Patient Health Questionnaire (PHQ) assessment of depression, and the World Health Organization Disability Assessment Schedule II (WHODAS II). The survey response rate was 62%. We used multivariable regression models to assess relationships between obesity, depression, and disability.
  
  
  RESULTS
  The mean age was 52 years; 82% were White; and 80% were currently employed. One percent were underweight, 39% normal weight, 27% overweight, and 34% obese. Mild depressive symptoms were present in 23% and moderate-to-severe symptoms were present in 13%. After multivariable adjustment, depression was a strong independent predictor of worse disability in all 7 domains (cognition, mobility, self-care, social interaction, role functioning, household, and work), but obesity was only a significant predictor of greater mobility, role-functioning, household, and work limitations (P < 0.05) (overweight was not significantly associated with any disability domain). Overall, the effect on disability was stronger and more pervasive for depression than obesity, and there was no significant interaction between the two conditions (P > 0.05). Overweight and obesity were associated with 5760 days of absenteeism per 1000 person-years, and depression was associated with 18,240 days of absenteeism per 1000 person-years.
  
  
  CONCLUSIONS
  The strong relationships between depression, obesity and disability suggest that these conditions should be routinely screened and treated among middle-aged women.
authors: University of Washington, Division of General Internal Medicine, Harborview Medical Center, 325 Ninth Ave, Campus Box 359780, Seattle, WA 98104, United States. Electronic address:arterburn.d@ghc.org.
authors: David
authors: D
authors: Arterburn
authors: Group Health Research Institute, 1730 Minor Ave, Suite 1600, Seattle, WA 98101, United States.
authors: Emily O
authors: EO
authors: Westbrook
authors: Group Health Research Institute, 1730 Minor Ave, Suite 1600, Seattle, WA 98101, United States.
authors: Evette J
authors: EJ
authors: Ludman
authors: Group Health Research Institute, 1730 Minor Ave, Suite 1600, Seattle, WA 98101, United States.
authors: Belinda
authors: B
authors: Operskalski
authors: University of Minnesota, Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 S 2nd Street, Suite 300, Minneapolis, MN 55454, United States.
authors: Jennifer A
authors: JA
authors: Linde
authors: Oregon Research Institute, 1715 Franklin Blvd, Eugene, OR 97403, United States.
authors: Paul
authors: P
authors: Rohde
authors: University of Minnesota, Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 S 2nd Street, Suite 300, Minneapolis, MN 55454, United States.
authors: Robert W
authors: RW
authors: Jeffery
authors: Group Health Research Institute, 1730 Minor Ave, Suite 1600, Seattle, WA 98101, United States.
authors: Greg E
authors: GE
authors: Simon