title: Is there a bi-directional relationship between depression and obesity among adult men and women? Systematic review and bias-adjusted meta analysis.
abstract: The rapidly increasing prevalence of both obesity and depression represent two major public health concerns worldwide. But the evidence regarding the direction and strength of the association between these two disorders, for both adult men and women, are remain inconclusive. We systematically reviewed publications from five different databases: Pubmed, Embase, BIOSIS, CINAHL and PsychINFO. A total of 21 articles were included for the systematic review and 19 of them for the meta-analysis using a bias-adjusted (quality effect) model. This resulted in the inclusion of approximately 226,063 (33.7% men) participants. Those who were depressed had a 37% (RR: 1.37, 95% CI: 1.17, 1.48) increased risk of being obese, and who were obese had an 18% increased risk of being depressed (RR: 1.18, 95% CI: 1.04, 1.35). Those who were depressed had a 2% (RD: 0.02, 95% CI: 0.01, 0.03) excess risk of obesity, however, the reciprocal associations were not significant. The association between overweight and depression was not found significant in either direction. Both men and women were at risk of obesity and depression bi-directionally. In sensitivity analyses bi-directional associations were more pronounced among young and middle aged adults and in studies with longer follow-up. The findings of this study suggest that the strength of the association is greater for the direction leading from depression to obesity and this link was more pronounced for young and middle aged women.
authors.affiliation: School of Pharmacy, The University of Queensland, 20 Cornwall Street, Woolloongabba 4102, QLD, Australia. Electronic address: mannan.munim@uq.net.au.
authors.forename: Munim
authors.initials: M
authors.lastname: Mannan
authors.affiliation: School of Public Health, The University of Queensland, Herston Road, Herston 4006, QLD, Australia. Electronic address: mamun@sph.uq.edu.au.
authors.forename: Abdullah
authors.initials: A
authors.lastname: Mamun
authors.affiliation: School of Public Health, The University of Queensland, Herston Road, Herston 4006, QLD, Australia. Electronic address: sardoi@gmax.net.
authors.forename: Suhail
authors.initials: S
authors.lastname: Doi
authors.affiliation: School of Pharmacy, The University of Queensland, 20 Cornwall Street, Woolloongabba 4102, QLD, Australia. Electronic address: a.clavarino@sph.uq.edu.au.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Clavarino
mesh_terms: D000328:Adult; D015897:Comorbidity; D003866:Depressive Disorder / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D009765:Obesity / Q000453:epidemiology*
keywords: Depression; Meta-analysis; Obesity; Relative risk (RR); Risk difference (RD)