title: The relationship between the BMI and the emotional status of Alexandria University students, Egypt.
abstract: BACKGROUND
  Although the relationship between obesity and depression has been researched extensively, the relation of the wide range of body-weight problems, as indicated by the BMI, to emotional health problems has received little attention.
  
  
  OBJECTIVE
  To assess the rate of concomitant co-occurrence of emotional health and weight problems in Alexandria University students, and to investigate the relationship between their BMI and emotional status.
  
  
  METHODS
  A cross-sectional study was carried out on 842 university students (17-27 years), enrolled in four faculties of Alexandria University, Egypt, during the academic year 2012-2013. Participants of both sexes were interviewed to collect sociodemographic data. Weight and height were measured, and then the BMI was calculated and classified into underweight, normal weight, overweight, and obese according to age-corresponding and sex-corresponding standards. The Arabic version of Depression Anxiety Stress Scales was used to assess the emotional status of students. The curve of fit was used to test the statistical quadratic trend.
  
  
  RESULTS
  Co-occurrence of depression, anxiety, or stress with any weight problem was prevalent among 7.4, 6.7, and 9.6% of the students, respectively. Obese and underweight students recorded higher rates of emotional problems compared with normal and overweight students, revealing a U-shaped relationship between the BMI and emotional states (R=0.01). This relationship was significant only for anxiety and stress (P<0.05). A significant relationship (P<0.05) was found with the three emotional states among male participants (R=0.02), but only for anxiety among female participants (R=0.01). After controlling for age and sex, only being underweight increased the risk of anxiety and stress (odds ratio=2.95, P<0.001 and odds ratio=2.18, P=0.01, respectively).
  
  
  CONCLUSIONS
  Findings revealed a U-shaped relationship between the BMI and the emotional status of university students, where sex differences were evident. University preventive strategies and treatment services should address such alarming coexisting problems among youth.
authors.affiliation: aMental Health Specialist, Ministry of Health bMental Health Specialty, Department of Family Health cDepartment of Nutrition, High Institute of Public Health, Alexandria University, Alexandria, Egypt.
authors.forename: Heba A
authors.initials: HA
authors.lastname: Abdel Sadek
authors.forename: Mervat W
authors.initials: MW
authors.lastname: Abu-Nazel
authors.forename: Zeinab N
authors.initials: ZN
authors.lastname: Shata
authors.forename: Nesrin K
authors.initials: NK
authors.lastname: Abd El-Fatah
mesh_terms: D000293:Adolescent; D000328:Adult; D001007:Anxiety / Q000453:epidemiology / Q000523:psychology*; D015992:Body Mass Index; D001835:Body Weight; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology / Q000523:psychology*; D004534:Egypt / Q000453:epidemiology; D004644:Emotions; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D016015:Logistic Models; D008297:Male; D009765:Obesity / Q000453:epidemiology / Q000523:psychology*; D050177:Overweight / Q000453:epidemiology / Q000523:psychology; D011569:Psychiatric Status Rating Scales; D017678:Sex Distribution; D013315:Stress, Psychological / Q000453:epidemiology / Q000523:psychology*; D013334:Students; D013851:Thinness / Q000453:epidemiology / Q000523:psychology*; D014495:Universities; D055815:Young Adult