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Association Between Obesity and Psychiatric Disorders in the US Adult Population
Gregory E. Simon, MD, MPH;
Michael Von Korff, ScD;
Kathleen Saunders, JD;
Diana L. Miglioretti, PhD;
Paul K. Crane, MD, MPH;
Gerald van Belle, PhD;
Ronald C. Kessler, PhD
Arch Gen Psychiatry. 2006;63:824-830.
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.
Design Cross-sectional epidemiologic survey.
Setting Nationally representative sample of US adults.
Participants A total of 9125 respondents who provided complete data on psychiatric disorder, height, and weight. Response rate was 70.9%.
Main Outcome Measures 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  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.
Author Affiliations: Center for Health Studies, Group Health Cooperative (Drs Simon, Von Korff, Saunders, and Miglioretti), Department of Medicine, University of Washington School of Medicine (Dr Crane), and Department of Biostatistics, University of Washington School of Public Health and Community Medicine (Drs Miglioretti and van Belle), Seattle; and Department of Health Care Policy, Harvard Medical School, Boston, Mass (Dr Kessler).
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