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Obese youths are not more likely to become depressed, but depressed youths are more likely to become obese

  • R. E. Roberts (a1) and H. T. Duong (a1)

Overweight/obesity and depression are both major public health problems among adolescents. However, the question of a link between overweight/obesity and depression remains unresolved in this age group. We examined whether obesity increases risk of depression, or depression increases risk of obesity, or whether there is a reciprocal effect.


A two-wave prospective cohort study of adolescents aged 11–17 years at baseline (n = 4175) followed up a year later (n = 3134) sampled from the Houston metropolitan area. Overweight was defined as 95th percentile >body mass index (BMI) ⩽85th percentile and obese as BMI >95th percentile. Three indicators of depression were examined: any DSM-IV mood disorder, major depression, and symptoms of depression.


Data for the two-wave cohort indicated no evidence of reciprocal effects between weight and depression. Weight status predicted neither major depression nor depressive symptoms. However, mood disorders generally and major depression in particular increased risk of future obesity more than twofold. Depressed males had a sixfold increased risk of obesity. Females with depressive symptoms had a marginally increased risk of being overweight but not obese.


Our findings, combined with those of recent meta-analyses, suggest that obese youths are not more likely to become depressed but that depressed youths are more likely to become obese.

Corresponding author
*Address for correspondence: R. E. Roberts, Ph.D., UTHealth, School of Public Health, University of Texas Health Science Center at Houston, 1200 Herman Pressler Dr., Suite E1017, Houston, TX 77030, USA. (Email:
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Ajilore, O, Haroon, E, Kumaran, S, Darwin, C, Binesh, N, Mintz, J, Miller, J, Thomas, MA, Kumar, A (2007). Measurement of brain metabolites in patients with type 2 diabetes and major depression using proton magnetic resonance spectroscopy. Neuropsychopharmacology 32, 12241231.
Anderson, SE, Cohen, P, Naumova, EN, Jacques, PF, Must, A (2007). Adolescent obesity and risk for subsequent major depressive disorder and anxiety disorder: prospective evidence. Psychosomatic Medicine 69, 740747.
Andrews, FF, Morgan, JN, Sonquist, JA, Klem, L (1973). Multiple Classification Analysis: A Report on a Computer Program for Multiple Regression Using Categorical Predictors, 2nd edn. Institute for Social Research, University of Michigan: Ann Arbor, MI.
APA (2000). Diagnostic and Statistical Manual of Mental Disorders, 4th edn. American Psychiatric Association: Washington, DC.
Armstrong, N, Welsman, J (1997). Young People and Physical Activity. Oxford University Press: Oxford.
Bardone, AM, Moffitt, TE, Caspi, A, Dickson, N, Stanton, WR, Silva, PA (1998). Adult physical outcomes of adolescent girls with conduct disorder, depression, and anxiety. Journal of the American Academy of Adolescent and Psychiatry 37, 594601.
Blaine, B (2008). Does depression cause obesity? A meta-analysis of longitudinal studies of depression and weight control. Journal of Health Psychology 13, 11901197.
Bremmer, MA, Beekman, AT, Deeg, DJ, Penninx, BW, Dik, MG, Hack, CE, Hoogendijk, WJ (2008). Inflammatory markers in late-life depression: results from a population-based study. Journal of Affective Disorders 106, 249255.
CDC (2006). About BMI for Children and Teens ( Accessed December 2012.
Dallman, MF, Pecoraro, N, Akana, SF, La Fleur, SE, Gomez, F, Houshyar, H, Bell, ME, Bhatnagar, S, Laugero, KD, Manalo, S (2003). Chronic stress and obesity: a new view of ‘comfort food’. Proceedings of the National Academy of Sciences USA 100, 1169611701.
Daniels, J (2005). Weight and weight concern: are they associated with reported depressive symptoms in adolescents? Journal of Pediatric Health Care 19, 3341.
Demyttenaere, K, Jaspers, L (2008). Bupropion and SSRI-induced side effects. Journal of Psychopharmacology 22, 792804.
Emery, CF, Fondow, MD, Schneider, CM, Christofi, FL, Hunt, C, Busby, AK, Needleman, BJ, Melvin, WS, Elsayed-Awad, HM (2007). Gastric bypass surgery is associated with reduced inflammation and less depression: a preliminary investigation. Obesity Surgery 17, 759763.
Faith, M, Matz, P, Jorge, M (2002). Obesity-depression associations in the population. Journal of Psychosomatic Research 53, 935942.
Haines, J, Neumark-Sztainer, D (2009). Psychosocial consequences of obesity and weight bias: implications for interventions. In Obesity in Youth: Causes, Consequences, and Cures (ed. Heinberg, L. J. and Thompson, J. K.), pp. 7998. American Psychological Association: Washington, DC.
Heinberg, LJ, Thompson, JK (eds) (2009). Obesity in Youth: Causes, Consequences, and Cures. American Psychological Association: Washington, DC.
Herva, A, Laitinen, J, Miettunen, J, Veijola, J, Karvonen, JT, Laksy, K, Joukamaa, M (2006). Obesity and depression: results from the longitudinal Northern Finland 1966 Birth Cohort Study. International Journal of Obesity (2005) 30, 520527.
Holsen, I, Kraft, P, Roysamb, E (2001). The relationship between body image and depressed mood in adolescence: a 5-year longitudinal panel study. Journal of Health Psychology 6, 613627.
Kendler, KS (1998). Adversity, stress, and psychopathology: a psychiatric genetic perspective. In Adversity, Stress and Psychopathology(ed. Dohrenwend, B. P.), pp. 477495. Oxford University Press: New York.
Kessler, RC, Avenevoli, S, Costello, J, Green, JG, Gruber, MS, Heering, S, Merikangas, KR, Pennell, BE, Sampson, NA, Zaslavsky, AM (2009). National Comorbidity Survey replication adolescent supplement (NCS-A): II. Overview and design. Journal of American Academy Child and Adolescent Psychiatry 48, 380385.
Lepkowski, J, Bowles, J (1996). Sampling error software for personal computers. Survey Statistician 35, 1017.
Lohman, TG, Roche, AF, Martorell, R (1991). Anthropometric Standardization Reference Manual. Human Kinetic Books: Champaign, IL.
Luppino, FS, de Wit, LM, Bouvy, PF, Stijnen, T, Cuijpers, P, Penninx, BW, Zitman, FG (2010). Overweight, obesity, and depression. A systematic review and meta-analysis of longitudinal studies. Archives of General Psychiatry 67, 220229.
Mead, GE, Morley, W, Campbell, P, Greig, CA, McMurdo, M, Lawlor, DA (2008). Exercise for depression. Cochrane Database System Reviews. Issue 3, Art. No. CD004366.
Merikangas, AK, Mendola, P, Pastor, PN, Reuben, CA, Cleary, SD (2012). The association between major depressive disorder and obesity in US adolescents: results from the 2001–2004 National Health and Nutrition Examination Survey. Journal of Behavioral Medicine 35, 149154.
Mustillo, S, Worthman, C, Erkanli, A, Keeler, G, Angold, A, Costello, EJ (2003). Obesity and psychiatric disorder: developmental trajectories. Pediatrics 111, 851859.
National Institutes of Health (1998). Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults – the evidence report. Obesity Research 6 (Suppl. 2), 51S209S.
Needham, BL, Crosnoe, R (2005). Overweight status and depressive symptoms during adolescence. Journal of Adolescent Health 36, 4855.
Neumark-Sztainer, D, Wall, M, Guo, J, Story, M, Haines, J, Eisenberg, M (2006). Obesity, disordered eating, and eating disorders in a longitudinal study of adolescents: how do dieters fare 5 years later? Journal of American Dietetic Association 106, 559568.
Ogden, CL, Carroll, MD, Flegal, KM (2008). High body mass index for age among US children and adolescents, 2003–2006. Journal of the American Medical Association 299, 24012405.
Pallister, E, Waller, G (2008). Anxiety in the eating disorders: understanding the overlap. Clinical Psychology Reviews 28, 366368.
Pasquali, R, Vicennati, V (2000). Activity of the hypothalamic-pituitary-adrenal axis in different obesity phenotypes. International Journal of Obesity Related and Metabolic Disorders 24 (Suppl. 2), S47S49.
Pine, DS, Cohen, P, Brook, J, Coplan, JD (1997). Psychiatric symptoms in adolescence as predictors of obesity in early adulthood: a longitudinal study. American Journal of Public Health 87, 13031310.
Pine, DS, Goldstein, RB, Wolk, S, Weissman, MM (2001). The association between childhood depression and adulthood body mass index. Pediatrics 107, 10491056.
Richardson, LP, Davis, R, Poulton, R, McCauley, E, Moffitt, TE, Caspi, A, Connell, F (2003). A longitudinal evaluation of adolescent depression and adult obesity. Archives of Pediatric and Adolescent Medicine 157, 739–145.
Ringham, RM, Levine, MD, Marcus, MD (2009). Psychological comorbidity and childhood overweight. In Obesity in Youth: Causes, Consequences, and Cures(ed. Heinberg, L. J. and Thompson, J. K.), pp. 115134. American Psychological Association: Washington, DC.
Roberts, RE, Alegria, M, Roberts, CR, Chen, IG (2005). Mental health problems of adolescents as reported by their caregivers: a comparison of European, African, and Latino Americans. Journal of Behavioral Health Services Research 32, 113.
Roberts, RE, Roberts, CR (2007). Ethnicity and risk of psychiatric disorder among adolescents. Research in Human Development 4, 89117.
Roberts, RE, Roberts, CR, Chan, WY (2009). One-year incidence of psychiatric disorders and associated risk factors among adolescents in the community. Journal of Child Psychology and Psychiatry 50, 405415.
Roberts, RE, Roberts, CR, Xing, Y (2007). Are Mexican American adolescents at greater risk of suicidal behaviors? Suicide and Life-Threatening Behavior 37, 1021.
Ross, CE (1994). Overweight and depression. Journal of Health and Social Behavior 35, 6379.
Rutter, M, Silberg, J, O'Connor, T, Simonoff, E (1999 a). Genetics and child psychiatry: I. Advances in quantitative and molecular genetics. Journal of Child Psychology and Psychiatry 40, 318.
Rutter, M, Silberg, J, O'Connor, T, Simonoff, E (1999 b). Genetics and child psychiatry: II. Empirical research findings. Journal of Child Psychology and Psychiatry 40, 1955.
SAS Institute (2004). SAS/STAT 9.1: User's Guide. SAS Institute Inc.: Cary, NC.
Shaffer, D, Fisher, P, Lucas, CP, Dulcan, MK, Schwab-Stone, ME (2000). NIMH Diagnostic Interview Schedule for Children Version IV (NIMH DISC-IV): description, differences from previous versions, and reliability of some common diagnoses. Journal of the American Academy of Child and Adolescent Psychiatry 39, 2838.
Silventoinen, K, Rokholm, B, Kaprio, J, Sørensen, TI (2010). The genetic and environmental influences on childhood obesity: a systematic review of twin and adoption studies. International Journal of Obesity 34, 2940.
Stice, E (2001). A prospective test of the dual pathway model of bulimic pathology: mediating effects of dieting and negative affect. Journal of Abnormal Psychology 110, 124135.
Stice, E, Bearman, S (2001). Body-image and eating disturbances prospectively predict increases in depression symptoms in adolescent girls: a growth curve analysis. Developmental Psychology 37, 597607.
Stunkard, AJ, Foch, TT, Hrubec, Z (1986). A twin study of human obesity. Journal of the American Medical Association 256, 5154.
Sussman, N, Ginsberg, DL, Bikoff, J (2001). Effects of nefazodone on body weight: a pooled analysis of selective serotonin reuptake inhibitor- and imipramine- controlled trials. Journal Clinical Psychiatry 62, 256260.
ter Bogt, T, van Dorsselaer, S, Monshouwer, K, Verdurmen, J, Engels, R, Vollebergh, W (2006). Body mass index and body weight perception as risk factors for internalizing and externalizing problem behavior among adolescents. Journal of Adolescent Health 39, 2734.
Vaccarino, V, Johnson, BD, Sheps, DS, Reis, SE, Kelsey, SF, Bittner, V, Rutledge, T, Shaw, LJ, Sopko, G, Bairey Merz, CN; National Heart, Lung, and Blood Institute (2007). Depression, inflammation, and incident cardiovascular disease in women with suspected coronary ischemia: the National Heart, Lung, and Blood Institute-sponsored WISE study. Journal of the American College of Cardiology 50, 20442050.
Walker, BR (2001). Activation of the hypothalamic-pituitary-adrenal axis in obesity: cause or consequence? Growth Hormone and IGF Research 11 (Suppl. A), S91S95.
Zametkin, AJ, Zoon, CK, Klein, HW, Munson, S (2004). Psychiatric aspects of child and adolescent obesity: a review of the past 10 years. Journal of the American Academy of Child and Adolescent Psychiatry 43, 134150.
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