​Depressive symptoms and weight loss behaviors in U.S. adults

Elizabeth A Vrany; Misty A W Hawkins; Wei Wu; Jesse C Stewart

doi:10.1016/j.eatbeh.2018.03.006

Depressive symptoms and weight loss behaviors in U.S. adults

Eat Behav. 2018 Apr:29:107-113. doi: 10.1016/j.eatbeh.2018.03.006. Epub 2018 Mar 24.

Authors

Elizabeth A Vrany¹, Misty A W Hawkins², Wei Wu¹, Jesse C Stewart³

Affiliations

¹ Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis, IN, United States.
² Department of Psychology, Oklahoma State University, Stillwater, OK, United States.
³ Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis, IN, United States. Electronic address: jstew@iupui.edu.

PMID: 29631125
DOI: 10.1016/j.eatbeh.2018.03.006

Abstract

Objective: We sought to determine whether depressive symptoms are associated with attempting to lose weight and engaging in weight loss behaviors in a large, diverse sample of adults representative of the U.S.

Methods: Respondents were 23,106 adults, free of cardiovascular disease and diabetes, who participated in the 2005-2014 years of the National Health and Nutrition Examination Survey (NHANES). Depressive symptoms were measured using the Patient Health Questionnaire-9 (PHQ-9), and weight loss variables were obtained from a Weight History Questionnaire.

Results: PHQ-9 total was not associated with attempting to lose weight in the past year (OR = 1.03, 95%CI = 1.00-1.06, p = 0.074; n = 23,106). Among respondents who attempted to lose weight (n = 9582), PHQ-9 total was associated with a lower odds of exercising (OR = 0.84, 95%CI = 0.79-0.89, p < 0.001) and a greater odds of skipping meals (OR = 1.31, 95%CI = 1.22-1.41, p < 0.001), eating diet foods/products (OR = 1.16, 95%CI = 1.08-1.24, p < 0.001), eating less food (OR = 1.09, 95%CI = 1.04-1.15, p < 0.001), taking non-prescription supplements (OR = 1.31, 95%CI = 1.23-1.41, p < 0.001), taking prescription diet pills (OR = 1.28, 95%CI = 1.10-1.49, p = 0.001), and taking laxatives/vomiting (OR = 1.55, 95%CI = 1.28-1.88, p < 0.001).

Conclusions: Although depressive symptoms were not associated with attempting to lose weight in the past year, adults who attempted to lose weight tended to employ potentially ineffective/unhealthy weight loss behaviors and avoid effective behaviors. This pattern of behaviors may be another mechanism that explains the excess risk of obesity in depressed adults and may be a modifiable target for future interventions. Given the cross-sectional nature of this study, reverse causality is a possibility. Future studies should investigate the prospective associations between depressive symptoms and weight loss behaviors.

Keywords: Depression; Diet; Obesity; Physical activity; Weight loss behaviors.

MeSH terms

Adult
Cross-Sectional Studies
Depression / psychology*
Exercise / psychology
Feeding Behavior / psychology*
Female
Humans
Male
Middle Aged
Nutrition Surveys
Obesity / psychology
Risk Factors
Surveys and Questionnaires
United States
Weight Loss*