Background: It has been hypothesized that depression and obesity are bi-directionally associated, and when overweight people appear to show a lower risk of depression, this supports the "Jolly Fat" hypothesis. The aim of this study was to examine the "Jolly Fat" hypothesis in middle-aged women in Korea, by different perceived stress levels.
Methods: We performed a cross-sectional study of 44 to 56 aged Korean women (n = 2201) who underwent a health check-up program at the healthcare centers of Kangbuk Samsung Hospital (Seoul and Suwon centers) in Korea. General and abdominal obesity were defined as body mass index ≥25 kg/m2 and waist circumference ≥85 cm, respectively. Depressive symptoms were measured by a Korean version of the Center for Epidemiologic Studies-Depression scale. The association between obesity and depressive symptoms was investigated by using multiple logistic regression analyses by different levels of perceived stress, with adjustment for potential confounding factors.
Results: The prevalence of general and abdominal obesity and depressive symptoms were 23.7%, 21.4%, and 16.5%, respectively. Women with general obesity were less likely to have depressive symptoms (odds ratio [OR]: 0.50; 95% confidence interval [CI]: 0.25-1.00; p-value: 0.049) in the low-stress group. We also found that women with abdominal obesity had a 60% decrease in the odds of having depressive symptoms (OR: 0.40; 95% CI: 0.18-0.87; p-value: 0.02) in the low-stress group. No significant association was found in the high-stress group.
Conclusions: These findings indicate that the relationship between obesity and depressive symptoms in the Korean middle-aged women supports the "Jolly Fat" hypothesis. Further, our results underscore the role of stress as an important potential mediator exerting effects on the association between obesity and depressive symptoms.
Keywords: abdominal obesity; depression/epidemiology; middle aged; obesity/epidemiology; psychological stress.