The Relationship Between Obesity with Depression and Anxiety Levels: a Cross-Sectional, Case-Control Study

Year 2023, Volume: 7 Issue: 2, 152 - 158, 31.08.2023

Fatma Balkoca , Mahcube Cubukcu , Nur Şimşek Yurt

https://doi.org/10.25048/tudod.1323889

Cited By: 2

Abstract

Aim: This study aims to investigate the relationship between obesity and depression and anxiety by determining the depression and
anxiety levels of obese and non-obese patients.
Material and Methods: This study was carried out between 01.02.2022 and 30.04.2022 at Samsun University Faculty of Medicine.
Among all the patients registered in the obesity center, 110 patients who met the inclusion criteria and 110 non-obese patients who
applied to the family medicine clinic as the control group were included in the study. Data were collected through a questionnaire
formed using sociodemographic characteristics, Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI).
Results: The study encompassed of 220 patients, among whom 144 individuals (constituting 65.5% of the sample) were identified as
female. Depression and anxiety levels were higher in obese subjects than in non-obese subjects (p=0.020, p=0.040, respectively). Once
the body mass index (BMI) groups of the participants were compared according to BDI and BAI, severe depression symptoms and severe
anxiety symptoms higher in the morbidly obese group. The difference between the groups according to both BDI and BAI was found to
be statistically significant (respectively; p=0.005, p=0.008). The presence of moderate and severe depression and anxiety symptoms were
determined as independent risk factors for the development of obesity (respectively; OR=5.329, 95% CI 2.98-13.41, p=0.012; OR=3.452,
95% CI 1.56-7.89, p=0.023).
Conclusion: This study revealed that the prevalence of depression and anxiety symptoms was found to be high in obese individuals. It
was observed that as BMI increased, the severity of depression and anxiety symptoms increased.

Keywords

Obesity, Depression, Anxiety, Morbid obesity

Obezite ile Depresyon ve Anksiyete Düzeyleri Arasındaki İlişki: Kesitsel, Vaka Kontrol Çalışması

Abstract

Amaç: Bu çalışma, obez ve obez olmayan hastaların depresyon ve anksiyete düzeylerini belirleyerek obezite ile depresyon ve anksiyete
arasındaki ilişkiyi araştırmayı amaçlamaktadır.
Gereç ve Yöntemler: Bu çalışma 01.02.2022-30.04.2022 tarihleri arasında Samsun Üniversitesi Tıp Fakültesi'nde gerçekleştirildi. Obezite
merkezine kayıtlı tüm hastalardan dahil edilme kriterlerini karşılayan 110 hasta ve kontrol grubu olarak aile hekimliği kliniğine başvuran
obez olmayan 110 hasta çalışmaya alındı. Veriler, sosyodemografik özellikler, Beck Depresyon Envanteri (BDÖ) ve Beck Anksiyete
Ölçeği (BAÖ) kullanılarak oluşturulan anket aracılığıyla toplanmıştır.
Bulgular: Çalışmaya %65,5'i (n=144) kadın olmak üzere toplam 220 hasta dahil edildi. Depresyon ve anksiyete düzeyleri obezlerde
obez olmayanlara göre daha yüksekti (sırasıyla p=0,020, p=0,040). Katılımcıların beden kütle indeksi (BKİ) grupları BDÖ ve BAÖ'ye
göre karşılaştırıldığında, morbid obez grupta şiddetli depresyon semptomları ve şiddetli anksiyete semptomları daha yüksekti. Gruplar arasındaki fark hem BDÖ hem de BAÖ açısından istatistiksel olarak anlamlı bulunmuştur (sırasıyla; p=0,005, p=0,008). Orta ve şiddetli
depresyon ve anksiyete semptomlarının varlığı, obezite gelişimi için bağımsız risk faktörleri olarak belirlendi (sırasıyla; OR=5,329,
p=0,012; OR=3,452, p=0,023).
Sonuç: Bu çalışma, obez bireylerde depresyon ve anksiyete belirtilerinin yaygınlığının yüksek olduğunu ortaya koymuştur. BKİ arttıkça
depresyon ve anksiyete belirtilerinin şiddetinin arttığı görülmüştür

Keywords

Obezite, Depresyon, Anksiyete, Morbid obezite

References

• 1. World Health Organization. Obesity (Internet). (cited 22.02.2023). Available from: https://www.who.int/healthtopics/ obesity#tab=tab_1.
• 2. Cypess AM, Lehman S, Williams G, Tal I, Rodman D, Goldfine AB, et al. Identification and importance of brown adipose tissue in adult humans. N Engl J Med. 2009;360(15):1509-17.
• 3. World Health Organization. Body mass index (BMI) (Internet). (cited 22.02.2023). Available from: https://www. who.int/data/gho/data/themes/topics/topic-details/GHO/ body-mass-index?introPage=intro_3.html.
• 4. Satman I, Yilmaz T, Sengül A, Salman S, Salman F, Uygur S, Bastar I, Tütüncü Y, Sargin M, Dinççag N, Karsidag K, Kalaça S, Ozcan C, King H. Population-based study of diabetes and risk characteristics in Turkey: results of the turkish diabetes epidemiology study (TURDEP). Diabetes Care. 2002;25(9):1551-1556.
• 5. World Health Organization. Obesity and overweight. (Internet). 2021 (cited 23.02.2023). Available from: https:// www.who.int/news-room/fact-sheets/detail/obesity-andoverweight.
• 6. Satman I, Omer B, Tutuncu Y, Kalaca S, Gedik S, Dinccag N, Karsidag K, Genc S, Telci A, Canbaz B, Turker F, Yilmaz T, Cakir B, Tuomilehto J; TURDEP-II Study Group. Twelve-year trends in the prevalence and risk factors of diabetes and prediabetes in Turkish adults. Eur J Epidemiol. 2013;28(2):169-180.
• 7. Janssen I. The public health burden of obesity in Canada. Can J Diabetes. 2013;37(2):90-96.
• 8. Guh DP, Zhang W, Bansback N, Amarsi Z, Birmingham CL, Anis AH. The incidence of co-morbidities related to obesity and overweight: A systematic review and meta-analysis. BMC Public Health. 2009;9:88.
• 9. Kirk SF, Price SL, Penney TL, Rehman L, Lyons RF, Piccinini- Vallis H, Vallis TM, Curran J, Aston M. Blame, shame, and lack of support: a multilevel study on obesity management. Qual Health Res. 2014;24(6):790-800.
• 10. Cairney J, Corna LM, Veldhuizen S, Kurdyak P, Streiner DL. The social epidemiology of affective and anxiety disorders in later life in Canada. Can J Psychiatry. 2008;53(2):104-111.
• 11. Goldney RD, Wittert GA. Obesity and depression or anxiety. BMJ. 2009;339:871.
• 12. Fulton S, Decarie-Spain L, Fioramonti X, Guiard B, Nakajima S. The menace of obesity to depression and anxiety prevalence. Trends Endocrinol Metab. 2022;33(1):18-35.
• 13. Belibagli MC, Celikkanat S. Problem-solving self-appraisals of obese patients. Eur Rev Med Pharmacol Sci. 2019;23:10498- 10500.
• 14. Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J. An inventory for measuring depression. Arch Gen Psychiatry. 1961;4(6):561-571.
• 15. Hisli N. A reliability and validity study of Beck Depression Inventory in a university student sample. J Psychol. 1989;7:3- 13.
• 16. Beck AT, Epstein N, Brown G, Steer RA. An inventory for measuring clinical anxiety: Psychometric properties. J Consult Clin Psychol. 1988;56(6):893-897.
• 17. Ulusoy M, Sahin NH, Erkmen H. Turkish version of the Beck Anxiety Inventory: psychometric properties. Journal of Cognitive Psychotherapy. 1998;12(2):163.
• 18. Vallis M. Quality of life and psychological well-being in obesity management: Improving the odds of success by managing distress. Int J Clin Pract. 2016;70(3):196-205.
• 19. Chooi YC, Ding C, Magkos F. The epidemiology of obesity. Metabolism. 2019;92:6-10.
• 20. Milaneschi Y, Simmons WK, van Rossum EFC, Penninx BW. Depression and obesity: Evidence of shared biological mechanisms. Mol Psychiatry. 2019;24(1):18-33.
• 21. Mannan M, Mamun A, Doi S, Clavarino A. Prospective associations between depression and obesity for adolescent males and females-a systematic review and meta-analysis of longitudinal studies. PloS One. 2016;11(6):e0157240.
• 22. Cakmur H, Güneş UB. Research the relationship between obesity and depression ın outpatient clinics. Turk J Fam Med. 2018;22(2):58-65.
• 23. Sevinçer GM, Konuk N, İpekçioğlu D, Crosby RD, Cao L, Coskun H, Mitchell JE. Association between depression and eating behaviors among bariatric surgery candidates in a Turkish sample. Eat Weight Disord. 2017;22:117-123.
• 24. Woo YS, Seo HJ, McIntyre RS, Bahk WM. Obesity and its potential effects on antidepressant treatment outcomes in patients with depressive disorders: A literature review. Int J Mol Sci. 2016;17(1):80.
• 25. Capuron L, Lasselin J, Castanon N. Role of adiposity-driven inflammation in depressive morbidity. Neuropsychopharmacology. 2017;42(1):115-128.
• 26. Amiri S, Behnezhad S. Obesity and anxiety symptoms: A systematic review and meta-analysis. Neuropsychiatr. 2019;33(2):72-89.
• 27. Strine TW, Mokdad AH, Dube SR, Balluz LS, Gonzalez O, Berry JT, Manderscheid R, Kroenke K. The association of depression and anxiety with obesity and unhealthy behaviors among community-dwelling US adults. Gen Hosp Psychiatry. 2008;30(2):127-137.
• 28. Zhao G, Ford ES, Dhingra S, Li C, Strine TW, Mokdad AH. Depression and anxiety among US adults: Associations with body mass index. Int J Obes. 2009;33(2):257-266.
• 29. Lawlor DA, Hart CL, Hole DJ, Gunnell D, Davey Smith G. Body mass index in middle life and future risk of hospital admission for psychoses or depression: Findings from the Renfrew/Paisley study. Psychol Med. 2007;37(8):1151-1161.
• 30. Eren I, Erdi O. The Frequency of Psychiatric Disorders in Obese Patients. Clinic Psychiatr. 2003;6(3):152-157.
• 31. Sharafi SE, Garmaroudi G, Ghafouri M, Bafghi SA, Ghafouri M, Tabesh MR, Alizadeh Z. Prevalence of anxiety and depression in patients with overweight and obesity. Obes Med. 2020;17:100169.