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Association between body mass index and mental health among Scottish adult population: a cross-sectional study of 37272 participants

Published online by Cambridge University Press:  25 November 2013

Z. Ul-Haq ,
D. F. Mackay ,
E. Fenwick  and
J. P. Pell
Z. Ul-Haq
Affiliation:
Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK Institute of Public Health and Social Sciences, Khyber Medical University, Peshawar, KPK, Pakistan
D. F. Mackay
Affiliation:
Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
E. Fenwick
Affiliation:
Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
J. P. Pell*
Affiliation:
Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
*
*Address for correspondence: J. P. Pell, M.D., Henry Mechan Professor of Public Health, Institute of Health and Wellbeing, University of Glasgow, 1 Lilybank Gardens, Glasgow G12 8RZ, UK. (Email: jill.pell@glasgow.ac.uk)
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Abstract

Background

The evidence is conflicting as to whether body mass index (BMI) is associated with mental health and, if so, to what extent it varies by sex and age. We studied mental health across the full spectrum of BMI among the general population, and conducted subgroup analyses by sex and age.

Method

We undertook a cross-sectional study of a representative sample of the Scottish adult population. The Scottish Health Survey provided data on mental health, measured by the General Health Questionnaire-12 (GHQ), BMI, demographic and life-style information. Good mental health was defined as a GHQ score <4, and poor mental health as a GHQ score ⩾4. Logistic regression models were applied.

Results

Of the 37 272 participants, 5739 (15.4%) had poor mental health. Overall, overweight participants had better mental health than the normal-weight group [adjusted odds ratio (OR) 0.93, 95% confidence interval (CI) 0.87–0.99, p = 0.049], and individuals who were underweight, class II or class III obese had poorer mental health (class III obese group: adjusted OR 1.26, 95% CI 1.05–1.51, p = 0.013). There were significant interactions of BMI with sex (p = 0.013) and with age (p < 0.001). Being overweight was associated with significantly better mental health in middle-aged men only. In contrast, being underweight at all ages or obese at a young age was associated with significantly poorer mental health in women only.

Conclusions

The adverse associations between adiposity and mental health are specific to women. Underweight women and young women who are obese have poorer mental health. In contrast, middle-aged overweight men have better mental health.

Keywords

Body mass indexGeneral Health Questionnaire-12health-related quality of lifemental healthobesityoverweightunderweight
Type
Original Articles
Information
Psychological Medicine , Volume 44 , Issue 10 , July 2014 , pp. 2231 - 2240
Copyright
Copyright © Cambridge University Press 2013 

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References

Aalto, AM, Elovainio, M, Kivimaki, M, Uutela, A, Pirkola, S (2012). The Beck Depression Inventory and General Health Questionnaire as measures of depression in the general population: a validation study using the Composite International Diagnostic Interview as the gold standard. Psychiatry Research 197, 163–171.Google Scholar
Baumeister, H, Harter, M (2007). Mental disorders in patients with obesity in comparison with healthy probands. International Journal of Obesity 31, 1155–1164.Google Scholar
Brandheim, S, Rantakeisu, U, Starrin, B (2013). BMI and psychological distress in 68,000 Swedish adults: a weak association when controlling for an age–gender combination. BMC Public Health 13, 68.Google Scholar
Carroll, DD, Blanck, HM, Serdula, MK, Brown, DR (2010). Obesity, physical activity, and depressive symptoms in a cohort of adults aged 51 to 61. Journal of Aging and Health 22, 384–398.Google Scholar
Cattarin, JA, Thompson, JK (1994). A three-year longitudinal study of body image, eating disturbance, and general psychological functioning in adolescent females. Eating Disorders: Journal of Treatment and Prevention 2, 114–125.CrossRefGoogle Scholar
Connor-Greene, PA (1998). Gender differences in body weight perception and weight-loss strategies of college students. Women and Health 14, 27–42.Google Scholar
Crisp, AH, McGuiness, B (1976). Jolly fat: relation between obesity and psychoneurosis in general population. British Medical Journal 1, 7–9.Google Scholar
De Wit, L, Luppino, F, van Straten, A, Penninx, B, Zitman, F, Cuijpers, P (2010). Depression and obesity: a meta-analysis of community-based studies. Psychiatry Research 178, 230–235.CrossRefGoogle ScholarPubMed
De Wit, LM, van Straten, A, van Herten, M, Penninx, BW, Cuijpers, P (2009). Depression and body mass index, a u-shaped association. BMC Public Health 9, 14.Google Scholar
Flegal, KM, Kit, BK, Orpana, H, Graubard, BI (2013). Association of all-cause mortality with overweight and obesity using standard body mass index categories: a systematic review and meta-analysis. Journal of the American Medical Association 309, 71–82.Google Scholar
Friedman, MA, Brownell, KD (1995). Psychological correlates of obesity: moving to the next research generation. Psychological Bulletin 117, 3–20.Google Scholar
Goldberg, DP, Gater, R, Sartorius, N, Ustun, TB, Piccinelli, M, Gureje, O, Rutter, C (1997). The validity of two versions of the GHQ in the WHO study of mental illness in general health care. Psychological Medicine 27, 191–197.Google Scholar
Goldberg, DP, Oldehinkel, T, Ormel, J (1998). Why GHQ threshold varies from one place to another. Psychological Medicine 28, 915–921.Google Scholar
Goldney, RD, Dunn, KI, Air, TM, Dal, GE, Taylor, AW (2009). Relationships between body mass index, mental health, and suicidal ideation: population perspective using two methods. Australian and New Zealand Journal of Psychiatry 43, 652–658.Google Scholar
Harrison, K, Cantor, J (1997). The relationship between media consumption and eating disorders. Journal of Communication 47, 40–66.Google Scholar
Heo, M, Pietrobelli, A, Fontaine, KR, Sirey, JA, Faith, MS (2006). Depressive mood and obesity in US adults: comparison and moderation by sex, age, and race. International Journal of Obesity 30, 513–519.Google Scholar
Holi, MM, Marttunen, M, Aalberg, V (2003). Comparison of the GHQ-36, the GHQ-12 and the SCL-90 as psychiatric screening instruments in the Finnish population. Nordic Journal of Psychiatry 57, 233–238.Google Scholar
Jarvinen, O, Julkunen, J, Tarkka, MR (2007). Impact of obesity on outcome and changes in quality of life after coronary artery bypass grafting. World Journal of Surgery 31, 318–325.CrossRefGoogle ScholarPubMed
Jorm, AF, Korten, AE, Christensen, H, Jacomb, PA, Rodgers, B, Parslow, RA (2003). Association of obesity with anxiety, depression and emotional well-being: a community survey. Australian and New Zealand Journal of Public Health 27, 434–440.CrossRefGoogle ScholarPubMed
Keenan, K, Grant, I, Ramsay, J (2011). Scottish Health Survey: Topic Report: Obesity. The Scottish Government: Edinburgh.Google Scholar
Krul, AJ, Daanen, HA, Choi, H (2011). Self-reported and measured weight, height and body mass index (BMI) in Italy, the Netherlands and North America. European Journal of Public Health 21, 414–419.Google Scholar
Lavie, CJ, Milani, RV, Ventura, HO (2009). Obesity and cardiovascular disease: risk factor, paradox, and impact of weight loss. Journal of the American College of Cardiology 53, 1925–1932.Google Scholar
Linna, M, Kaprio, J, Raevuori, A, Sihvola, E, Keski-Rahkonen, A, Rissanen, A (2013). Body mass index and subjective well-being in young adults: a twin population study. BMC Public Health 13, 231.Google Scholar
Lohmander, LS, Gerhardsson de Verdier, M, Rollof, J, Nilsson, PM, Engström, G (2009). Incidence of severe knee and hip osteoarthritis in relation to different measures of body mass: a population-based prospective cohort study. Annals of the Rheumatic Diseases 68, 490–496.Google Scholar
Madrigal, H, Sanchez-Villegas, A, Martinez-Gonzalez, MA, Kearney, J, Gibney, MJ, Irala, J, Martinez, JA (2000). Underestimation of body mass index through perceived body image as compared with self-reported body mass index in the European Union. Public Health 114, 468–473.Google Scholar
McCrea, RL, Berger, YG, King, MB (2012). Body mass index and common mental disorders: exploring the shape of the association and its moderation by age, gender and education. International Journal of Obesity 36, 414–421.Google Scholar
McManus, S, Meltzer, H, Brugha, T, Bebbington, P, Jenkins, R (editors) (2009). Adult Psychiatric Morbidity in England, 2007: Results of a Household Survey. NHS Information Centre for Health and Social Care: Leeds.Google Scholar
Minniti, A, Bissoli, L, Di, FV, Olivieri, M, Mandragona, R, Mazzali, G, Fontana, G, Corzato, F, Costa, A, Bosello, O, Zamboni, M (2011). Comparison of physical and psychological status in younger and older overweight-obese women. Nutrition, Metabolism and Cardiovascular Diseases 21, 909–914.Google Scholar
Mokdad, AH, Ford, ES, Bowman, BA, Dietz, WH, Vinicor, F, Bales, VS, Marks, JS (2003). Prevalence of obesity, diabetes, and obesity-related health risk factors, 2001. Journal of the American Medical Association 289, 76–79.CrossRefGoogle ScholarPubMed
Mond, J, Rodgers, B, Hay, P, Owen, C (2011). Mental health impairment in underweight women: do body dissatisfaction and eating-disordered behavior play a role? BMC Public Health 11, 547.Google Scholar
Morris, J, Koehn, S, Happell, B, Dwyer, T, Moxham, L (2010). Implications of excess weight on mental wellbeing. Australian Health Review 34, 368–374.CrossRefGoogle ScholarPubMed
Nihalani, N, Schwartz, TL, Siddiqui, UA, Megna, JL (2011). Weight gain, obesity, and psychotropic prescribing. Journal of Obesity 2011, 893629.Google Scholar
Ohayon, MM (2007). Epidemiology of depression and its treatment in the general population. Journal of Psychiatric Research 41, 207–213.Google Scholar
Olfson, M, Marcus, SC (2009). National patterns in antidepressant medication treatment. Archives of General Psychiatry 66, 848–856.Google Scholar
Palinkas, LA, Wingard, DL, Barrett-Connor, E (1996). Depressive symptoms in overweight and obese older adults: a test of the ‘jolly fat’ hypothesis. Journal of Psychosomatic Research 40, 59–66.Google Scholar
Petry, NM, Barry, D, Pietrzak, RH, Wagner, JA (2008). Overweight and obesity are associated with psychiatric disorders: results from the National Epidemiologic Survey on Alcohol and Related Conditions. Psychosomatic Medicine 70, 288–297.Google Scholar
Renehan, AG, Tyson, M, Egger, M, Heller, RF, Zwahlen, M (2008). Body-mass index and incidence of cancer: a systematic review and meta-analysis of prospective observational studies. Lancet 371, 569–578.Google Scholar
Rennie, KL, Jebb, SA (2005). Prevalence of obesity in Great Britain. Obesity Reviews 6, 11–12.Google Scholar
Rosmond, R, Bjorntorp, P (2000). Quality of life, overweight, and body fat distribution in middle-aged men. Behavioral Medicine 26, 90–94.Google Scholar
Royston, P, Altman, DG, Sauerbrei, W (2006). Dichotomizing continuous predictors in multiple regression: a bad idea. Statistics in Medicine 25, 127–141.Google Scholar
Scott, KM, Bruffaerts, R, Simon, GE, Alonso, J, Angermeyer, M, de Girolamo, G, Demyttenaere, K, Gasquet, I, Haro, JM, Karam, E, Kessler, RC, Levinson, D, Medina Mora, ME, Oakley Browne, MA, Ormel, J, Villa, JP, Uda, H, Von Korff, M (2008). Obesity and mental disorders in the general population: results from the World Mental Health Surveys. International Journal of Obesity 32, 192–200.Google Scholar
Sheldon, P (2010). Pressure to be perfect: influences on college students’ body esteem. Southern Communication Journal 75, 277–298.Google Scholar
Ul-Haq, Z, Mackay, DF, Fenwick, E, Pell, JP (2012). Impact of metabolic co-morbidity on the association between body mass index and health-related quality of life: a Scotland-wide cross-sectional study of 5,608 participants. BMC Public Health 12, 143.Google Scholar
Ul-Haq, Z, Mackay, DF, Fenwick, E, Pell, JP (2013 a). Meta-analysis of the association between body mass index and health-related quality of life among adults, assessed by the SF-36. Obesity (Silver Spring) 21, E322–E327.Google Scholar
Ul-Haq, Z, Mackay, DF, Fenwick, E, Pell, JP (2013 b). Meta-analysis of the association between body mass index and health-related quality of life among children and adolescents, assessed using the Pediatric Quality of Life Inventory Index. Journal of Pediatrics 162, 280–286.Google Scholar
WHO (1995). Physical status: the use and interpretation of anthropometry: report of a WHO expert committee. Technical Report Series 854, 1–452.Google Scholar
WHO (2010). Mental health: strengthening our response (http://www.who.int/mediacentre/factsheets/fs220/en). World Health Organization. Accessed 1 September 2013.Google Scholar