Few studies have examined the association between weight and psychiatric disorders in psychiatric treatment samples, and no known studies in treatment samples have examined potential moderators of the psychiatric illness–weight relationship. The aim of the present study is to examine if weight is associated with specific mood and anxiety disorders in a psychiatric treatment-seeking sample, and if a person's sex moderate any of these associations. Greater knowledge of particular subgroups experiencing psychiatric illness–obesity comorbidity could aid in better providing personalized treatment.
Methods
Participants (N = 3,585) were administered a semi-structured diagnostic interview at initial presentation for treatment. Hierarchical logistic regression analyses examined simple effects of body mass index (BMI) and sex on current mood and anxiety disorders and the moderating effects of sex.
Results
We did not find simple effects between BMI and mood/anxiety disorders after controlling for demographic variables. Female sex moderated a relationship between BMI and social anxiety disorder (SAD) only.
Conclusions
Findings suggest that the presence of SAD in psychiatric patients is associated with a higher BMI only for females, yet this was not the case for the presence of other mood and anxiety disorders. Further research examining the relationship between SAD, weight, and sex is warranted.
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References
1.
OgdenCL, CarrollMD, CurtinLR, . Prevalence of overweight and obesity in the United States, 1999-2004. JAMA. 2006;295:1549–1555.
2.
FlegalKM, CarrollMD, KitBK, . Prevalence of obesity and trends in the distribution of body mass index among US adults, 1999-2010. JAMA. 2012;307:491–497.
3.
SteinCJ, ColditzGA.The epidemic of obesity. J Clin Endocrinol Metab. 2004;89:2522–2525.
4.
WangY, MiJ, ShanXY, . Is China facing an obesity epidemic and the consequences? The trends in obesity and chronic disease in China. Int J Obes (Lond). 2007;31:177–188.
5.
McTigueK, LarsonJC, ValoskiA, . Mortality and cardiac and vascular outcomes in extremely obese women. JAMA. 2006;296:79–86.
6.
MustA, JacquesPF, DallalGE, . Long-term morbidity and mortality of overweight adolescents. A follow-up of the Harvard Growth Study of 1922 to 1935. N Engl J Med.1992;327:1350–1355.
7.
GortmakerSL, MustA, PerrinJM, . Social and economic consequences of overweight in adolescence and young adulthood. N Engl J Med. 1993;329:1008–1012.
8.
McElroySL, KotwalR, MalhotraS, . Are mood disorders and obesity related? A review for the mental health professional. J Clin Psychiatry. 2004;65:634–651., quiz 730.
9.
de WitL, LuppinoF, van StratenA, . Depression and obesity: a meta-analysis of community-based studies. Psychiat Res. 2010;178:230–235.
10.
LuppinoFS, de WitLM, BouvyPF, . Overweight, obesity, and depression: a systematic review and meta-analysis of longitudinal studies. Arch Gen Psychiatry. 2010;67:220–229.
11.
GariepyG, NitkaD, SchmitzN.The association between obesity and anxiety disorders in the population: a systematic review and meta-analysis. Int J Obes (Lond). 2010;34:407–419.
12.
ScottKM, BruffaertsR, SimonGE, . Obesity and mental disorders in the general population: results from the world mental health surveys. Int J Obes (Lond). 2008;32:192–200.
13.
McCreaRL, BergerYG, KingMB.Body mass index and common mental disorders: exploring the shape of the association and its moderation by age, gender and education. Int J Obes (Lond). 2012;36:414–421.
14.
MatherAA, CoxBJ, EnnsMW, . Associations of obesity with psychiatric disorders and suicidal behaviors in a nationally representative sample. J Psychosom Res. 2009;66:277–285.
15.
FagioliniA, FrankE, HouckPR, . Prevalence of obesity and weight change during treatment in patients with bipolar I disorder. J Clin Psychiatry. 2002;63:528–533.
16.
FagioliniA, KupferDJ, HouckPR, . Obesity as a correlate of outcome in patients with bipolar I disorder. Am J Psychiatry. 2003;160:112–117.
17.
MarantoCL, StenoienAF.Weight discrimination: a multidisciplinary analysis. Employee Responsibilities and Rights Journal. 2000;12:9–24.
18.
ChenEY, BrownM.Obesity stigma in sexual relationships. Obes Res. 2005;13:1393–1397.
19.
BarryD, PietrzakRH, PetryNM.Gender differences in associations between body mass index and DSM-IV mood and anxiety disorders: results from the National Epidemiologic Survey on Alcohol and Related Conditions. Ann Epidemiol. 2008;18:458–466.
20.
FirstMB, SpitzerRL, WilliamsJBW, . Structured Clinical Interview for DSM-IV Axis Disorders I.New York, NY: Biometrics Research Department; 1996.
21.
KuczmarskiMF, KuczmarskiRJ, NajjarM.Effects of age on validity of self-reported height, weight, and body mass index: findings from the Third National Health and Nutrition Examination Survey, 1988-1994. J Am Diet Assoc. 2001;101:28–34.; quiz 35-36.
22.
NiedhammerI, BugelI, BonenfantS, . Validity of self-reported weight and height in the French GAZEL cohort. Int J Obesity Rel Metab Disord. 2000;24:1111–1118.
23.
SimonGE, LudmanEJ, LindeJA, . Association between obesity and depression in middle-aged women. Gen Hosp Psychiatry. 2008;30:32–39.
24.
ZimmermanM, MattiaJI.Psychiatric diagnosis in clinical practice: is comorbidity being missed? Compr Psychiatry. 1999;40:182–191.
25.
WhismanMA, McClelland DesigningGH., testing, and interpreting interactions and moderator effects in family research. J Fam Psychol.2005;19:111–120.
World Health Organization Executive Committee on Physical Status. Physical status: the use and interpretation of anthropometry. Geneva, Switzerland: WHO; 1995.
28.
EatonNR, KeyesKM, KruegerRF, . An invariant dimensional liability model of gender differences in mental disorder prevalence: evidence from a national sample. J Abnorm Psychol. 2012;121:282–288.
29.
KatzelnickDJ, KobakKA, DeLeireT, . Impact of generalized social anxiety disorder in managed care. Am J Psychiatry. 2001;158:1999–2007.
30.
RuscioAM, BrownTA, ChiuW T, . Social fears and social phobia in the USA: results from the National Comorbidity Survey Replication. Psychol Med. 2008;38:15–28.
31.
DalrympleKL, GalioneJ, HraboskyJ, . Diagnosing social anxiety disorder in the presence of obesity: implications for a proposed change in DSM-5. Depress Anxiety. 2011;28:377–382.
32.
de WitLM, FokkemaM, van StratenA, . Depressive and anxiety disorders and the association with obesity, physical, and social activities. Depress Anxiety. 2010;27:1057–1065.
33.
PuhlRM, HeuerCA.The stigma of obesity: a review and update. Obesity (Silver Spring). 2009;17:941–964.
34.
FriedmanKE, ReichmannSK, CostanzoPR, . Weight stigmatization and ideological beliefs: relation to psychological functioning in obese adults. Obes Res. 2005;13:907–916.
35.
GavinAR, SimonGE, LudmanEJ.The association between obesity, depression, and educational attainment in women: the mediating role of body image dissatisfaction. J Psychosom Res. 2010;69:573–581.
36.
SahingözM, UguzF, GezgincK, . Axis I and Axis II diagnoses in women with PCOS. Gen Hosp Psychiatry. 2013;35:508–511.
37.
DemyttenaereK, JaspersL.Review: bupropion and SSRI-induced side effects. J Psychopharmacol. 2008;22:792–804.
38.
FavaM, JudgeR, HoogSL, . Fluoxetine versus sertraline and paroxetine in major depressive disorder: changes in weight with long-term treatment. J Clin Psychiatry. 2000;61:863–867.
39.
van der LindenGJ, SteinDJ, van BalkomAJ.The efficacy of the selective serotonin reuptake inhibitors for social anxiety disorder (social phobia): a meta-analysis of randomized controlled trials. Int Clin Psychopharmacol. 2000;(suppl 2):S15–S23.
40.
ComerJS, MojtabaiR, OlfsonM.National trends in the antipsychotic treatment of psychiatric outpatients with anxiety disorders. Am J Psychiatry. 2011;168:1057–1065.
41.
HungCI, LiuCY, HsiaoMC, . Metabolic syndrome among psychiatric outpatients with mood and anxiety disorders. BMC Psychiatry. 2014;14:185.
42.
SmitsJA, RosenfieldD, MatherAA, . Psychotropic medication use mediates the relationship between mood and anxiety disorders and obesity: findings from a nationally representative sample. J Psychiatr Res. 2010;44:1010–1016.
43.
KalarchianMA, MarcusMD, LevineMD, . Psychiatric disorders among bariatric surgery candidates: relationship to obesity and functional health status. Am J Psychiatry. 2007;164:328–334.; quiz 374.
44.
ButlerAC, ChapmanJE, FormanEM, . The empirical status of cognitive-behavioral therapy: a review of meta-analyses. Clin Psychol Rev. 2006;26:17–31.
45.
HofmannSG, AsnaaniA, VonkIJ, . The efficacy of cognitive behavioral therapy: a review of meta-analyses. Cognitive Ther Res. 2012;36:427–440.
46.
OlatunjiBO, CislerJM, DeaconBJ.Efficacy of cognitive behavioral therapy for anxiety disorders: a review of meta-analytic findings. Psychiatr Clin North Am. 2010;33:557–577.
47.
CooperZ, FairburnCG, HawkerDM.Cognitive-behavioural treatment of obesity: a clinician's guide. New York, NY: Guilford Press; 2003.
48.
CresciB, TesiF, La FerlitaT, . Group versus individual cognitive-behavioral treatment for obesity: results after 36 months. Eat Weight Disord. 2007; 12:147–153.
49.
MelchiondaN, BesteghiL, Di DomizioS, . Cognitive behavioural therapy for obesity: one-year follow-up in a clinical setting. Eat Weight Disord. 2003;8:188–193.
