This study investigates whether the association between obesity and depression is mediated by the perception of body weight and verifies the combined effect of being obese and having a self-perception of being fat on depression in a population-based sample of 1238 individuals. Weight perception mediated the association between depression and obesity in 39.3 percent of participants. In stratified analysis, mediation occurred in the following groups: non-single, those with more schooling, non-alcohol abusers, non-smokers, and those who did not engage in physical activity. Being obese and having a self-perception of being fat produced a potentiating effect, significantly increasing the likelihood of depression.
American Psychiatric Association (2013) Diagnostic and Statistical Manual of Mental Disorders (DSM-5) (5th edn). Arlington, TX: American Psychiatric Association.
2.
Center for Disease Control and Prevention (2011) Mental illness surveillance among adults in the United States. Morbidity and Mortality Weekly Report60(3): 1–32.
3.
DalyMRobinsonESutinAR (2017) Does knowing hurt? Perceiving oneself as overweight predicts future physical health and well-being. Psychological Science28(7): 872–881.
4.
DumithSCPaulitschRGCarpenaMX, et al. (2018) Planning and execution of a population health survey by means of a multidisciplinary research consortium. Scientia Medica28(3): 30407.
5.
EidsdottirSTKristjanssonALSigfusdottirID, et al. (2014) Association between higher BMI and depressive symptoms in Icelandic adolescents: The mediational function of body image. European Journal of Public Health24(6): 888–892.
6.
Flores-CornejoFKamego-TomeMZapata-PachasMA, et al. (2017) Association between body image dissatisfaction and depressive symptoms in adolescents. Revista Brasileira de Psiquiatria39(4): 316–322.
7.
FonsecaMJFaersteinEChorD, et al. (2004) Validity of self-reported weight and height and the body mass index within the “Pro-saude” study. Revista Saude Publica38(3): 392–398.
8.
FriedmanKEReichmannSKCostanzoPR, et al. (2002) Body image partially mediates the relationship between obesity and psychological distress. Obesity Research10(1): 33–41.
9.
GaskinJLPulverAJBranchK, et al. (2013) Perception or reality of body weight: Which matters to the depressive symptoms. Journal of Affective Disorders150(2): 350–355.
10.
GavinARSimonGELudmanEJ (2010) The association between obesity, depression, and educational attainment in women: The mediating role of body image dissatisfaction. Journal of Psychosomatic Research69(6): 573–581.
11.
GorberSCTremblayMMoherD, et al. (2007) A comparison of direct vs. self-report measures for assessing height, weight and body mass index: A systematic review. Obesity Reviews8(4): 307–326.
12.
Instituto Brasileiro de Geografia e Estatística (2011) Censo Demográfico 2010. Rio de Janeiro, Brazil: Instituto Brasileiro de Geografia e Estatística.
13.
JacksonKLJanssenIAppelhansBM, et al. (2014) Body image satisfaction and depression in midlife women: The Study of Women’s Health Across the Nation (SWAN). Archives of Women’s Mental Health17(3): 177–187.
14.
JungSJWooHTChoS, et al. (2017) Association between body size, weight change and depression: Systematic review and meta-analysis. British Journal of Psychiatry211(1): 14–21.
15.
KarlsonKBHolmABreenR (2012) Comparing regression coefficients between same-sample nested models using logit and probit: A new method. Sociological Methodology42: 286–313.
16.
KimDSKimHSChoY, et al. (2008) The effects of actual and perceived body weight on unhealthy weight control behaviors and depressed mood among adult women in Seoul, Korea. Journal of Preventive Medicine and Public Health41(5): 323–330.
17.
KohlerUKarlsonKBHolmA (2011) Comparing coefficients of nested nonlinear probability models. The Stata Journal11(3): 420–438.
18.
McLarenLKuhD (2004) Women’s body dissatisfaction, social class, and social mobility. Social Science and Medicine58(9): 1575–1584.
19.
MarkowitzSFriedmanMAArentSM (2008) Understanding the relation between obesity and depression: Causal mechanisms and implications for treatment. Clinical Psychology: Science and Practice15(1): 1–20.
20.
MunhozTNNunesBPWehrmeisterFC, et al. (2016) A nationwide population-based study of depression in Brazil. Journal of Affective Disorders192: 226–233.
21.
MurphyJMHortonNJBurkeJD, et al. (2009) Obesity and weight gain in relation to depression: Findings from the Stirling County Study. International Journal of Obesity33(3): 335–341.
22.
Pereira-MirandaECostaPRFQueirozVAO, et al. (2017) Overweight and obesity associated with higher depression prevalence in adults: A systematic review and meta-analysis. Journal of the American College of Nutrition36(3): 223–233.
23.
PreissKBrennanLClarkeD (2013) A systematic review of variables associated with the relationship between obesity and depression. Obesity Reviews14(11): 906–918.
24.
PuhlRMHeuerCA (2009) The stigma of obesity: A review and update. Obesity17(5): 941–964.
25.
RajanTMMenonV (2017) Psychiatric disorders and obesity: A review of association studies. Journal of Postgraduate Medicine63(3): 182–190.
26.
RobertsREDuongHT (2013) Perceived weight, not obesity, increases risk for major depression among adolescents. Journal of Psychiatric Research47(8): 1110–1117.
27.
RobinsonESutinADalyM (2017) Perceived weight discrimination mediates the prospective relation between obesity and depressive symptoms in U.S. and U.K. Adults36(2): 112–121.
28.
SantosISTavaresBFMunhozTN, et al. (2013) Sensitivity and specificity of the Patient Health Questionnaire-9 (PHQ-9) among adults from the general population. Cadernos de Saúde Pública29(8): 1533–1543.
29.
SimonGEVon KorffMSaundersK, et al. (2006) Association between obesity and psychiatric disorders in the US adult population. Archives of General Psychiatry63(7): 824–830.
30.
Ter BogtTFMvan DorsselaerSAFMMonshouwerK, et al. (2006) Body mass index and body weight perception as risk factors for internalizing and externalizing problem behavior among adolescents. Journal of Adolescent Health39(1): 27–34.
31.
World Health Organization (2004) Obesity: Preventing and Managing the Global Epidemic. Report of a WHO Consultation. Geneva: World Health Organization.
32.
World Health Organization (2017) World Health Organization Report—Depression and Other Common Mental Disorders: Global Health Estimates. Geneva: World Health Organization.
33.
World Health Organization (2018) Noncommunicable Diseases Country Profiles 2018. Geneva: World Health Organization.
34.
XieBUngerJBGallaherP, et al. (2010) Overweight, body image, and depression in Asian and Hispanic adolescents. American Journal Health Behavior34(4): 476–488.
