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BMC Psychiatry. 2011; 11: 130.
Published online Aug 11, 2011. doi:  10.1186/1471-244X-11-130
PMCID: PMC3163524
Waist circumference, abdominal obesity, and depression among overweight and obese U.S. adults: national health and nutrition examination survey 2005-2006
Guixiang Zhao,corresponding author1 Earl S Ford,1 Chaoyang Li,2 James Tsai,1 Satvinder Dhingra,2 and Lina S Balluz2
1Division of Adult and Community Health, National Center for Chronic Disease Prevention and Health Promotion, Atlanta, GA 30341, USA
2Division of Behavioral Surveillance, Public Health Surveillance Program Office, Office of Surveillance, Epidemiology and Laboratory Services, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA
corresponding authorCorresponding author.
Guixiang Zhao: fwj4/at/cdc.gov; Earl S Ford: esf2/at/cdc.gov; Chaoyang Li: cli/at/cdc.gov; James Tsai: jxt9/at/cdc.gov; Satvinder Dhingra: SDhingra/at/cdc.gov; Lina S Balluz: LBalluz/at/cdc.gov
Received October 20, 2010; Accepted August 11, 2011.
Abstract
Background
Obesity is associated with an increased risk of mental illness; however, evidence linking body mass index (BMI)-a measure of overall obesity, to mental illness is inconsistent. The objective of this study was to examine the association of depressive symptoms with waist circumference or abdominal obesity among overweight and obese U.S. adults.
Methods
A cross-sectional, nationally representative sample from the 2005-2006 National Health and Nutrition Examination Survey was used. We analyzed the data from 2,439 U.S. adults (1,325 men and 1,114 nonpregnant women) aged ≥ 20 years who were either overweight or obese with BMI of ≥ 25.0 kg/m2. Abdominal obesity was defined as waist circumference of > 102 cm for men and > 88 cm for women. Depressive symptoms (defined as having major depressive symptoms or moderate-to-severe depressive symptoms) were assessed by the Patient Health Questionnaire-9 diagnostic algorithm. The prevalence and the odds ratios (ORs) with 95% confidence intervals (CIs) for having major depressive symptoms and moderate-to-severe depressive symptoms were estimated using logistic regression analysis.
Results
After multivariate adjustment for demographics and lifestyle factors, waist circumference was significantly associated with both major depressive symptoms (OR: 1.03, 95% CI: 1.01-1.05) and moderate-to-severe depressive symptoms (OR: 1.02, 95% CI: 1.01-1.04), and adults with abdominal obesity were significantly more likely to have major depressive symptoms (OR: 2.18, 95% CI: 1.35-3.59) or have moderate-to-severe depressive symptoms (OR: 2.56, 95% CI: 1.34-4.90) than those without. These relationships persisted after further adjusting for coexistence of multiple chronic conditions and persisted in participants who were overweight (BMI: 25.0-< 30.0 kg/m2) when stratified analyses were conducted by BMI status.
Conclusion
Among overweight and obese U.S. adults, waist circumference or abdominal obesity was significantly associated with increased likelihoods of having major depressive symptoms or moderate-to-severe depressive symptoms. Thus, mental health status should be monitored and evaluated in adults with abdominal obesity, particularly in those who are overweight.
Keywords: abdominal obesity, depressive symptoms, PHQ-9 diagnostic algorithm, waist circumference
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