TitleAssociation of metabolically healthy obesity with depressive symptoms: pooled analysis of eight studies.
Publication TypeJournal Article
Year of Publication2014
AuthorsJokela, M, Hamer, M, Singh-Manoux, A, Batty, GD, Kivimäki, M
JournalMol Psychiatry
Date Published2014 Aug
KeywordsAdolescent, Adult, Age Distribution, Aged, Aged, 80 and over, Blood Pressure, Body Mass Index, C-Reactive Protein, Cross-Sectional Studies, Depression, Female, Glycated Hemoglobin A, Health Status, Humans, Lipids, Male, Middle Aged, Obesity, Psychiatric Status Rating Scales, Risk Factors, Young Adult

The hypothesis of metabolically healthy obesity posits that adverse health effects of obesity are largely avoided when obesity is accompanied by a favorable metabolic profile. We tested this hypothesis with depressive symptoms as the outcome using cross-sectional data on obesity, metabolic health and depressive symptoms. Data were extracted from eight studies and pooled for individual-participant meta-analysis with 30,337 men and women aged 15-105 years (mean age=46.1). Clinic measures included height, weight and metabolic risk factors (high blood pressure, high triglycerides, low high-density lipoprotein cholesterol, high C-reactive protein and high glycated hemoglobin). Depressive symptoms were assessed using clinical interview or standardized rating scales. The pooled sample comprised 7673 (25%) obese participants (body mass index ⩾30 kg m(-2)). Compared to all non-obese individuals, the OR for depressive symptoms was higher in metabolically unhealthy obese individuals with two or more metabolic risk factors (1.45; 95% confidence interval (CI)=1.30, 1.61) and for metabolically healthy obese with ⩽1 metabolic risk factor (1.19; 95% CI=1.03, 1.37), adjusted for sex, age and race/ethnicity. Metabolically unhealthy obesity was associated with higher depression risk (OR=1.23; 95% CI=1.05, 1.45) compared with metabolically healthy obesity. These associations were consistent across studies with no evidence for heterogeneity in estimates (all I(2)-values<4%). In conclusion, obese persons with a favorable metabolic profile have a slightly increased risk of depressive symptoms compared with non-obese, but the risk is greater when obesity is combined with an adverse metabolic profile. These findings suggest that metabolically healthy obesity is not a completely benign condition in relation to depression risk.

Alternate JournalMol. Psychiatry
PubMed ID24296976
PubMed Central IDPMC4921125
Grant ListRE/10/005/28296 / / British Heart Foundation / United Kingdom
R01 HL036310 / HL / NHLBI NIH HHS / United States
K013351 / / Medical Research Council / United Kingdom
R01 AG034454 / AG / NIA NIH HHS / United States
MR/K013351/1 / / Medical Research Council / United Kingdom
/ / Wellcome Trust / United Kingdom
R01AG034454 / AG / NIA NIH HHS / United States
R01HL036310 / HL / NHLBI NIH HHS / United States