Journal
JOURNAL OF AFFECTIVE DISORDERS
Volume 245, Issue -, Pages 145-151Publisher
ELSEVIER SCIENCE BV
DOI: 10.1016/j.jad.2018.10.116
Keywords
OCD; Obesity; Overweight; BMI; Depression; Comorbidity
Categories
Funding
- Netherlands Organisation for Health Research and Development (ZonMw) [10-000-1002]
- VU University Medical Center
- GGZ inGeest
- Leiden University Medical Center
- Leiden University
- GGZ Rivierduinen
- University Medical Center Groningen
- University of Groningen
- Lentis
- GGZ Friesland
- GGZ Drenthe
- Rob Giel Onderzoekscentrum
- Academic Department of Psychiatry, VU Medical Centre/GGZ inGeest, Amsterdam, the Netherlands
- Marina de Wolf Centre for Anxiety Research, Ermelo
- Centre for Anxiety Disorders Overwaal, Lent
- Dimence, GGZ Overijssel
- Department of Psychiatry, Leiden University Medical Centre, Leiden
- Mental Health Care Centre Noord-en Midden-Limburg, Venray
- Academic Anxiety Centre, PsyQ Maastricht, Maastricht University, Division Mental Health and Neuroscience
- Stichting Steun
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Background: : Psychiatric disorders are associated with overweight/obesity. Obsessive-compulsive disorder (OCD) may be an exception, as anecdotal evidence suggests lower BMI in OCD. Additionally, depression is associated with elevated BMI, but effects of comorbid secondary depression are unknown. The aim of the present study was to assess BMI and risk for overweight/obesity in OCD and to assess the effect of comorbid depression on BMI. Methods: : BMI, demographics, and clinical status were assessed in large samples of individuals with OCD, anxiety disorders, depressive disorders, comorbid anxiety/depressive disorders, and non-clinical controls (NCC). Results: : Although no initial differences were found between the samples on BMI, the non-depressed OCD subsample had significantly lower BMI and risk for overweight/obesity compared to all other clinical samples. NCC were nearly twice as likely to be overweight compared to non-depressed OCD. Limitations: : Eating disorders were excluded in the OCD sample, but BMI < 17 was used as an exclusion criterion in the clinical control groups in lieu of screening for Anorexia. Group differences on demographics were controlled for. Recruitment methodology differed between samples. Conclusions: : OCD is associated with significantly lower rates of obesity and overweight, but this relationship was not found when comorbid depression was present. This suggests that the purer the phenotype of OCD, the more substantial protective factor against overweight/obesity emerges compared to other clinical samples and NCC. An OCD-specific reward/anhedonia model, previously offered to elucidate lower smoking rates in OCD, may account for lower BMI in OCD. These results warrant careful clinical attention to the negative impact of comorbid depression on OCD that spans from increasing risk for obesity and cigarette smoking, to hindering treatment response.
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