Association between body size, weight change and depression: systematic review and meta-analysis

Background The association between body size, weight change and depression has not been systematically summarised, especially for individuals who are underweight. Aims To conduct a systematic review and a meta-analysis to examine the association between indices of body size, weight change and depression. Method A total of 183 studies were selected. Fully adjusted hazard ratios (HRs) or odds ratios (ORs) were extracted. A total of 76 studies contributed to data synthesis with a random-effect model, and subgroup analyses were conducted to evaluate the effect of potential moderators. Results In cohort studies, underweight at baseline increased the risk of subsequent depression (OR = 1.16, 95% Cl 1.08-1.24). Overweight (BMI 25-29.9 kg/m(2)) showed no statistically significant relationship with depression overall; however, the subgroup analyses found different results according to gender (men: OR = 0.84, 95% Cl 0.72-0.97, women: OR = 1.16, 95% Cl 1.07-1.25). In cross-sectional designs, obesity with BMI >40 kg/m(2) showed a greater pooled odds ratio than obesity with BMI >30 kg/m(2). Conclusions Both underweight and obesity increase the risk of depression. The association between overweight and depression differs by gender.