Association of depression and anxiety disorders with weight change in a prospective community-based study of children followed up into adulthood

Objective: To investigate childhood to adulthood weight change associated with anxiety and depression. Design: The Children in the Community Study. A prospective longitudinal investigation. Setting: Albany and Saratoga Counties, New York. Participants: Eight hundred twenty individuals (403 females and 417 males) assessed at 4 time points: in 1983 when they were 9 to 18 years old (n = 776), in 1985 to 1986 when they were 11 to 22 years old (n = 775), in 1991 to 1994 when they were 17 to 28 years old (n = 776), and in 2001 to 2003 when they were 28 to 40 years old (n = 661). Main Exposures: Anxiety disorders and depression assessed by structured diagnostic interview. Main Outcome Measures: Centers for Disease Control and Prevention body mass index z score (BMIz), a measure of weight status; and association of anxiety and depression with BMIz level and annual change. Results: In females, anxiety disorders were associated with higher weight status, a BMIz of 0.13 (95% confidence interval, 0.01-0.25) units higher compared with females without anxiety disorders. Female depression was associated with a gain in BMIz of 0.09 units/y (95% confidence interval, 0.03-0.15 units/y), modified by the age when depression was first observed, such that early depression onset was associated with a higher subsequent BMIz than depression onset at older ages. In males, childhood depression was associated with a lower BMIz (-0.46; 95% confidence interval, -0.93 to 0.02 units lower at the age of 9 years), but BMIz trajectories for males with or without depression converged in adulthood; male anxiety disorders were not substantively associated with weight status. Conclusions: Anxiety disorders and depression were associated with a higher BMIz in females, whereas these disorders in males were not associated with a higher BMIz. These results, if causal and confirmed in other prospective studies, support treating female anxiety and depression as part of comprehensive obesity prevention efforts.