Depression Improves With Weight Loss
posted 10/30/03
Severe obesity is associated with a high risk for depression, especially those with diabetes and among young women with poor body image. However, depression improves with loss of weight.
Dr. John B. Dixon and colleagues from Monash University, in Melbourne, Australia, note that the association between depression and severe obesity is unclear. In a study reported in the September 22nd issue of the Archives of Internal Medicine, they examined depression before and after gastric-restrictive weight loss surgery.
The researchers report that 487 consecutive patients completed Beck Depression Inventory (BDI) questionnaires before and at yearly intervals after surgery, to follow changes with time. The team used paired preoperative and 1-year postoperative scores from 262 patients to identify predictors of change in BDI scores.
The mean preoperative BDI score for the 487 patients was 17.7. Younger age, female sex, a history of depression, poor physical function, and poor body image were independently associated with higher depression scores.
"Body mass index, weight, waist, hip, and neck circumference, and waist-hip ratio did not predict higher BDI scores," Dr. Dixon and colleagues found. Also, fasting plasma glucose and insulin levels and calculated insulin resistance index were not predictive of BDI scores.
The investigators observed an association between weight loss and a significant and sustained fall in BDI scores. The mean scores at 1 and 4 years after surgery were 7.8 and 9.6, respectively.
Female sex, younger age, a greater percentage of excess weight loss, and a poorer preoperative appearance evaluation were independently associated with greater falls in BDI score at 1 year. There was a significant correlation between fall in BDI score and improved appearance evaluation (p < 0.001).
Dr. Dixon and colleagues conclude that the findings support the notion of depression as a comorbidity of obesity, and that those most affected by depression derive the greatest mental health benefit from bariatric procedures.
posted 10/30/03
Severe obesity is associated with a high risk for depression, especially those with diabetes and among young women with poor body image. However, depression improves with loss of weight.
Dr. John B. Dixon and colleagues from Monash University, in Melbourne, Australia, note that the association between depression and severe obesity is unclear. In a study reported in the September 22nd issue of the Archives of Internal Medicine, they examined depression before and after gastric-restrictive weight loss surgery.
The researchers report that 487 consecutive patients completed Beck Depression Inventory (BDI) questionnaires before and at yearly intervals after surgery, to follow changes with time. The team used paired preoperative and 1-year postoperative scores from 262 patients to identify predictors of change in BDI scores.
The mean preoperative BDI score for the 487 patients was 17.7. Younger age, female sex, a history of depression, poor physical function, and poor body image were independently associated with higher depression scores.
"Body mass index, weight, waist, hip, and neck circumference, and waist-hip ratio did not predict higher BDI scores," Dr. Dixon and colleagues found. Also, fasting plasma glucose and insulin levels and calculated insulin resistance index were not predictive of BDI scores.
The investigators observed an association between weight loss and a significant and sustained fall in BDI scores. The mean scores at 1 and 4 years after surgery were 7.8 and 9.6, respectively.
Female sex, younger age, a greater percentage of excess weight loss, and a poorer preoperative appearance evaluation were independently associated with greater falls in BDI score at 1 year. There was a significant correlation between fall in BDI score and improved appearance evaluation (p < 0.001).
Dr. Dixon and colleagues conclude that the findings support the notion of depression as a comorbidity of obesity, and that those most affected by depression derive the greatest mental health benefit from bariatric procedures.
Source: Diabetes In Control.com: Arch Intern Med 2003;163:2058-2065.
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