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Association between common mental disorder and obesity over the adult life course

  • Mika Kivimäki (a1), G. David Batty (a2), Archana Singh-Manoux (a3), Hermann Nabi (a4), Séverine Sabia (a4), Adam G. Tabak (a5), Tasnime N. Akbaraly (a6), Jussi Vahtera (a7), Michael G. Marmot (a6) and Markus Jokela (a6)...



Prospective data on the association between common mental disorders and obesity are scarce, and the impact of ageing on this association is poorly understood.


To examine the association between common mental disorders and obesity (body mass index 30 kg/m2) across the adult life course.


The participants, 6820 men and 3346 women, aged 35–55 were screened four times during a 19-year follow-up (the Whitehall II study). Each screening included measurements of mental disorders (the General Health Questionnaire), weight and height.


The excess risk of obesity in the presence of mental disorders increased with age (P = 0.004). The estimated proportion of people who were obese was 5.7% at age 40 both in the presence and absence of mental disorders, but the corresponding figures were 34.6% and 27.1% at age 70. The excess risk did not vary by gender or according to ethnic group or socioeconomic position.


The association between common mental disorders and obesity becomes stronger at older ages.

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Corresponding author

Mika Kivimäki, Department of Epidemiology and Public Health, University College London, 1–19 Torrington Place, WC1E 6BT London, UK. Email:


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The Whitehall II study has been supported by grants from the Medical Research Council; British Heart Foundation; Health and Safety Executive; Department of Health; National Heart Lung and Blood Institute (HL36310), US, NIH: National Institute on Aging (AG13196), US, NIH; Agency for Health Care Policy Research (HS06516); and the John D and Catherine T MacArthur Foundation Research Networks on Successful Midlife Development and Socioeconomic Status and Health. M.K. and J.V. are supported by the Academy of Finland (Projects no. 117604, 124322); G.D.B. is a Wellcome Trust Research Fellow; A.S.-M. is supported by a ‘EURYI’ award from the European Science Foundation; and M.G.M. is supported by a MRC Research Professorship.

Declaration of interest




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Association between common mental disorder and obesity over the adult life course

  • Mika Kivimäki (a1), G. David Batty (a2), Archana Singh-Manoux (a3), Hermann Nabi (a4), Séverine Sabia (a4), Adam G. Tabak (a5), Tasnime N. Akbaraly (a6), Jussi Vahtera (a7), Michael G. Marmot (a6) and Markus Jokela (a6)...
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What about effect of obesity on mental health; chicken or the egg?

Maheshi Wikramanayake, CT3
02 September 2009

I was very interested to read the paper by M. Kivimaki et al (BJP 195, 149-155) which dealt with association between mental health illness and prevalence of obesity. This article linked Mental illness and obesity and established an association with progressing age but not causality of obesity.

Being someone who has recently struggled with obesity and have now over come obesity, I am more aware of the feeling associated with being obese such as low self esteem, anxiety and low mood. We are more aware of the importance of control weight and monitoring physical health of psychiatric patients which has also been highlighted by the governing health bodies frequently over recent years and has resulted in several initiatives being implemented throughout the UK.

The department of health statistics illustrates the magnitude of the weight problems in the UK: 1 in 4 adults in England are obese, and this ispredicted to increase to 9 in 10 by 2050 if current patterns continue. At present obesity is estimated to cost the NHS £4.2 billion yearly and widercost to the community is estimated to be £16 billion.With the increasing problem of obesity in the general population especially in children and young adults, a lot of emphasis has been placedon the physical consequences of obesity, but the impact on mental health and the potential impact on an already stretched mental health service does not appear to be as great a concern at present.

It was interesting to find that there was limited literature available on the association between obesity and risk of mental health disorders. Obesity has been shown to be associated with a 25% increase in odds of mood and anxiety disorders1. Surveys in the US and Canada have found an association between obesity and depressive symptoms 2, especially in womenand a negative or no association in men3. There have also been surveys that show a strong association between obesity and depression in those under 65 years3.

Long term studies have shown that weight loss is associated with decreased risk of depression4. Depression also predicts a greater difficulty in losing weight5.The above facts serve to illustrate the potential impacts that obesity canhave on the development of mental health problems in the general population and thus highlights the need to continue to implement strategies to address this rapidly growing problem and prevent the likely great increase of mental health illness in particular mood and anxiety disorders.

As mental health professionals, we have to be concerned with the management of weight in the primary health setting and elsewhere to prevent the onset of mental illness, as well as continuing to monitor and manage the effects of mental health illness and medications on physical well being of those with mental health problems.


1.Simon GE, et al Association between Obesity and Psychiatric disorders in the US adult population, Arch Gen Psychiatry.2006 July; 63(7): 824-830

2.Johnston E, et al The relation of body mass index to depressive symptoms, Can J Public Health. 2004;95: 179-83.

3.Heo M, et al Depressive mood and obesity in US adults: comparison and moderation by sex, age and race, Into J Obes.2005.

4.Dixon J, et al Depression in Association With Severe Obesity :Changes With Weight Loss, Arch Intern Med. 2003;163:2058-2065.

5.McGuire M, et al What predicts weight regain in a group of successful weight losers. J Consult Clin Psychol 1999; 67: 177-85
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