Common mental disorder and obesity: insight from four repeat measures over 19 years: prospective Whitehall II cohort study

doi:10.1136/bmj.b3765

Published 6 October 2009, doi:10.1136/bmj.b3765
Cite this as: BMJ 2009;339:b3765

Research

Common mental disorder and obesity: insight from four repeat measures over 19 years: prospective Whitehall II cohort study

Mika Kivimäki, professor of social epidemiology¹^,2, Debbie A Lawlor, professor of epidemiology³, Archana Singh-Manoux, senior research fellow¹^,4, G David Batty, Wellcome Trust fellow⁵^,6^,7, Jane E Ferrie, senior research fellow¹, Martin J Shipley, senior lecturer in medical statistics¹, Hermann Nabi, research fellow⁴, Séverine Sabia, research fellow⁴, Michael G Marmot, head of department and director¹, Markus Jokela, senior research fellow¹^,2

¹ Department of Epidemiology and Public Health, University College London, London WC1E 6BT, ² Finnish Institute of Occupational Health, Helsinki, Finland, ³ MRC Centre for Causal Analyses in Translational Epidemiology, University of Bristol, Bristol, ⁴ INSERM U687-IFR69, Hôpital Paul Brousse, Villejuif Cedex, France, ⁵ MRC Social and Public Health Sciences Unit, University of Glasgow, Glasgow, ⁶ Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, ⁷ The George Institute for International Health, University of Sydney, Sydney, Australia

Correspondence to: M Kivimäki m.kivimaki{at}ucl.ac.uk

Objectives To examine potential reciprocal associations betweencommon mental disorders and obesity, and to assess whether dose-responserelations exist.

Design Prospective cohort study with four measures of commonmental disorders and obesity over 19 years (Whitehall II study).

Setting Civil service departments in London.

Participants 4363 adults (28% female, mean age 44 years at baseline).

Main outcome Common mental disorder defined as general healthquestionnaire "caseness;" overweight and obesity based on WordHealth Organization definitions.

Results In models adjusted for age, sex, and body mass indexat baseline, odds ratios for obesity at the fourth screeningwere 1.33 (95% confidence interval 1.00 to 1.77), 1.64 (1.13to 2.36), and 2.01 (1.21 to 3.34) for participants with commonmental disorder at one, two, or three preceding screenings comparedwith people free from common mental disorder (P for trend<0.001).The corresponding mean differences in body mass index at themost recent screening were 0.20, 0.31, and 0.50 (P for trend<0.001).These associations remained after adjustment for baseline characteristicsrelated to mental health and exclusion of participants who wereobese at baseline. In addition, obesity predicted future riskof common mental disorder, again with evidence of a dose-responserelation (P for trend=0.02, multivariable model). However, thisassociation was lost when people with common mental disorderat baseline were excluded (P for trend=0.33).

Conclusions These findings suggest that in British adults thedirection of association between common mental disorders andobesity is from common mental disorder to increased future riskof obesity. This association is cumulative such that peoplewith chronic or repeat episodes of common mental disorder areparticularly at risk of weight gain.

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: http://creativecommons.org/licenses/by-nc/2.0/ and http://creativecommons.org/licenses/by-nc/2.0/legalcode.

Add to CiteULike CiteULike Add to Complore Complore Add to Connotea Connotea Add to Del.icio.us Del.icio.us Add to Digg Digg Add to Reddit Reddit Add to StumbleUpon StumbleUpon Add to Technorati Technorati Twitter What's this?

Relevant Articles

Obesity and depression or anxiety: Evan Atlantis, Robert D Goldney, and Gary A Wittert
BMJ 2009 339: b3868. [Extract] [Full Text]

On the Treatment of the Local Irritation Caused by Contact with Certain Species of Acalephæ: Edward Headlam Greenhow
Br Med J 1861 1: 7. [PDF]

This article has been cited by other articles:

(2009). Common Mental Disorder Elevates Risk for Subsequent Obesity. JWatch General 2009: 3-3 [Full text]
Atlantis, E., Goldney, R. D, Wittert, G. A (2009). Obesity and depression or anxiety. BMJ 339: b3868-b3868 [Full text]

Rapid Responses:

Read all Rapid Responses

Overweight and mental health: a complex relationship.: Isabelle Ellen Pitrou, et al.
bmj.com, 8 Oct 2009 [Full text]
The direction of association between mental disorders and obesity: some challenges in interpreting results: Norbert Schmitz, et al.
bmj.com, 14 Oct 2009 [Full text]
Comments from a Public Health perspective: Dr. J. N. Ramlackhansingh, et al.
bmj.com, 5 Nov 2009 [Full text]
Direction of causality between common mental disorders and obesity: Authors' response: Mika Kivimaki, et al.
bmj.com, 1 Dec 2009 [Full text]
Nutrition and physical exercise are necessary but not sufficient for preventing obesity: Cristina Fortes, et al.
bmj.com, 13 Jan 2010 [Full text]