Abstract
OBJECTIVE: The purpose of this paper is to reexamine the association between major depression and obesity in adolescents, testing the hypothesis that body image mediates this association. This is the first paper to examine this question using DSM-IV diagnosis of depression and data from a two-wave cohort of adolescents. METHODS: Participants were 4175 youths 11-17 years of age sampled from the community who were followed up a year later (n=3134). Major depression was assessed using DSM-IV diagnostic criteria. Body image was measured with perceived weight. Obesity was defined as BMI ≥95th percentile using measured height and weight. RESULTS: When we examined a model which included obesity, perceived weight, major depression and covariates, there was no association between major depression at baseline and obesity at follow-up. We found no independent association between major depression and body weight. LIMITATIONS: The study was limited in that it is not a national sample, BMI was the only measure of adiposity, perceived weight was the only measure of body image, and there were no data on lifetime trajectories of depression, obesity, or body image. CONCLUSIONS: If there is an etiologic link between major depression and body weight among adolescents, it most likely operates through processes involving components of body image, since controlling for body image eliminated the association between depression and obesity. Clinically, addressing body image in depressed patients who are obese may improve outcomes.