Associations between Overall and Abdominal Obesity and Suicidal Ideation among US Adult Women

The Mental "Weight" of Discrimination: The Relationship between Perceived Interpersonal Weight Discrimination and Suicidality in the United States

Extant research has investigated the relationship between body weight and suicidality because obesity is highly stigmatized, leading to social marginalization and discrimination, yet has produced mixed results. Scholars have speculated that factors associated with body weight, such as weight discrimination, may better predict suicidality than body weight itself. We consider this possibility among a sample of 12,057 adult participants ages 33 to 43 in Wave V of the National Longitudinal Study of Adolescent to Adult Health through investigation of the relationships between weight discrimination and two dimensions of suicidality-suicide ideation and attempts. We also examine gender as a moderator of these relationships. We find that weight discrimination is positively associated with both suicide ideation and attempts, and this relationship is similar among men and women. Our findings underscore the need to address issues of weight discrimination in our society to better promote mental well-being.

The relationship between obesity and suicide ideation among young adults in the United States

The prevalence of both obesity and suicide ideation has risen in the last several decades among young adults in the United States (U.S.). Obesity is highly stigmatized in the U.S. and leads to discrimination and societal rejection, which suggests that obesity may increase the risk of suicide ideation. However, no U.S. population-representative studies to date have investigated the relationship between body weight and suicide ideation among young adults. We make this contribution by analyzing data from Wave III of the National Longitudinal Study of Adolescent to Adult Health (Add Health). Our results indicate obesity is not related to suicide ideation among young men or young women and overweight young men have lower odds of suicide ideation than normal weight young men. We speculate that these findings may be attributable to the very high U.S. overweight and obesity prevalence, which has made obesity more common despite stigmatization.

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First nationally representative study of young adults' weight and suicide ideation.

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Obesity is not associated with suicide ideation among U.S. young men and women.

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Overweight is associated with a lower risk of suicide ideation among young men.

Associations of Body Weight and Waist Circumference with Psychopathology, Substance Use, and Well-Being in an Adult Transdiagnostic Sample

BACKGROUND

Prior studies have established inconsistent associations between body weight and mental health. However, most work has relied on body mass index (BMI) and examination of a single mental health variable. The present study examined associations of BMI and waist circumference with multiple mental health variables in a transdiagnostic psychiatric sample.

METHODS

Nursing staff measured waist circumference and calculated the BMI of 742 adults (54.6% female, 45.4% male) presenting for psychiatric treatment. Participants completed the Patient Health Questionnaire (PHQ-9), Generalized Anxiety Disorder Scale (GAD-7), Behavior and Symptom Identification Scale (BASIS-24), and Mental Health Continuum-Short Form (MHC-SF) as part of standard clinical monitoring. Suicide risk was assessed using the clinician-administered Mini International Neuropsychiatric Interview (M.I.N.I.). For curve fit estimation regression models, we entered BMI and waist circumference as independent variables separately; we entered seven dependent variables separately: 1) depression, 2) anxiety, 3) substance use, 4) self-harm, 5) interpersonal functioning, 6) well-being, and 7) suicide risk.

RESULTS

Increased BMI was associated with decreased well-being and increased depression. Increased waist circumference was associated with worse interpersonal functioning. Non-linear (quadratic) associations were observed between weight and depression, substance use, self-harm, and suicide.

LIMITATIONS

Most of the sample was White and only 2.6% was in the underweight category, limiting broad applicability of findings. Cross-sectional design precludes causal attributions.

CONCLUSIONS

Given associations between well-being, depression, interpersonal functioning, substance use, self-harm, and suicide with weight, findings may be used to inform mental health treatment, particularly by tailoring interventions to high-risk weight categories (underweight, obese) in psychiatric populations.

Pregnancy-Related Weight and Postpartum Depressive Symptoms: Do the Relationships Differ by Race/Ethnicity?

Background: There are significant racial/ethnic disparities in the prevalence of postpartum depression. Prior research in the general population suggests that weight status is related to depression and that this relationship varies by race/ethnicity. However, few studies have investigated whether race/ethnicity moderates the relationship between pregnancy-related weight and postpartum depressive symptoms (PPDS). The objective of this study is to examine the relationship between pregnancy-related weight and maternal PPDS overall and by race/ethnicity. Materials and Methods: This study used data from the Early Childhood Longitudinal Study-Birth Cohort (n ≈ 6950). Ordinary least-squares and logistic regression was used to examine whether pregnancy-related weight, including preconception weight status and gestational weight gain (GWG), was associated with PPDS measured using the Center for Epidemiologic Studies-Depression Scale (CES-D). Stratified analyses were used to assess whether these relationships varied by race/ethnicity. Results: Preconception obesity (body mass index [BMI] ≥30 kg/m²) was associated with higher levels of PPDS (β = 0.601, 95% confidence interval [CI], 0.149-1.053). GWG adequacy was not associated with PPDS. Among non-Hispanic (NH) whites, preconception obesity was positively associated with PPDS (β = 1.016, 95% CI, 0.448-1.584). In contrast, among Hispanics, preconception overweight (25 kg/m² ≤ BMI <30 kg/m²) was associated with lower levels of PPDS (β = -0.887, 95% CI, -1.580 to -0.195). There were no statistically significant relationships between pregnancy-related weight and PPDS among NH black or Asian women, but both groups were significantly more likely than NH whites to report PPDS. Conclusion: Whether and how pregnancy-related weight is associated with PPDS varies by race/ethnicity. Addressing preconception weight could help reduce overall levels of PPDS among NH whites but would likely fail to mitigate racial/ethnic disparities in postpartum mental health.

Variation of all-cause and cause-specific mortality with body mass index in one million Swedish parent-son pairs: An instrumental variable analysis

BACKGROUND

High body mass index (BMI) is associated with mortality, but the pervasive problem of confounding and reverse causality in observational studies limits inference about the direction and magnitude of causal effects. We aimed to obtain estimates of the causal association of BMI with all-cause and cause-specific mortality.

METHODS AND FINDINGS

In a record-linked, intergenerational prospective study from the general population of Sweden, we used two-sample instrumental variable (IV) analysis with data from 996,898 fathers (282,407 deaths) and 1,013,083 mothers (153,043 deaths) and their sons followed up from January 1, 1961, until December 31, 2004. Sons' BMI was used as the instrument for parents' BMI to compute hazard ratios (HRs) for risk of mortality per standard deviation (SD) higher parents' BMI. Using offspring exposure as an instrument for parents' exposure is unlikely to be affected by reverse causality (an important source of bias in this context) and reduces confounding. IV analyses supported causal associations between higher BMI and greater risk of all-cause mortality (HR [95% confidence interval (CI)] per SD higher fathers' BMI: 1.29 [1.26-1.31] and mothers' BMI: 1.39 [1.35-1.42]) and overall cancer mortality (HR per SD higher fathers' BMI: 1.20 [1.16-1.24] and mothers' BMI: 1.29 [1.24-1.34]), including 9 site-specific cancers in men (bladder, colorectum, gallbladder, kidney, liver, lung, lymphatic system, pancreas, and stomach) and 11 site-specific cancers in women (gallbladder, kidney, liver, lung, lymphatic system, ovaries, pancreas, stomach, uterus, cervix, and endometrium). There was evidence supporting causal associations between higher BMI in mothers and greater risk of mortality from kidney disease (HR: 2.17 [1.68-2.81]) and lower risk of mortality from suicide (HR: 0.77 [0.65-0.90]). In both sexes, there was evidence supporting causal associations between higher BMI and mortality from cardiovascular diseases (CVDs), stroke, diabetes, and respiratory diseases. We were unable to test the association between sons' and mothers' BMIs (as mothers' data were unavailable) or whether the instrument was independent of unmeasured or residual confounding; however, the associations between parents' mortality and sons' BMI were negligibly influenced by adjustment for available confounders.

CONCLUSIONS

Consistent with previous large-scale meta-analyses and reviews, results supported the causal role of higher BMI in increasing the risk of several common causes of death, including cancers with increasing global incidence. We also found positive effects of BMI on mortality from respiratory disease, prostate cancer, and lung cancer, which has been inconsistently reported in the literature, suggesting that the causal role of higher BMI in mortality from these diseases may be underestimated. Furthermore, we expect different patterns of bias in the current observational and IV analyses; therefore, the similarities between our findings from both methods increases confidence in the results. These findings support efforts to understand the mechanisms underpinning these effects to inform targeted interventions and develop population-based strategies to reduce rising obesity levels for disease prevention.

Association between body mass index and suicidal ideation among seniors in Shandong, China

BACKGROUND

Recently, an emerging group of studies has reported the association between Body Mass Index (BMI) and suicidal ideation in the Western countries. However, this relationship is still unclear with controversial results, and we have little knowledge about this relationship in China which is one of few countries reported higher suicide rates.

METHODS

This study aims to analyze the association between BMI and suicidal ideation among seniors (≥60 years old) in Shandong, China. A total of 3313 seniors were included in the data analysis. Suicidal ideation, weight, height, socio-demographic and psychological variables were evaluated in this study. Logistic regression was conducted to explore the association between BMI and suicidal ideation among male and female seniors.

RESULTS

The results showed that 4.2% of the seniors reported suicidal ideation, and 3.4% for men, 4.9% for women. After controlling social-demographic variables, economic status, physical disease, social support and mental health, an inverse relationship between BMI and suicidal ideation was found for men, but not for women. Mental health was still an important factor associated with suicidal ideation.

CONCLUSION

The results inform health care professors that underweight in male seniors can be associated with higher risk of suicidal ideation in China.

U-shaped relationship between depression and body mass index in the Korean adults

BACKGROUND

Although a number of studies have examined the relationship between depression and obesity, it is still insufficient to establish the specific pattern of relationship between depression and body mass index (BMI) categories. Thus, this study was aimed to investigate the relationship between depression and BMI categories.

METHODS

A cross-sectional study was conducted for a cohort of 159,390 Korean based on Kangbuk Samsung Health Study (KSHS). Study participants were classified into 5 groups by Asian-specific cut-off of BMI (18.5, 23, 25 and 30kg/m²). The presence of depression was determined by Center for Epidemiologic Studies-Depression scales (CES-D)≥16 and≥25. The adjusted odd ratios (ORs) for depression were evaluated by multiple logistic regression analysis, in which independent variable was 5 categories of BMI and dependent variable was depression. Subgroup analysis was conducted by gender and age.

RESULTS

When normal group was set as a reference, the adjusted ORs for depression formed U-shaped pattern of relationship with BMI categories [underweight: 1.31 (1.14-1.50), overweight: 0.94 (0.85-1.04), obese group: 1.01 (0.91-1.12), severe obese group: 1.28 (1.05-1.54)]. This pattern of relationship was more prominent in female and young age group than male and elderly subgroup. BMI level with the lowest likelihood of depression was 18.5kg/m² to 25kg/m² in women and 23kg/m² to 25kg/m² in men.

CONCLUSIONS

There was a U-shaped relationship between depression and BMI categories. This finding suggests that both underweight and severe obesity are associated with the increased risk for depression.

Body Mass Index Is an Important Predictor for Suicide: Results from a Systematic Review and Meta-Analysis

Public health concerns for the independent management of obesity and suicidal behavior are rising. Emerging evidence suggests body weight plays an important role in quantifying the risk of suicide. In light of these findings, we aimed to clarify the association between body mass index (BMI) and suicidal behavior by systematically reviewing and evaluating the literature. Studies were identified by searching MEDLINE, EMBASE, PsycINFO, and CINAHL from inception to January 2015, supplemented by hand and grey literature searches. Study screening, data extraction, and risk of bias assessment were conducted in duplicate. We included 38 observational studies. Meta-analyses supported an inverse association between BMI and completed suicide. Pooled summary estimates demonstrated that underweight was significantly associated with an increased risk of completed suicide (HR = 1.21, 95% CI 1.07 to 1.36, p = .002), and obesity (HR = 0.71, 95% CI 0.56 to 0.89, p = .003) and overweight (HR = 0.78, 95% CI 0.75 to 0.82, p < .0001) were significantly associated with a decreased risk of completed suicide relative to normal weight. A qualitative summary of the literature demonstrated conflicting evidence regarding the association between BMI and attempted suicide and revealed no association between BMI and suicidal ideation. BMI may be used to aid the assessment of suicide risk, especially that of completed suicide. However, unmeasured confounders and systematic biases of individual studies limit the quality of evidence.

A pilot study of the relationship between diet and mental health in female university students enrolled in a training course for registered dietitians

OBJECTIVE

The purpose of the present pilot study was to investigate the link between diet and mental health in female university students enrolled in a training course for registered dietitians.

SUBJECTS AND METHODS

A total of 62 female university students, with a mean age of 18.79 ± 0.45 years, participated in this cross-sectional study. Diet surveys were performed using the brief-type self-administered diet history questionnaire (BDHQ). Mental health was also evaluated using the general health questionnaire-12 (GHQ-12), which was the shortest form and clinically available. Lifestyles such as physical activity levels were also evaluated.

RESULTS

The mean energy intake was 1379 ± 575 kcal and the mean GHQ score was 3.11 ± 2.41. Among nutrients, vegetable fat and sucrose showed a weak positive correlation with the GHQ scores. Among food groups, potatoes, fats and oils, and confectioneries also showed a weak positive correlation with the GHQ scores. A multiple regression analysis showed that the confectioneries were the determining factor for the GHQ scores.

CONCLUSION

Proper education concerning their diets and reducing confectioneries in their daily lives might be beneficial for the mental health of female university students.