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Childhood Overweight and Obesity Tied to Lifetime MDD Risk

Key clinical point: Childhood overweight and obesity are associated with an increased risk of lifetime major depressive disorder (MDD), but no association is seen with depressive symptoms during late life.

Major finding: Lifetime MDD risk was higher with overweight and obesity at age 8 years (odds ratio [OR], 4.30); although the risk was raised at age 13 years (OR, 3.00), this did not reach statistical significance. Using a GDS cutoff of ≥5, overweight and obesity at age 8 (OR, 0.99) or 13 years (OR, 0.94) were not linked to higher depressive symptoms during late life.

Study details: Analysis based on the sub-sample of 889 Age, Gene/Environment Susceptibility (AGES)-Reykjavik participants with complete late-life GDS data and childhood body mass index information available for either age 8 years (n=664) or 13 years (n=711) from early life.

Disclosures: This study was funded by the EU FP7 MooDFOOD Project ‘Multi-country cOllaborative project on the rOle of Diet, FOod-related behaviour, and Obesity in the prevention of Depression’. The original AGES-Reykjavik study was funded by NIH, the NIA Intramural Research Program, Hjartavernd, and the Althingi. The authors declared no conflict of interest.

Commentary

“This longitudinal study of 101 subjects examined whether obesity/being overweight in childhood predicted major depressive disorder—specifically late life depression 60 years later and lifetime major depressive disorder. Adjustments were made for confounders, including gender, education, physical activity, smoking and alcohol use. Lifetime MDD risk was increased (OR = 4.3) with obesity/being overweight at age 8 years. This risk may have been increased at age 13. Late life depression had no association with childhood obesity/being overweight.

The link between obesity and the lifetime risk of major depression is complex and likely multifactorial. Being overweight in childhood can adversely affect self-esteem or be associated with bullying—both of which are risk factors for depression. Obesity may cause metabolic/hormonal changes that increase depression risk.

Finally, obesity and depression may have the same cause. There is evidence that inflammation or shared genetic risks may play a role in both conditions. Epigenetic change from childhood trauma may contribute to both. Also, in 2019, the ACEs study reported that adverse childhood experiences in infants/toddlers increases the risk of childhood obesity.”

A Gita Ramamurthy, MD

Director, Psychiatry Consultation-Liaison Service

Citation:

Gibson-Smith et al. BMC Pediatr. 2020 Jan 21. doi: 10.1186/s12887-020-1930-8.