Temporal relationships between overweight and obesity and DSM-IV substance use, mood, and anxiety disorders: results from a prospective study, the National Epidemiologic Survey on Alcohol and Related Conditions.
Level 3 - non-randomized controlled study
Prospective nationally representative longitudinal cohort study
PubMed 21457678 · doi:10.4088/JCP.10m06077gry
What was done
Data were analyzed from Waves 1 (2001-2002) and 2 (2004-2005) of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), a nationally representative prospective cohort of 34,653 US civilian adults. Multivariable regression analyses controlling for covariates evaluated the prospective associations between baseline overweight/obesity and the 3-year incidence of DSM-IV substance use, mood, and anxiety disorders, as well as baseline psychiatric predictors of incident overweight/obesity.
What was found
Overweight and obese women had an increased risk of incident major depressive disorder (AOR = 1.3, 95% CI: 1.02-1.56 and AOR = 1.2, 95% CI: 1.02-1.51, respectively; P < .05). Conversely, higher weight status was associated with decreased risk for incident substance use disorders: overweight men had lower risk of incident drug abuse (AOR = 0.7, 95% CI: 0.44-0.96; P < .05), obese men had lower risk of incident alcohol dependence (AOR = 0.7, 95% CI: 0.52-0.97; P < .05), and obese women had lower risk of incident alcohol abuse (AOR = 0.6, 95% CI: 0.45-0.88; P < .05) and drug dependence (AOR = 0.4, 95% CI: 0.21-0.91; P < .05). Baseline drug dependence in men (AOR = 0.4, 95% CI: 0.19-0.99; P < .05) and specific phobia in women (AOR = 0.8, 95% CI: 0.66-0.95; P < .05) predicted reduced risk of becoming overweight or obese.
Why it matters
This study provides prospective evidence that excess weight increases vulnerability to major depression in women, while revealing an inverse longitudinal association with substance use disorders in both sexes.
Limits
The follow-up duration was limited to 3 years between two survey waves. BMI and psychiatric diagnoses relied on structured survey assessments without clinical verification, and unmeasured confounding factors could influence these observational relationships.
Cited by
- contradicts Individuals with an alcohol use disorder are approximately 70% more likely to also be overweight.