Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
BMC Public Health
Published in: BMC Public Health 1/2011

Open Access 01-12-2011 | Research article

Mental ill-health across the continuum of body mass index

Authors: Shona J Kelly, Mark Daniel, Eleonora Dal Grande, Anne Taylor

Published in: BMC Public Health | Issue 1/2011

Login to get access

Abstract

Background

Several studies have found a non-linear relationship between mental ill-health and BMI with higher rates in both the underweight and the obese. This study evaluated the shape of the relationship between BMI and distress, suicidal ideation and self-reported mental ill-health conditions in a large population sample.

Methods

Data were drawn from the South Australian Monitoring and Surveillance System (SAMSS) for the years 2002 to 2009 (n = 46,704). SAMSS monitors population trends in state and national risk factors and chronic diseases. Samples are drawn from all households with a functioning number in the Australian White Pages. Computer assisted telephone interviews collected information on self-reported height and weight, demographic and health behaviours. Respondents completed the Kessler Distress and suicidal ideation scales and reported specific mental ill-health conditions. BMI was categorized into deciles to allow for assessment of the shape of any associations with other variables. Logistic regression was used to examine associations between each mental ill-health condition and BMI-decile controlling for age in the base model. This was followed by a full model that added SES and the health-adverse coping behaviours of smoking, alcohol and physical activity to test for changes from the base model.

Results

Non-linear associations were observed between BMI-decile and mental ill-health but statistically significantly greater odds of mental ill-health were observed only in the obese and not in the underweight after controlling for age, health-adverse behaviours and socioeconomic status. The association between BMI and mental ill-health might best be described as 'threshold'. Elevated odds were apparent for middle-aged persons, whereas younger and older individuals had a significantly lower odds of having a mental ill-health condition.

Conclusions

In conclusion, this study has provided no support for the hypothesis of increased mental ill-health problems in the underweight but it has demonstrated the non-linear relationships between BMI and mental ill-health and between BMI and health-adverse behaviours. Non-linear relationships with BMI need to be recognized and addressed during analysis.
Appendix
Available only for authorised users
Literature
1.
Kelly S, Leonardi-Bee J, Lilley J: Associations of morbidity in the underweight. European Journal of Clinical Nutrition. 2010, 64: 475-82. 10.1038/ejcn.2010.13.CrossRefPubMed
2.
Delaney JAC, Daskalopoulou SS, Brophy JM, Steele RJ, Opatrny L, Suissa S: Lifestyle variables and the risk of myocardial infarction in the General Practice Research Database. BMC Cardiovasc Disord. 2007, 7: 38-10.1186/1471-2261-7-38.CrossRefPubMedPubMedCentral
3.
Diehr P, O'Meara ES, Fitzpatrick A, Newman AB, Kuller L, burke G: Weight, mortality, years of healthy life, and active life expectancy in older adults. J Am Geriatr Soc. 2008, 56 (1): 76-83. 10.1111/j.1532-5415.2007.01500.x.CrossRefPubMed
4.
Flegal KM, Graubard BI, Williamson DF, Gail MH: Excess deaths associated with underweight, overweight, and obesity. JAMA. 2005, 293: 1861-7. 10.1001/jama.293.15.1861.CrossRefPubMed
5.
Flegal KM, Graubard BI, Williamson DF, Gail MH: Impact of smoking and preexisting illness on estimates of the fractions of deaths associated with underweight, and obesity in the US population. American Journal of Epidemiology. 2007, 166 (8): 975-82. 10.1093/aje/kwm152.CrossRefPubMed
6.
Gu D, He J, Duan X, Reynolds K, Wu X, Chen J, Huang G, Chen C, Whelton P: Body weight and mortality among men and women in China. JAMA. 2006, 295: 776-83. 10.1001/jama.295.7.776.CrossRefPubMed
7.
Hjartaker A, Adami HO, Lund E, Weiderpass E: Body mass index and mortality in a prospectively studied cohort of Scandinavian women: the women's lifestyle and health cohort study. Eur J Epidemiol. 2005, 20: 747-54. 10.1007/s10654-005-2145-x.CrossRefPubMed
8.
Katzmarzyk PT, Craig CL, Bouchard C: Original atricle underweight, overweight and obesity: relationships with mortality in the 13-year follow-up of the Canada Fitness Survey. J Clin Epidemiol. 2001, 54: 916-20. 10.1016/S0895-4356(01)00356-0.CrossRefPubMed
9.
Bjerkeset O, Romundstad P, Evans J, Gunnell D: Association of adult body mass index and height with anxiety, depression, and suicide in the general population. American Journal of Epidemology. 2008, 167 (2): 193-202.CrossRef
10.
Molarius A, Berglund K, Eriksson C, Eriksson HG, Linden-Bostrom M, Nordstrom E, Persson C, Sahlqvist L, Starrin B, Ydreborg B: Mental health symptoms in relation to socio-economic conditions and lifestyle factors - a population-based study in Sweden. BMC Public Health. 2009, 9: 302-10.1186/1471-2458-9-302.CrossRefPubMedPubMedCentral
11.
Hopman WM, Berger C, Joseph L, Barr SI, Gao Y, Prior JC, Poliquin S, Towheed T, Anastassiades T, CaMos Research Group: The association between body mass index and health-related quality of life: data from CaMos, a stratified population study. Qual Life Res. 2007, 16: 1595-603. 10.1007/s11136-007-9273-6.CrossRefPubMed
12.
Ali SM, Lindstrom M: Socioeconomic, psychosocial, behavioural, and psychological determinants of BMI among young women: differing patterns for underweight and overweight/obesity. European Journal of Public Health. 2005, 16 (3): 324-30.CrossRef
13.
Groessl EJ, Kaplan RM, Barrett-Connor E, Ganiats TG: Body mass index and quality of well-being in a community of older adults. Am J Prev Med. 2004, 26 (2): 126-9. 10.1016/j.amepre.2003.10.007.CrossRefPubMed
14.
Kaplan MS, Huguet N, Newsom JT, McFarland BH: Characteristics of physically inactive older adults with arthritis: results of a population-based study. Preventive Medicine. 2003, 37: 61-7. 10.1016/S0091-7435(03)00059-8.CrossRefPubMed
15.
Jonsson S, Hedblad B, Engstrom G, Nilsson P, Berglund G, Janzon L: Influence of obesity on cardiovascular risk. Twenty-three-year follow-up of 22 025 men from an urban Swedish population. Interntional Journal of Obesity. 2002, 26: 1046-53. 10.1038/sj.ijo.0802060.CrossRef
16.
LaCousiere DY, Baksh L, Bloebaum L, Varner MW: Maternal body mass index and self-reported postpartum depressive symptoms. Matern Child Health J. 2006, 10 (4): 385-90. 10.1007/s10995-006-0075-1.CrossRef
17.
Kotsis VT, Stabouli SV, Papamichael CM, Zakopoulos NA: Impact of obesity in intima media thickness of carotid arteries. Obesity. 2006, 14 (10): 1708-10.1038/oby.2006.196.CrossRefPubMed
18.
Ali SM, Lindstrom M: Socioeconomic, pyschosocial, behavioural, and psychological determinants of BMI among young women: differing patterns for underweight and overweight/obesity. Eur J Pub Health. 2005, 16 (3): 324-30.CrossRef
19.
Neovius K, Johansson K, Rossner S, Neovius M: Disability pension, employment and obesity status: a systematic review. Obesity Reviews. 2008, 9: 572-81. 10.1111/j.1467-789X.2008.00502.x.CrossRefPubMed
20.
Kress AM, Peterson MR, Hartzell MC: Association between obesity and depressive symptoms among U.S. Military active duty service personnel, 2002. J Psychosom Res. 2006, 60: 263-71. 10.1016/j.jpsychores.2005.08.011.CrossRefPubMed
21.
Okoro CA, Hootman JM, Strine TW, Balluz LS, Mokad AH: Disability, arthritis, and body weight among adults 45 years and older. Obesity Research. 2004, 12 (5): 854-61. 10.1038/oby.2004.103.CrossRefPubMed
22.
Heo M, Allison DB, Faith MS, Zhu S, Fontaine KR: Obesity and quality of life: mediating effects of pain and comorbidities. Obesity Research. 2003, 11 (2): 209-16. 10.1038/oby.2003.33.CrossRefPubMed
23.
Kelly SJ: Self-reported health: stitching together a picture from the fabric of life [electronic dissertation]. 2003, Vancouver: University of British Columbia
24.
Gariepy G, Nitka D, Schmitz N: The association between obesity and anxiety disorders in the population: a systematic review and meta-analysis. Int J Obesity. 2010, 34: 407-19. 10.1038/ijo.2009.252.CrossRef
25.
Kragelund C, Hassager C, Hildebrandt P, Torp-Pedersen C, Kober L: Impact of obesity on long-term prognosis following acute myocardial infraction. International Journal of Cardiology. 2005, 98: 123-31. 10.1016/j.ijcard.2004.03.042.CrossRefPubMed
26.
Dowson J: Associations of the severity of depressive disorders in women with psychogenic low weight. Journal of Affective Disorders. 2004, 78: 279-84. 10.1016/S0165-0327(02)00309-9.CrossRefPubMed
27.
Atlantis E, Ball K: Association between weight perception and psychological distress. Int J Obesity. 2008, 32: 715-21. 10.1038/sj.ijo.0803762.CrossRef
28.
Miller DK, Malmstrom TK, Joshi S, Andresen EM, Morley JE, Wolinsky FD: Clinically relevant levels of depressive symptoms in community-dwelling middle-aged African Americans. J Am Geriatr Soc. 2004, 52: 741-8. 10.1111/j.1532-5415.2004.52211.x.CrossRefPubMed
29.
McLaren L, Beck CA, Patten SB, Fick GH, Adair CE: The relationship between body mass index and mental health. A population-based study of the effects of the definition of mental health. Social Psychiatry & Psychiatric Epidemiology. 2008, 43: 63-71. 10.1007/s00127-007-0269-x.CrossRef
30.
Viera AJ: Predisease: when does it make sense?. Epi Rev. 2011, 33: 122-34. 10.1093/epirev/mxr002.CrossRef
31.
de Wit LM, van Straten A, van Herten M, Penninx BWJH, Cuijpers P: Depression and body mass index, a u-shaped association. BMC Public Health. 2009, 9 (14):
32.
Taylor A, Dal Grande E: Chronic disease and risk factor surveillance using the SA Monitoring and Surveillance System (SAMSS)-history, results and future challenges. Public Health Bulletin. 2008, 3 (5): 17-21.
33.
Brooks RT, Beard J, Steel Z: Factor structure and interpretation of the K10. Psychol Assess. 2006, 18 (1): 62-70.CrossRefPubMed
34.
Goldney RD, Winefield AH, Tiggemann M, Winefield HR, Smith S: Suicidal ideation in a young adult population. Acta Psychiatr Scand. 1989, 79: 481-9. 10.1111/j.1600-0447.1989.tb10291.x.CrossRefPubMed
35.
Council NHaMR: Australian Alcohol Guidelines: Health Risks and Benefits. 2001, Canberra: Commonwealth of Australia
36.
Armstrong T, Bauman A, Davies J: Physical activity patterns of Australian adults. Results of the 1999 National Physical Activity Survey. 2000, Canberra: Australian Institute of Health and Welfare
37.
Kakizaki M, Kuriyama S, Sato Y, Shimazu T, Matsuda-Ohmori K, Nakaya N, Fukao A, Fukudo S, Tsuji I: Personality and body mass index: a cross-sectional analysis from the Miyagi Cohort Study. J Psychosom Res. 2008, 64: 71-80. 10.1016/j.jpsychores.2007.07.008.CrossRefPubMed
38.
Goldney RD, Dunn KI, Air TM, Dal Grande E, Taylor AW: Relationships between body mass index, mental health, and suicidal ideation: population perspectives using two methods. Australian & New Zealand Journal of Psychiatry. 2009, 43: 652-8. 10.1080/00048670902970825.CrossRef
39.
Kivimaki M, Ferrie JE, Batty GD, Davey Smith G, Elovainio M, Marmot MG, Shipley MJ: Optimal form of operationalizing BMI in relation to all-cause and cause-specific mortality: the original Whitehall study. Obesity. 2008, 16 (8): 1926-32. 10.1038/oby.2008.322.CrossRefPubMed
40.
Keith SW, Fontaine KR, Pajewski NM, Mehta T, Allison DB: Use of self-reported height and weight biases the body mass index-mortality association. Int J Obesity. 2011, 35: 401-8. 10.1038/ijo.2010.148.CrossRef
41.
Taylor AW, Dal Grande E, Gill TK, Chittleborough CR, Wilson DH, Adams RJ, Grant JF, Phillips PJ, Appleton S, Ruffin RE: How valid are self reported height and weight? A comparison between CATI self-report and clinic measurements using a large representative cohort study. Australian & New Zealand Journal of Public Health. 2006, 30 (3): 238-46. 10.1111/j.1467-842X.2006.tb00864.x.CrossRef
42.
Lee S-K: Validity of self-reported weight and height: comparison between immigrant and non-immigrant mexican americans in NHANES 3. J Immigr Health. 2005, 7 (2): 127-31. 10.1007/s10903-005-2646-4.CrossRefPubMed
43.
Nettleton S: The sociology of health and illness. 1995, Cambridge: Polity Press
44.
Dal Grande E, Taylor AW: Sampling and coverage issues of telephone surveys used for collecting health information in Australia: results from a face-to-face survey from 1999 to 2008. BMC Medical Research Methodology. 2010, 10: 77-10.1186/1471-2288-10-77.CrossRefPubMed
Metadata
Title
Mental ill-health across the continuum of body mass index
Authors
Shona J Kelly
Mark Daniel
Eleonora Dal Grande
Anne Taylor
Publication date
01-12-2011
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2011
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-11-765

Other articles of this Issue 1/2011

BMC Public Health 1/2011 Go to the issue

Study protocol

Study protocol: a pragmatic randomised controlled trial of a 12-week physical activity and nutritional education program for overweight Aboriginal and Torres Strait Islander women

Study protocol

Optimizing diffusion of an online computer tailored lifestyle program: a study protocol

Research article

Giving offspring a healthy start: parents' experiences of health promotion and lifestyle change during pregnancy and early parenthood

Research article

Primary care utilisation patterns among an urban immigrant population in the Spanish National Health System

Research article

Weight gain and incident obesity among male snus users

Research article

Study on Occupational Allergy Risks (SOLAR II) in Germany: Design and methods