Changes in the association between overweight and depression across three major ethnic groups, 2005–2018

Background: The relationship between body weight and depression may have changed along with the climbing trend of obesity prevalence, but most previous studies examined the association with a single cross-sectional survey. The present study assessed the change in the association between depression and body weight, measured and perceived from 2005 to 2018, among three major racial/ethnic groups. Methods: We analyzed the data of 27,387 adults aged ≥18, collected in the National Health and Nutrition Examination Survey. Surveys from 2005 to 2010 were combined as the early period and the surveys from 2011 to 2018 as the recent period. Results: A switching pattern was observed among white women. In the 2005–2010 survey period, only self-perceived overweight was significantly associated with depression [Odds ratio (OR) = 3.25 (95% confidence interval = 1.33, 7.90)]. However, in the 2011–2018 survey period, self-perceived overweight was not associated with depression anymore [1.32 (0.72, 2.41)], but obesity measured directly was significantly associated with depression [2.59 (1.04, 6.48)]. Among white men, self-perceived overweight and obesity measured directly were significantly associated with depression only in 2011–2018; [2.57 (1.18, 5.58)] and [0.29 (0.10, 0.80)], respectively. Obesity directly measured consistently associated with increased odds of depression among black men. No significant associations were observed in Hispanic and black women in any survey period. Conclusion: Significant gender and ethnic differences exist, and the associations between body weight and depression have evolved in sex-race-specific trajectories. The interventions must be consistently fine-tuned following the dynamics of the relationship between body weight and overall well-being.