Atypical Depression May Carry Increased Risk of Obesity

Atypical major depressive disorder predicted obesity in recent study

(RxWiki News) Major depressive disorder and obesity have previously been connected to chronic conditions like cancer, high blood pressure and diabetes. But major depressive disorder and obesity may also be connected.

A recent study found that people with atypical major depressive disorder (MDD) faced a higher risk of being obese than people who had other types of MDD or did not have MDD.

The researchers said this finding emphasized the need to be able to clearly identify people with atypical MDD to help prevent obesity.

"Discuss the risk of obesity with your psychiatrist."

The lead author of this study was Aurélie M. Lasserre, MD, from the Center for Psychiatric Epidemiology and Psychopathology at Lausanne University Hospital in Prilly, Switzerland.

The study included 3,054 citizens of Lausanne, Switzerland, who were randomly selected for a previous study in 2003.

The participants were between the ages of 35 and 66, and their average age was 50. Fifty-three percent were women.

The study authors excluded participants with diagnosed eating disorders and some mental disorders.

The researchers measured the patients' weights and heights to determine their body mass index (height to weight ratio). They defined obesity as having a body mass index (BMI) of 30 or more. The average starting BMI was 25.

The study authors then assessed the participants to see how many had MDD and what subtypes they displayed.

MDD, often known simply as depression, affects a patient’s ability to do everyday activities.

The researchers explained that atypical MDD involved mood reactivity (the ability to change moods) and two of the following symptoms: increased appetite or significant weight gain, excessive sleepiness, leaden paralysis (arms and legs heavy and unable to move) and a longstanding, acute fear of rejection.

Melancholic MDD required either a loss of energy or a lack of mood reactivity and three of the following symptoms: worse depression in the morning, early morning awakening, visible slowing of physical and emotional reactions and excessive guilt.

The research showed that 8 percent of the patients met the criteria for MDD. However, 37 percent reported experiencing at least one depressive episode in the past.

Among the participants with MDD, 10 percent had combined atypical and melancholic features, 14 percent had just atypical features, 29 percent had just melancholic features and 48 percent had unspecified features.

The study authors discovered that only the patients with atypical MDD at the beginning of the study showed a significant increase in BMI at follow-up.

The participants with atypical MDD were also 2.41 times more likely to be obese at follow-up than those with no MDD. The patients with any type of MDD only had 59 percent increased odds of being obese at follow-up versus those with no MDD.

Also, those with atypical MDD were more likely than those without MDD to experience an increase in BMI and waist size from the start of the study to follow-up.

The study authors found that the male participants with atypical MDD were more likely to experience an increase in body fat percentage.

The authors noted that there was, on average, a year in between the physical and psychiatric evaluations. Also, some of the patients did not complete the psychiatric portion at follow-up.

People with less healthy lifestyles were less likely to participate, the researchers noted. The findings were based on an urban sample of people from Switzerland — the results may not have been true in other groups.

This study was published Aug. 6 in JAMA Psychiatry.

The Swiss National Science Foundation provided funding. Some of the study authors received grants from GlaxoSmithKline.

Review Date: 
August 6, 2014