In an analysis of primary care records of 519,513 UK adults who were overweight or obese, the incidence of new cases of depression was 92 per 10,000 people per year. The risk for depression rose with higher weight, according to the study published in journal Obesity.
Compared with having overweight, the hazard of depression increased with each BMI category as follows: 30‐34 kg/m2, 1.13 (95% CI, 1.10‐1.16); 35‐39 kg/m2, 1.34 (95% CI, 1.29‐1.40); 40‐44 kg/m2, 1.51 (95% CI, 1.41‐1.61); 45‐49 kg/m2, 1.67 (95% CI, 1.48‐1.87); and attenuating at BMI 50+ kg/m2, 1.54 (95% CI, 1.29‐1.89).
Antidepressants were prescribed as first‐line therapy in two‐thirds (66.3%) of cases. Prescriptions for fluoxetine reduced over time (20.4% in 2000 vs 8.8% in 2018), and prescriptions for sertraline increased (4.3% in 2000 vs 38.9% in 2018).
The authors say the findings suggest there is some ambiguity over first‐line antidepressant therapy choices for people with both obesity and depression. They say there is an urgent need for guidance on antidepressant drug prescribing for people with overweight and obesity. They add that there is also a need for specific services that focus on both obesity and mood to address the complex issues that this vulnerable group of individuals face.
