The Relationship between Weight Status and Depressive Symptoms in a Population Sample with Obesity: The Mediating Role of Appearance Evaluation

Objectives: Identifying the underlying pathways between obesity and depression and which individuals with obesity are at risk for developing depressive symptoms is important for improving prevention and treatment efforts. The current study investigated appearance evaluation as a potential mediator of the relationship between obesity and depression. Methods: A total of 1,000 participants with a self-reported BMI greater than 30 kg/m(2) were interviewed about their experiences with an elevated body weight and completed measures on appearance evaluation and depression. Results: A negative relationship between satisfaction with appearance and BMI and a negative association between satisfaction with appearance and depression was found in men and women. Men reported less depressive symptoms and higher satisfaction with appearance compared to women. While no mediation effect could be determined in women, satisfaction with appearance mediated the obesity-depression relationship in men. Conclusions: Efforts to reduce adverse effects of either obesity or depression need to take the reciprocal relationship between the two conditions into account. The current findings underscore the importance of appearance evaluation for treatment efforts in individuals with obesity. Interventions addressing body image might improve both, psychological distress and weight management efforts in general. (C) 2018 The Author(s) Published by S. Karger GmbH, Freiburg