Relationship between obesity and depression: Characteristics and treatment outcomes with antidepressant medication

Marisa S.P. Toups, Alyson K. Myers, Stephen R. Wisniewski, Benji Kurian, David W. Morris, Augustus John Rush, Maurizio Fava, Madhukar H. Trivedi

Research output: Contribution to journalArticlepeer-review

48 Scopus citations


OBJECTIVE: Obesity and major depressive disorder often co-occur. However, differences between obese and normal-weight depressed patients and the moderating effect of obesity on antidepressant treatment outcome are not well studied. METHODS: Adults (n = 662) with major depressive disorder in the Combining Medications to Enhance Depression Outcomes study were randomized to treatment with escitalopram plus placebo, bupropion plus escitalopram, or venlafaxine plus mirtazapine for a 12-week primary treatment phase and 16-week follow-up. Body mass index (BMI) was calculated at baseline and categorized according to World Health Organization criteria: normal or low weight (NW), overweight, Obese I and Obese II+. A repeated-effects model, unadjusted and adjusted for baseline variables, assessed outcomes. RESULTS: Obesity was common (46.2%), only 25.5% were NW. Higher BMI was associated with greater medical illness (p < .001), social phobia (p = .003), and bulimia (p = .026). Lower BMI was associated with more frequent post-traumatic stress disorder (p = .002) and drug abuse (p < .001). Treatment outcomes did not differ including Week 12 remission rates (NW 36%, overweight 40%, Obese I 43%, Obese II+ 37%; p = .69). Lower BMI was associated with more frequent (p = .024 [unadjusted] and .053 [adjusted]) and more severe (p = .008 [unadjusted] and .053 [adjusted]) adverse effects. CONCLUSIONS: BMI was related to clinical presentation and prevalence of comorbidities, but not antidepressant outcomes. Lower BMI classes had more psychiatric comorbidities, potentially obscuring the relationship between BMI and antidepressant effects. TRIAL REGISTRATION: identifier: NCT00590863

Original languageEnglish (US)
Pages (from-to)863-872
Number of pages10
JournalPsychosomatic Medicine
Issue number9
StatePublished - 2013
Externally publishedYes


  • depression
  • obesity
  • treatment resistance

ASJC Scopus subject areas

  • Applied Psychology
  • Psychiatry and Mental health


Dive into the research topics of 'Relationship between obesity and depression: Characteristics and treatment outcomes with antidepressant medication'. Together they form a unique fingerprint.

Cite this