Mental Health Of Severely Obese Women Is Strongly Associated With Daily Energy Expenditure

PURPOSE: Our objective was to analyze relationships of body composition, blood pressure, and energy expenditure with anxiety and depression in overweight and severely obese women. METHODS: We measured body composition (body fat, body mass index [BMI], conicity index, fat free mass, and waist circumference), blood pressure, anxiety (Beck anxiety inventory), and depression (Beck depression inventory) in 92 overweight women who were 30 to 50 years old. RESULTS: The average BMI was 28.34 ± 0.38 kg·m2 for overweight, 32.15 ± 0.28 kg·m2 for obesity I (ObI), 37.55 ± 0.27 kg·m2 for ObII, and 59.34 ± 14.42 kg·m2 for ObIII. Age (ObI: β = 0.596, P = 0.027), waist circumference (ObIII: β = 1.066, P = 0.012), systolic blood pressure (ObI: β = -0.546, P = 0.025), and energy expenditure (ObI [β = -0.828, P = 0.002], ObII [β = -0.487, P = 0.020], and total sample [β = -0.699, P = 0.001) were significantly associated with anxiety. Relationships explained approximately 37% of the variance of anxiety (ObI: adjusted R2 = 0.42, P = 0.030; ObIII: adjusted R2 = 0.52, P = 0.002; total sample: adjusted R2 = 0.18, P = 0.001). Only the conicity index (total sample: β = -0.462, P = 0.044) and energy expenditure (ObIII [β = -1.447, P = 0.003] and total sample [β = -0.785, P = 0.001]) were significantly associated with depression. These variables appear to explain approximately 25% of the variance of depression. CONCLUSION: Anxiety and depression may stem from different factors in overweight and severely obese women. They were observed in our subjects regardless of age (except for the overweight group), body composition (except for waist circumference in ObIII), or blood pressure (except for systolic blood pressure in ObI). Energy expenditure was the strongest factor (except for waist circumference in ObIII) associated with anxiety and depression regardless of obese severity. Therapeutic interventions that enhance daily energy expenditure could offer a myriad of benefits for severely obese women with mental health issues.