Depressive symptoms are associated with obesity in adults with heart failure: An analysis of gender differences

Abstract

Background:

Depression is a predictor and consequence of obesity in the general population. Up to 50% of patients with heart failure exhibit elevated depressive symptoms or depressive disorders; however, research on the depression–obesity relationship in heart failure populations is limited, especially in regard to gender differences.

Aims:

To conduct total-sample and gender-stratified analyses to determine whether depressive symptoms are associated with body mass index (BMI) in a sample of patients with heart failure.

Method:

Participants were 348 (39% female, 26% non-White) patients with heart failure (aged 68.7±9.7 years) recruited from urban medical centers. Depressive symptoms were measured using the Patient Health Questionnaire-9 (PHQ-9). Height and weight were used to compute BMI (kg/m²). Regressions were performed for total sample and both genders. Regressions for BMI were run with demographic, medical, and psychological covariates in Step 1 and the PHQ-9 in Step 2.

Results:

Regression results (total sample) revealed that the PHQ-9 was associated with BMI after adjusting for covariates (β=.22, p=.004). For males, the relationship between PHQ-9 and BMI remained (β=.23, p=.024) and was driven by those with severe obesity (BMI ≥ 40 kg/m²). A trend between PHQ-9 and BMI was detected among females (β=.19, p=.091).

Conclusion:

BMI is related to depressive symptoms in adults with heart failure even after adjusting for demographic and medical covariates. Depressive symptoms were associated with BMI in males, whereas a trend was detected among females. These findings could ultimately be used to improve heart failure outcomes for depressed, obese individuals with heart failure.

Keywords

Body mass index depressive symptoms obesity heart failure gender

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