The Association Between Depressive Symptoms And Weight Loss Stages In Qatar: A Cross-Sectional General Population Investigation

Abstract

Background: Depression and overweight obesity (OO) have well-established bidirectional associations and are comorbid with other medical conditions. To date, the impact of weight management interventions remains small. Further research into the complex relationship between depression and body weight is warranted using the Transtheoretical model of behavior change (TTM) - an evidence-based dynamic framework for conceptualizing weight change. Aims: The present study aims to explore the association between weight loss stages of change (WLSC) as per TTM and depressive symptoms while identifying sociodemographic and health-related variables that are associated with both in the context of Qatar. Methods: A cross-sectional phone survey (n=2,131) sponsored by Qatar Diabetes Association was conducted by the Social and Economic Survey Research Institute at Qatar University in Spring of 2018. Data regarding sociodemographic, health-related, and behavioral variables were collected. Results: Age, gender, respondent type, ethnicity, education, employment, marital status, chronic conditions, OO, physical activity, smoking, and sleep were associated . with WLSC and depressive symptoms (p-value <0.3). Overall, non-significant association was found between WLSC and depressive symptoms (OR= 1.05, 95%CI= 0.82-1.34, p=0.7). Both contemplation (OR= 0.68, 95% CI= 0.25-1.89, p=0.46) and maintenance stages (OR=0.86, 95%CI= 0.33-2.22, p=0.76) were negatively associated with depressive symptoms. In contrast, preparation (OR=1.07, 95%CI=0.42-2.71, p=0.89) and no weight change/ relapse (OR=1.18, 95%CI=0.42-3.38, p=0.75) were positively associated with depressive symptoms. Finally, evidence emerged of effect modification by Body Mass Index (BMI) of associations between WLSC and depressive symptoms. Conclusion: Individuals in maintenance and contemplation stages of weight change experienced reduction in depressive symptoms compared to pre-contemplation stage. Moreover, the odds of depressive symptoms were higher among individuals in preparation stage and those who experienced no weight change or relapse compared to pre-contemplation stage. Furthermore, BMI appears to be an important variable in explaining differences in depressive symptoms across different WLSC as per TTM.