Increased odds of high body mass index in depression with self-reported antidepressant use

To the editor: The incidence of depression and obesity is on the rise, posing significant public health concerns. While the literature largely supports a positive correlation between depression and body mass index (BMI),1 2 earlier studies have suggested an inverse relationship3 or indicated a lack of association between depression and obesity.4 Monoaminergic antidepressants, such as selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs), are the first-line treatment options for major depression. Research strongly supports a correlation between antidepressant use and weight gain, particularly in the case of tricyclic antidepressants (TCAs) and monoamine oxidase inhibitors (MAOIs).5 6 However, there is limited evidence regarding the association between antidepressant use and BMI, with existing studies primarily focused on how obesity influences treatment outcomes. Several mechanisms, including antidepressant use, have been proposed to explain the relationship between mood disorders and obesity.7 Previous research demonstrated that depressive symptoms and antidepressant use were independently associated with BMI in postmenopausal women.8 However, there were no subset analyses comparing individuals with depression who were taking antidepressants with those with depression who were not. Findings from another study showed that women with depression who had never used antidepressants had reduced odds of having an obese BMI.9 Moreover, the positive relationship between antidepressant use and an obese BMI only became significant when analyses were limited to those with a history of depression.9 A large, population-level analysis is warranted to clarify the associations between depression, antidepressant use and BMI. This study investigated the independent associations of depression and self-reported antidepressant use (yes/no, antidepressant class and duration of use) with BMI. In a secondary analysis, the relationship between antidepressant use and BMI was investigated in a subset of participants with depression. ### Study population This study used data from the 2007–2018 National Health and Nutrition …