Contributions of depression and body mass index to body image

Nadine P.G. Paans*, Mariska Bot, Ingeborg A. Brouwer, Marjolein Visser, Brenda W.J.H. Penninx

*Corresponding author for this work

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Depression and body mass index (BMI) are known to be associated with body image, however, their independent or joint effects on body image in adults are largely unknown. Therefore, we studied associations of depression diagnosis, severity, and BMI with perceptual body size (PBS) and body image dissatisfaction (BID). Cross-sectional data from 882 remitted depressed patients, 242 currently depressed patients and 325 healthy controls from the Netherlands Study of Depression and Anxiety were used. Depressive disorders (DSM-IV based psychiatric interview), standardized self-reported depressive symptoms (Inventory of Depressive Symptomatology) and BMI were separately and simultaneously related to body image (the Stunkard Figure Rating scale) using linear regression analyses. Thereafter, interaction between depression and BMI was investigated. Analyses were adjusted for demographic and health variables. Higher BMI was associated with larger PBS (B = 1.13, p <.001) and with more BID (B = 0.61, p <.001). Independent of this, depression severity contributed to larger PBS (B = 0.07, p <.001), and both current (B = 0.21, p =.001) and remitted depression diagnosis (B = 0.12, p =.01) as well as depression severity (B = 0.11, p <.001) contributed to BID. There was no interaction effect between BMI and depression in predicting PBS and BID. In general, depression (current, remitted and severity) and higher BMI contribute independently to a larger body size perception as well as higher body image dissatisfaction. Efforts in treatment should be made to reduce body dissatisfaction in those suffering from depression and/or a high BMI, as BID can have long-lasting health consequences, such as development of anorexia and bulimia nervosa and an unhealthy lifestyle.

Original languageEnglish
Pages (from-to)18-25
Number of pages8
JournalJournal of Psychiatric Research
Early online date7 May 2018
Publication statusPublished - Aug 2018


Funding for this paper was provided by the European Union FP7 MooDFOOD Project ‘Multi-country cOllaborative project on the rOle of Diet, FOod-related behavior, and Obesity in the prevention of Depression’ (grant agreement no. 613598 ). The infrastructure for the NESDA study ( ) is funded through the Geestkracht program of the Netherlands Organisation for Health Research and Development ( ZonMw , grant number 10-000-1002 ) and financial contributions by participating universities and mental health care organizations ( VU University Medical Center , GGZ inGeest , Leiden University Medical Center , Leiden University , GGZ Rivierduinen , University Medical Center Groningen , University of Groningen , Lentis , GGZ Friesland , GGZ Drenthe , Rob Giel Onderzoekscentrum ). Appendix A

FundersFunder number
European Union FP7
Seventh Framework Programme613598
Universiteit Leiden
Rijksuniversiteit Groningen
GGZ InGeest
GGZ Friesland
GGZ Drenthe
Leids Universitair Medisch Centrum
Universitair Medisch Centrum Groningen


    • Body image
    • Body mass index
    • Depressive disorder
    • Depressive symptoms


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