Depression is common among obese teenagers, but the association between the two may largely be explained by teens’ experiences of being shamed, and other psychosocial factors, according to a review of studies on the topic..

“There is a clear statistical association between adolescent Obesity and adolescent Depression,” said study author Dr. Rickard L. Sjoberg, of Uppsala University in Sweden.

However, he added, “this association disappears when psychosocial factors and experiences of being treated in humiliating and degrading ways are controlled for.”

Sjoberg and colleagues analyzed data from 4,703 children, aged 15 and 17 years, who participated in the Survey of Adolescent Life in Vestmanland 2004, a psychosocial health survey administered triannually in Sweden. They found that overweight and Obesity was more common among boys than among girls, while Depression was more common among girls.

Obese teens reported experiencing more symptoms of Depression than their normal-weight or overweight peers and had a higher risk of Depression, the researchers report in the journal Pediatrics.

Also, obese teens were more likely to say they had been treated in a degrading manner, had been ignored or otherwise had shaming experiences within the past three months than were their normal-weight or overweight peers.

Further, adolescents who reported the highest number of shame experiences were more than 11 times more likely to be depressed than those who reported the lowest number of shame experiences, the report indicates.

The association between Obesity and major Depression disappeared, however, after the researchers took into consideration the adolescents’ gender, parental employment, and parental separation, the report indicates.

Teenagers with unemployed parents and those in families in which the parents were separated were more likely to have depressive symptoms than their peers. In fact, these variables predicted major Depression among the study group, the researchers note, and were unrelated to the teens’ weight.

Sjoberg speculated that the association between the teenagers’ Depression and having an unemployed parent may possibly be explained by the idea “that having a parent who has the experience of being unwanted at the labor market or incapable of meeting the demands of this market will put an increased psychological strain on the family system which will increase the risk of the adolescent developing Depression.”

He explained that, in Sweden, both parents are usually employed and that few mothers stay at home with their children beyond the first 18 months after birth when state funding allows one parent to stay home to care for an infant.

Altogether, the study’s findings imply “that an understanding of the social consequences of Obesity is also necessary in order to make sense of the Obesity-Depression association,” Sjoberg told.

He and his colleagues conclude that “these results suggest that clinical treatment of Obesity may sometimes not just be a matter of diet and exercise but also of dealing with issues of shame and social isolation.”

SOURCE: Pediatrics, September 2005.