Association between body fat percentage and depression: A cross-sectional study of NHANES

Background: Obesity and depression often co-occur and are interdependent. However, evidence regarding the association between body fat percentage in different regions and depression is scarce. Additionally, the impacts of sex-specific and BMI-stratified differences on the relationship between body fat percentage and depression remain unclear. Methods: Data were drawn from the NHANES for the years 2005-2006 and 2011-2018. Body fat percentage was assessed using dual-energy X-ray absorptiometry (DXA). Depression was evaluated using the Patient Health Questionnaire-9 (PHQ-9). Survey-weighted binary logistic regression analyses were employed to investigate the relationship between body fat percentage and depression. Stratification analysis were stratified by sex and BMI. Results: This study comprised 10,694 participants. Controlling confounders, the higher quartile of total body fat percentage was associated with increased OR for depression (Q4 vs Q1: OR, 1.46; 95 % CI, 1.04-2.05) as well as for leg (Q4 vs Q1: OR, 1.48; 95 % CI, 1.07-2.05), gynoid (Q4 vs Q1: OR, 1.51; 95 % CI, 1.11-2.05), subtotal (Q4 vs Q1: OR, 1.47; 95 % CI, 1.06-2.03) and head (Q3 vs Q1: OR, 1.30; 95 % CI, 1.00-1.68). In stratification analysis by sex and BMI, body fat percentage seemed to be more closely associated with depression in males or in the underweight and overweight groups. Limitation: Cross-sectional study design and self-reported depression. Conclusions: Elevated body fat percentage was strongly associated with higher prevalence of depression, especially in males or in the underweight and overweight groups.