The International Journal of Neuropsychopharmacology

Obesity among outpatients with Major Depressive Disorder

George I. Papakostas a1c1, Timothy Petersen a1, Dan V. Iosifescu a1, Alana M. Burns a1, Andrew A. Nierenberg a1, Jonathan E. Alpert a1, Jerrold F. Rosenbaum a1 and Maurizio Fava a1
a1 Depression Clinical and Research Program, Massachusetts General Hospital Harvard Medical School, Boston, MA, USA

Article author query
papakostas gi   [PubMed][Google Scholar] 
petersen t   [PubMed][Google Scholar] 
iosifescu dv   [PubMed][Google Scholar] 
burns am   [PubMed][Google Scholar] 
nierenberg aa   [PubMed][Google Scholar] 
alpert je   [PubMed][Google Scholar] 
rosenbaum jf   [PubMed][Google Scholar] 
fava m   [PubMed][Google Scholar] 


Studies focusing on the prevalence of obesity in Major Depressive Disorder (MDD), or the impact of excess body fat on the treatment of MDD are lacking. The aim of the present work is to systematically study obesity in MDD outpatients. A total of 369 MDD outpatients enrolled in an 8-wk trial of 20 mg fluoxetine had height and weight measured at baseline. We then examined: (1) the prevalence of being overweight or obese, (2) the relationship between obesity and a number of demographic and clinical variables, and, (3) the relationship between relative body weight and obesity with clinical response. We found that more than 50% of patients were overweight [body mass index (BMI) [gt-or-equal, slanted]25 kg/m2], while 20% were obese (BMI [gt-or-equal, slanted]30 kg/m2). Obese patients presented with worse somatic well-being scores than non-obese MDD patients, but they did not differ with respect to depression severity, anxiety, somatic complaints, hopelessness or hostility. Greater relative body weight, but not obesity, predicted non-response. In conclusion, greater relative body weight was found to place MDD outpatients at risk for fluoxetine resistance.

(Received November 24 2003)
(Reviewed March 31 2004)
(Revised May 2 2004)
(Accepted May 16 2004)

Key Words: Fluoxetine treatment; major depressive disorder; obesity.

c1 Dr G. I. Papakostas, Massachusetts General Hospital, Department of Psychiatry, Depression Clinical and Research Program, 15 Parkman Street, WACC 812, Boston, MA 02114, USA. Tel.: (617) 726-6697 Fax: (617) 726-7541 E-mail: