Longitudinal Trajectories of Depressive Symptoms and Their Associations With Risks of Underweight and Obesity in Women: A Population-Based Longitudinal Study in Korea

Abstract

Objective: We explored depressive symptom trajectories and their associations with underweight and obesity in Korean women.

Methods: This prospective cohort study involved 7,691 women enrolled in the Korean Longitudinal Survey of Women and Families, with a follow-up period spanning from 2014 to 2020. Depressive symptoms were evaluated through the 10-item version of the Center of Epidemiologic Studies Depression Scale. Growth mixture modeling was employed to identify trajectories of depressive symptoms. Multinomial logistic regressions were conducted to investigate the correlation between depression trajectories and the evolving risks of underweight and obesity over the study period.

Results: Five distinct trajectory classes were observed ("persistent low symptoms": N = 5,236, 68.1%; "decreasing symptoms": N = 930, 12.1%; "transient high symptoms": N = 421, 5.5%; "increasing symptoms" N = 825, 10.7%; and "persistent high symptoms": N = 279, 3.6%). Those with a low socioeconomic status, comorbidity, and who were divorced or widowed were more likely to follow the persistent high symptom trajectory. Among the 5 trajectories, the risks of underweight and obesity steadily increased in women following the trajectory with persistent high symptoms. For these women, the odds ratio (OR) of underweight increased from 2.27 (95% CI, 1.32-3.92) in 2014 to 3.39 (1.91-6.05) in 2020. They were not associated with obesity in 2014 (OR [95% CI]: 1.38 [0.61-3.11]) but exhibited an elevated risk of obesity in 2020 (3.76 [1.97-7.17]).

Conclusion: We observed considerable heterogeneity in the trajectories of depressive symptoms among women, and individuals with persistent high depressive symptoms face an escalating risk of both underweight and obesity.