(P28-032-23) Words Matter: Perception of Body Weight and Physician Comments Regarding Body Weight Are Associated With Depression in US Adults

Objectives: Studies suggest that being female, having diagnosed mental health troubles, and perceived or actual bias and discrimination by healthcare professionals contribute to the relationship between healthcare avoidance and obesity. Although this relationship is well established, the relationships between self-perception of body weight and depression and physical comments regarding body weight and depression, have been understudied. The objective of this study was to examine the association between self-perception of body weight and physical comments regarding body weight and depression in US adults.

Methods: The present study includes data from a nationally representative sample of 4,918 adult participants of the 2017-2018 NHANES. As part of the NHANES exam, depression was quantified using the validated 9-item Patient Health Questionnaire. During the in-home interview, participants were asked survey questions about their self-perception of body weight and asked to report about physician comments regarding body weight. Data analysis was conducted using SAS 9.4 using procedures to account for the complex survey design of the NHANES.  All models were adjusted for age, sex, race, educational attainment, and household income.

Results: Men and women who perceived their weight to be “about right” had significantly lower PHQ-9 scores than individuals who perceived that they were either overweight (p=0.001) or underweight (p=0.0007). Women who perceived themselves as overweight had three times the odds of having moderate to severe depression compared to women who perceived their weight to be “about right” (p=0.005). Being told one is overweight by a doctor was associated with an increased risk of depression in females (OR 2.7, 95% CI 1.5-4.5, p=0.01) but not males.  Similarly, being told to lose weight by a physician was associated with nearly twice the odds of depression among females but not males, after adjusting for age, race/ethnicity, household income and educational attainment.

Conclusions: The association between depression and physician comments regarding body weight appear to be sex specific. Given the established relationship between perceived or actual bias and discrimination by healthcare professionals and healthcare avoidance and obesity, it is prudent to educate physicians on how to discuss patient weight in a supportive way.

Funding Sources: None