Depressive symptoms and weight in midlife women: the role of stress eating and menopause status

OBJECTIVE: Obesity is prevalent in midlife women and contributes to poor health outcomes. Understanding mechanisms leading to weight gain in this population is of importance for prevention and intervention. The current study investigated the association between depressive symptoms and weight in midlife women by examining stress eating as a mediator between depressive symptoms and weight; and menopause status as a moderator of the associations of depressive symptoms, stress eating, and weight. METHODS: An archival analysis was performed using data from the Midlife in the United States II study. The sample consisted of 815 premenopausal and postmenopausal women. Measures included the Composite International Diagnostic Interview-Short Form, a coping questionnaire, and body mass index. RESULTS: Moderated mediation analyses were conducted with ordinary least squares path analyses using Hayes' PROCESS macro. Controlling for covariates, depressive symptoms were not directly associated with weight (b = -0.4, 95% confidence interval CI -0.4, 0.1). However, stress eating was a significant mediator between depressive symptoms and weight (b = 0.3, 95% CI 0.06, 0.3).The mediation was conditional on menopausal stage (b = 0.2, 95% CI 0.05, 0.4), with depressive symptoms and stress eating significantly associated in postmenopausal, not premenopausal women (b = 0.3, 95% CI 0.2, 0.5). CONCLUSIONS: Both stress eating and menopause status significantly contributed to the depressive symptom-weight association. Psychosocial factors play an important role in the association between depressive symptoms and weight, and the results highlight the need to focus on both behavioral factors, and also menopause status, when identifying who is at risk for the development of poor weight outcomes.