Trends in obesity prevalence among adults with depression in the United States, 2005 to 2023

Obesity and depression as chronic diseases increase the burden on society, and they often co-exist, interacting to worsen prognosis. However, the long-term trends in obesity prevalence specifically among the growing population of individuals with depression remain unclear. Investigating these trends is crucial for informing targeted treatment and public health strategies. Clinical data on adults aged ≥ 20 years with depression were extracted from the National Health and Nutrition Examination Survey 2005–2023. The primary outcome was obesity prevalence body mass index (BMI) ≥ 30 kg/m 2 . Trends in the prevalence of obesity among depressed adults in the US were assessed by a trend test. The study included 4035 adults aged ≥ 20 years with depression in the United States population, with an average age of 46.9 (± 16.3). The age-standardized prevalence of obesity among depressed Americans increased from 42.8% in 2005–2008 to 46.3% in 2021–2023 ( P for trend < 0.001). This upward numerical trajectory was particularly pronounced in the female depression population (44.0%-52.1%; P for trend = 0.198) and the 45–64 age group showed a higher prevalence of obesity compared to other age groups. Furthermore, the prevalence of grade II obesity (35 kg/m 2 ≤ BMI < 40 kg/m 2 ) and grade III obesity (BMI ≥ 40 kg/m 2 ) showed a significant increasing trend in both males and females, while grade I obesity (30 kg/m 2 ≤ BMI < 35 kg/m 2 ) exhibited a significant decreasing trend overall (from 21.0% to 19.0%; P for trend = 0.002). Notably, among Mexican Americans with depression, there was a significant decrease in the prevalence of grade I obesity from 30.2% in 2005–2008 to 10.3% in 2021–2023 ( P for trend < 0.001). From 2005 to 2023, the prevalence of obesity among US adults with depression increased, and this increase has been especially pronounced among female patients. Among women, the prevalence of obesity grade I, II, and III all increased. Among men, only the prevalence of obesity grade II and III increased. These findings underscore the urgent need for integrated clinical and public health interventions that address weight management as a core component of depression care to mitigate the compounded health burden. Not applicable.