The association between metabolically healthy obesity and risk of depression: a systematic review and meta-analysis
Authors' conclusion
MHO was associated with an increased risk of depression, particularly among women and populations from North America and Europe.
Study context
- Population
- Observational studies comparing metabolic-obesity phenotypes for risk of depression; databases searched up to 20 June 2024
- Participants
- 1,277,267 participants3 cohorts9 cross-sectional studies
- Comparison
- Metabolically healthy obesity (MHO), metabolically unhealthy nonobesity and metabolically unhealthy obesity vs metabolically healthy nonobesity
- Outcome
- Risk of depression (pooled OR)
Methodological detailsrandom-effects model, subgroup analyses and meta-regressions
- Random-effects model
- Subgroup analyses and meta-regressions
Pooled result
As reported in the abstract
Depression
Each group vs metabolically healthy nonobesityOdds ratio (95% CI)
MHOI² = 88.3%
1.08(1.04–1.12)
Metabolically unhealthy nonobesityI² = 99.6%
1.15(1.04–1.28)
Metabolically unhealthy obesityI² = 99.8%
1.30(1.12–1.51)
Further pooled results
| Outcome | OR (95% CI) | |
|---|---|---|
| Depression, MHO subgroupsMHOvs Metabolically healthy nonobesityWomen | 1.14 (1.08–1.20) | |
| Depression, MHO subgroupsMHOvs Metabolically healthy nonobesityNorth America | 1.26 (1.01–1.58) | |
| Depression, MHO subgroupsMHOvs Metabolically healthy nonobesityEurope | 1.23 (1.07–1.41) | |
| 0.512Odds ratio (log scale) |
Sources of heterogeneity
- Inconsistent MHO definitions and BMI cutoffs were important sources of heterogeneity (subgroup analysis)
- PQ = 29.87, p = 0.001
- Meta-regression
- P = 0.015, R² = 100%
Original publication
The association between metabolically healthy obesity and risk of depression: a systematic review and meta-analysis. Int J Obes (Lond). Published 20 March 2025. doi:10.
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