Weight Change, Obesity, Mental Health, and Health Perception: Self-Reports of College-Educated Women

Background: Overweight, weight cycling, and obesity are major health risks with psychological effects that should not be overlooked by mental health professionals.

Method: This article examines behavioral and other factors associated with weight, weight changes, and obesity in 3940 college-educated women, using data from responses to self-administered mailed questionnaires received from fall 1996 to winter 1997.

Results: The mean age of the women was 53.6 years, SD = 12.2. Body mass indexes, prevalence of obesity, and behavioral practices were more favorable than those of women in the general U.S. population. The mean body mass index of the sample was 23.3; median, 22.5; 6.5% were obese, 5% currently smoked, and 68% exercised regularly. Over the past 10 years, 31% maintained the same weight, 11% lost weight, 48% gained weight, and 10% gained and lost weight. Women who both gained and lost weight were more likely to report physician-diagnosed depression, alcoholism, and/or drug dependencies compared to women in the other 3 categories; the multivariable odds ratios are 1.48 (95% CI = 1.07, 2.05) versus those who maintained their weight, 1.38 (95% CI = 1.06, 1.80) versus those who gained weight, and 1.53 (95% CI = 1.06, 2.21) versus those who lost weight. Those who both lost and gained weight were also more likely to report having to forgo mental health care for financial reasons; the respective multivariable odds ratios versus those who maintained their weight, gained weight, and lost weight are 2.01 (95% CI = 1.28, 3.16), 2.21 (95% CI = 1.52, 3.22), and 2.19 (95% CI = 1.23, 3.89).

Conclusion: These findings affirm the view that mental health care deserves attention in the treatment of patients with problems with weight changes and weight control.