Using a Lifecourse Approach to Understand the Relationship Between Adolescent Weight Status and Later Life Depressive Symptoms

Purpose: Increasingly, studies of late life physical health and wellbeing have adopted a lifecourse approach—considering the downstream influences of early life factors on wellbeing in mid- and late-adulthood. Given the recent increase in obesity among children and adolescents, the long-term consequences of childhood and teen obesity on the risk of poor health in adulthood is a particularly salient question. Several studies have focused on the link between earlier life obesity and adult cardiovascular disease risk. Fewer studies have examined the association between earlier life weight status and other indicators of wellbeing, but there is evidence to believe that such relationships exist. For instance, overweight in adolescence was observed to confer a disadvantage on educational attainment and occupational standing, later life physical function, chronic health conditions, and mortality. From this growing area of research, there is evidence that the long-term consequences of teen weight status may also be associated with mental health in adulthood. No study has investigated this link in adolescent men and women. Our study investigates the longitudinal association between weight status measured in adolescence and mental health approximately 47 years later.

Method: We examine the links between a novel indicator of adolescent weight status and depressive symptoms in later life using the Wisconsin Longitudinal Study (WLS), a prospective cohort study following high school graduates from Wisconsin schools in 1957. The independent variable of interest is standardized relative body mass (SRBMI) from high school yearbook photographs in 1957. Using weight status determined from high school photographs is a strength, given that these photographs are not subject to the same bias as retrospective reports of body weight. Prior studies have used this measure and it has been proven to be a reliable measure of body weight.

The outcome measure, the Center for Epidemiological Studies Depression Scale (CES-D), was administered in 2004 when study participants are about 65 years of age. We also include a variety of controls in the models.

We calculate mean scores of the CES-D scale by each SRBMI category for both women and men. We then estimate odds ratios using gender stratified logistic regression models using the dichotomous CES-D measure for mild to moderate depression.

Results: The relationship between overweight in adolescence and depressive symptoms in later life is statistically significant for women (OR=1.7), even when adult BMI is controlled for. However, there is no relationship between adolescent weight and depressive symptoms in later life for men in the full model.

Conclusion and Implications: This study finds that overweight adolescents had poorer mental health in later life compared to their normal body weight counterparts.  Of particular interest are the gender differences in this relationship, with overweight teenage women having worse later life mental health than normal weight teen women in the full models. These findings are consistent with others suggesting that the body weight stigma has negative effects on women throughout the lifecourse, which has important social welfare and public health implications for healthy aging.