Depressive symptoms are associated with obesity in adults with heart failure: An analysis of gender differences

Misty A.W. Hawkins, Carly M. Goldstein, Mary A. Dolansky, John Gunstad, Joseph D. Redle, Richard Josephson, Joel W. Hughes

Research output: Contribution to journalArticlepeer-review

9 Scopus citations


Background: Depression is a predictor and consequence of obesity in the general population. Up to 50% of patients with heart failure exhibit elevated depressive symptoms or depressive disorders; however, research on the depression-obesity relationship in heart failure populations is limited, especially in regard to gender differences. Aims: To conduct total-sample and gender-stratified analyses to determine whether depressive symptoms are associated with body mass index (BMI) in a sample of patients with heart failure. Method: Participants were 348 (39% female, 26% non-White) patients with heart failure (aged 68.7±9.7 years) recruited from urban medical centers. Depressive symptoms were measured using the Patient Health Questionnaire-9 (PHQ-9). Height and weight were used to compute BMI (kg/m2). Regressions were performed for total sample and both genders. Regressions for BMI were run with demographic, medical, and psychological covariates in Step 1 and the PHQ-9 in Step 2. Results: Regression results (total sample) revealed that the PHQ-9 was associated with BMI after adjusting for covariates (β=.22, p=.004). For males, the relationship between PHQ-9 and BMI remained (β=.23, p=.024) and was driven by those with severe obesity (BMI ≥ 40 kg/m2). A trend between PHQ-9 and BMI was detected among females (β=.19, p=.091). Conclusion: BMI is related to depressive symptoms in adults with heart failure even after adjusting for demographic and medical covariates. Depressive symptoms were associated with BMI in males, whereas a trend was detected among females. These findings could ultimately be used to improve heart failure outcomes for depressed, obese individuals with heart failure.

Original languageEnglish
Pages (from-to)516-524
Number of pages9
JournalEuropean Journal of Cardiovascular Nursing
Issue number6
StatePublished - 1 Dec 2015
Externally publishedYes


  • Body mass index
  • depressive symptoms
  • gender
  • heart failure
  • obesity


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