Do negative emotional factors have independent associations with excess adiposity?

Objective: Taken in isolation, depression, anxiety, and hostility/anger have been shown to predict obesity. It is unknown whether these negative emotional factors are associated with adiposity, independently of each other. The objective of this review was to determine whether negative emotional factors have independent associations with adiposity. Methods: We searched for observational studies examining adiposity and two or more negative emotional factors. Studies which examined a negative emotional factor using analyses which controlled for other emotional factor(s) were selected for the review. Results: Three prospective and 11 cross-sectional studies met our inclusion/exclusion criteria. Of these investigations, 64% indicated that depression had positive associations with adiposity, independent of anxiety or hostility, and 56% indicated that anxiety had independent associations with adiposity. Only 33% of studies found independent associations for hostility and adiposity; however, far fewer studies were available. Conclusion: Depression and anxiety have independent associations with excess adiposity when controlling for other emotional factors. Additional studies are needed to determine whether hostility/anger is independently associated with excess adiposity. These results have implications for the design of effective obesity prevention programs.