{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,16]],"date-time":"2026-05-16T05:07:30Z","timestamp":1778908050520,"version":"3.51.4"},"reference-count":47,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T00:00:00Z","timestamp":1777334400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Behavioral Sciences"],"abstract":"<jats:p>Obesity and depression in childhood and adolescence represent major public health concerns, yet the nature and direction of their association remain incompletely understood. In the present study, we conducted a systematic review and stratified meta-analysis of epidemiological studies examining the relationship between obesity and depression in youth populations. A total of 945 records were identified through database searches, of which 18 studies met the inclusion criteria for the review. To ensure greater conceptual consistency, quantitative synthesis was restricted to studies examining categorical obesity (typically defined as body mass index (BMI) \u2265 95th percentile) and binary depression outcomes, which formed the longitudinal and cross-sectional meta-analytic cores, analyzed separately. Our longitudinal meta-analysis (k = 4; N = 5581) indicated that obesity was associated with an increased likelihood of subsequent depression (OR = 2.05, 95% CI: 1.40\u20132.99), whereas the cross-sectional meta-analysis (k = 6; N = 20,278) showed a weaker and non-significant association (OR = 1.40, 95% CI: 0.98\u20132.00) with moderate heterogeneity. Additional studies that could not be pooled due to differences in exposure or outcome definitions were integrated through narrative synthesis and showed mixed and generally less consistent patterns, broadly supporting the distinction between longitudinal and cross-sectional evidence. Overall, our findings suggest that obesity during childhood and adolescence is associated with an increased likelihood of subsequent depression, while concurrent associations appear more heterogeneous and more difficult to interpret. By distinguishing between study designs and prioritizing comparable effect estimates, this study provides a more transparent synthesis of the current evidence on the relationship between obesity and depression in youth.<\/jats:p>","DOI":"10.3390\/bs16050671","type":"journal-article","created":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T10:34:42Z","timestamp":1777458882000},"page":"671","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Does Obesity Increase the Risk of Depression in Youth? A Stratified Meta-Analysis of Longitudinal and Cross-Sectional Evidence"],"prefix":"10.3390","volume":"16","author":[{"given":"St\u0103ncule\u021b Carmen","family":"Ramona","sequence":"first","affiliation":[{"name":"Multidisciplinary Doctoral School, Vasile Goldi\u0219 Western University of Arad, 310025 Arad, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8432-1965","authenticated-orcid":false,"given":"Dan Octavian","family":"Rusu","sequence":"additional","affiliation":[{"name":"Department of Applied Psychology, Babes-Bolyai University of Cluj-Napoca, 4305849 Cluj-Napoca, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0667-2898","authenticated-orcid":false,"given":"Cristian","family":"Delcea","sequence":"additional","affiliation":[{"name":"Multidisciplinary Doctoral School, Vasile Goldi\u0219 Western University of Arad, 310025 Arad, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,28]]},"reference":[{"key":"ref_1","first-page":"558","article-title":"Adolescent obesity and risk for subsequent major depressive disorder and anxiety disorder: Prospective evidence","volume":"161","author":"Anderson","year":"2007","journal-title":"Archives of Pediatrics & Adolescent Medicine"},{"key":"ref_2","first-page":"390","article-title":"Body mass index, depression, and suicidal ideation among adolescents","volume":"47","author":"Gaines","year":"2010","journal-title":"Journal of Adolescent Health"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Borenstein, M., Hedges, L. V., Higgins, J. P. T., and Rothstein, H. R. (2009). Introduction to meta-analysis, John Wiley & Sons.","DOI":"10.1002\/9780470743386"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1037\/a0018645","article-title":"Obesity as a prospective predictor of depression in adolescent females","volume":"29","author":"Boutelle","year":"2010","journal-title":"Health Psychology"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"S266","DOI":"10.1139\/apnm-2015-0627","article-title":"Systematic review of the relationships between sleep duration and health indicators in school-aged children and youth","volume":"41","author":"Chaput","year":"2016","journal-title":"Applied Physiology, Nutrition, and Metabolism"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1240","DOI":"10.1136\/bmj.320.7244.1240","article-title":"Establishing a standard definition for child overweight and obesity worldwide: International survey","volume":"320","author":"Cole","year":"2000","journal-title":"BMJ"},{"key":"ref_7","first-page":"89","article-title":"Longitudinal associations between overweight status and depressive symptoms in the Indonesia Family Life Survey","volume":"345","author":"Colozza","year":"2025","journal-title":"Journal of Affective Disorders"},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Delgado-Floody, P., Caama\u00f1o-Navarrete, F., Jerez-Mayorga, D., Mart\u00ednez-Salazar, C., \u00c1lvarez, C., and Latorre-Rom\u00e1n, P. (2020). Association between obesity and depressive symptoms in adolescents. Nutrients, 12, (9).","DOI":"10.3390\/nu12113489"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1064","DOI":"10.1136\/bmj.38636.593461.68","article-title":"Effectiveness and efficiency of search methods in systematic reviews of complex evidence: Audit of primary sources","volume":"331","author":"Greenhalgh","year":"2005","journal-title":"BMJ"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1097\/00001648-199901000-00008","article-title":"Causal diagrams for epidemiologic research","volume":"10","author":"Greenland","year":"1999","journal-title":"Epidemiology"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"282","DOI":"10.3109\/17477160903473697","article-title":"Self-esteem and quality of life in obese children and adolescents: A systematic review","volume":"5","author":"Griffiths","year":"2010","journal-title":"International Journal of Pediatric Obesity"},{"key":"ref_12","first-page":"89","article-title":"Pathways to suicide-related behavior in childhood and adolescence: The role of body mass index and body dissatisfaction","volume":"152\u2013154","author":"Hammerton","year":"2014","journal-title":"Journal of Affective Disorders"},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Higgins, J. P. T., Thomas, J., Chandler, J., Cumpston, M., Li, T., Page, M. J., and Welch, V. A. (2019). Cochrane handbook for systematic reviews of interventions, John Wiley & Sons. [2nd ed.].","DOI":"10.1002\/9781119536604"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"557","DOI":"10.1136\/bmj.327.7414.557","article-title":"Measuring inconsistency in meta-analyses","volume":"327","author":"Higgins","year":"2003","journal-title":"BMJ"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"980","DOI":"10.1097\/00004583-199707000-00021","article-title":"Schedule for affective disorders and schizophrenia for school-age children\u2013present and lifetime version (K-SADS-PL): Initial reliability and validity data","volume":"36","author":"Kaufman","year":"1997","journal-title":"Journal of the American Academy of Child & Adolescent Psychiatry"},{"key":"ref_16","first-page":"995","article-title":"The children\u2019s depression inventory (CDI)","volume":"21","author":"Kovacs","year":"1985","journal-title":"Psychopharmacology Bulletin"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"606","DOI":"10.1046\/j.1525-1497.2001.016009606.x","article-title":"The PHQ-9: Validity of a brief depression severity measure","volume":"16","author":"Kroenke","year":"2001","journal-title":"Journal of General Internal Medicine"},{"key":"ref_18","first-page":"1","article-title":"2000 CDC growth charts for the united states: Methods and development","volume":"11","author":"Kuczmarski","year":"2002","journal-title":"Vital and Health Statistics"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"220","DOI":"10.1001\/archgenpsychiatry.2010.2","article-title":"Overweight, obesity, and depression: A systematic review and meta-analysis of longitudinal studies","volume":"67","author":"Luppino","year":"2010","journal-title":"Archives of General Psychiatry"},{"key":"ref_20","first-page":"715","article-title":"Prospective associations between depression and obesity for adolescent males and females\u2014A systematic review and meta-analysis of longitudinal studies","volume":"55","author":"Mannan","year":"2016","journal-title":"Journal of Adolescent Health"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"906","DOI":"10.1038\/ijo.2014.19","article-title":"Obesity and depression in adolescence and beyond: Reciprocal risks","volume":"38","author":"Marmorstein","year":"2014","journal-title":"International Journal of Obesity"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1007\/s10865-011-9340-x","article-title":"The association between major depressive disorder and obesity in US adolescents: Results from the 2001\u20132004 national health and nutrition examination survey","volume":"35","author":"Merikangas","year":"2012","journal-title":"Journal of Behavioral Medicine"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1038\/s41380-018-0017-5","article-title":"Depression and obesity: Evidence of shared biological mechanisms","volume":"24","author":"Milaneschi","year":"2019","journal-title":"Molecular Psychiatry"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"e20161878","DOI":"10.1542\/peds.2016-1878","article-title":"National trends in the prevalence and treatment of depression in adolescents and young adults","volume":"138","author":"Mojtabai","year":"2016","journal-title":"Pediatrics"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"e05392","DOI":"10.1016\/j.heliyon.2020.e05392","article-title":"Physical inactivity and sedentary lifestyle behaviors in the Bangladeshi population during COVID-19 pandemic: An online cross-sectional survey","volume":"6","author":"Moonajilin","year":"2020","journal-title":"Heliyon"},{"key":"ref_26","unstructured":"NCD Risk Factor Collaboration (2017). Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: A pooled analysis of 2416 population-based measurement studies in 128\u00b79 million children, adolescents, and adults. The Lancet, 390, (10113), 2627\u20132642."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1016\/j.jadohealth.2003.12.015","article-title":"Overweight status and depressive symptoms during adolescence","volume":"36","author":"Needham","year":"2005","journal-title":"Journal of Adolescent Health"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"766","DOI":"10.1016\/S0140-6736(14)60460-8","article-title":"Global, regional, and national prevalence of overweight and obesity in children and adults during 1980\u20132013: A systematic analysis for the global burden of disease study 2013","volume":"384","author":"Ng","year":"2014","journal-title":"The Lancet"},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"\u00d6zmen, D., \u00d6zmen, E., Ergin, D., \u00c7etinkaya, A. C., Sen, N., Dundar, P. E., and Taskin, E. O. (2007). The association of self-esteem, depression and body satisfaction with obesity among Turkish adolescents. BMC Public Health, 7.","DOI":"10.1186\/1471-2458-7-80"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"n71","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 statement: An updated guideline for reporting systematic reviews","volume":"372","author":"Page","year":"2021","journal-title":"BMJ"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"676","DOI":"10.1001\/jama.295.6.676","article-title":"Comparison of two methods to detect publication bias in meta-analysis","volume":"295","author":"Peters","year":"2006","journal-title":"JAMA"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1016\/j.jad.2016.05.022","article-title":"Overweight during childhood and internalizing symptoms in early adolescence: The mediating role of peer victimization and the desire to be thinner","volume":"202","author":"Pryor","year":"2016","journal-title":"Journal of Affective Disorders"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"941","DOI":"10.1038\/oby.2008.636","article-title":"The stigma of obesity: A review and update","volume":"17","author":"Puhl","year":"2009","journal-title":"Obesity"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1177\/014662167700100306","article-title":"The CES-D scale: A self-report depression scale for research in the general population","volume":"1","author":"Radloff","year":"1977","journal-title":"Applied Psychological Measurement"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"891","DOI":"10.1038\/ijo.2010.222","article-title":"Long-term impact of overweight and obesity in childhood and adolescence on morbidity and premature mortality in adulthood: Systematic review","volume":"35","author":"Reilly","year":"2011","journal-title":"International Journal of Obesity"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"2143","DOI":"10.1017\/S0033291712002991","article-title":"Obese youths are not more likely to become depressed, but depressed youths are more likely to become obese","volume":"43","author":"Roberts","year":"2013","journal-title":"Psychological Medicine"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1097\/00004583-200001000-00014","article-title":"NIMH Diagnostic Interview Schedule for Children Version IV (NIMH DISC-IV): Description, differences from previous versions, and reliability of some common diagnoses","volume":"39","author":"Shaffer","year":"2000","journal-title":"Journal of the American Academy of Child & Adolescent Psychiatry"},{"key":"ref_38","first-page":"1809","article-title":"Obesity, shame, and depression in school-aged children: A population-based study","volume":"94","author":"Nilsson","year":"2005","journal-title":"Pediatric Obesity"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"e12883","DOI":"10.1111\/ijpo.12883","article-title":"Psychiatric comorbidity associated with weight status in 9 to 10 year old children","volume":"17","author":"Smith","year":"2022","journal-title":"Pediatric Obesity"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1136\/archdischild-2017-314608","article-title":"Is obesity associated with depression in children? Systematic review and meta-analysis","volume":"104","author":"Sutaria","year":"2019","journal-title":"Archives of Disease in Childhood"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"340","DOI":"10.1542\/peds.2004-0678","article-title":"Overweight, obesity, and health-related quality of life among adolescents: The national longitudinal study of adolescent health","volume":"115","author":"Swallen","year":"2005","journal-title":"Pediatrics"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1056","DOI":"10.1016\/S0140-6736(11)60871-4","article-title":"Depression in adolescence","volume":"379","author":"Thapar","year":"2012","journal-title":"The Lancet"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1037\/abn0000410","article-title":"Age, period, and cohort trends in mood disorder indicators and suicide-related outcomes in a nationally representative dataset, 2005\u20132017","volume":"128","author":"Twenge","year":"2019","journal-title":"Journal of Abnormal Psychology"},{"key":"ref_44","first-page":"29","article-title":"Life-course body mass index and depressive symptoms: A cohort study of Chinese children and adolescents","volume":"152\u2013154","author":"Wang","year":"2014","journal-title":"Journal of Affective Disorders"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"634","DOI":"10.1038\/sj.ijo.0803142","article-title":"Depression in adolescent obesity: Cultural moderators of the association between obesity and depressive symptoms","volume":"30","author":"Wardle","year":"2006","journal-title":"International Journal of Obesity"},{"key":"ref_46","unstructured":"Wells, G. A., Shea, B., O\u2019Connell, D., Peterson, J., Welch, V., Losos, M., and Tugwell, P. (2026, April 26). The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses, Available online: https:\/\/www3.med.unipmn.it\/dispense_ebm\/2009-2010\/Corso%20Perfezionamento%20EBM_Faggiano\/NOS_oxford.pdf."},{"key":"ref_47","unstructured":"World Health Organization (2026, March 30). Obesity and overweight, Available online: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/obesity-and-overweight."}],"container-title":["Behavioral Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-328X\/16\/5\/671\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,16]],"date-time":"2026-05-16T04:15:28Z","timestamp":1778904928000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-328X\/16\/5\/671"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,28]]},"references-count":47,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2026,5]]}},"alternative-id":["bs16050671"],"URL":"https:\/\/doi.org\/10.3390\/bs16050671","relation":{},"ISSN":["2076-328X"],"issn-type":[{"value":"2076-328X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,28]]}}}