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Background A bidirectional relationship has been reported between depression and obesity. Malta, a European small state, is a highly prevalent country for obesity making this population ideal to study this relationship. The aim of this study was to identify the adiposity characteristics of a population-based depression sub-group and explore for any relationships between depression and an increase in adiposity. Methods A nationally representative health examination survey was conducted in Malta. Body mass index was measured while a validated questionnaire was used to establish the presence of depression and the sociodemographic characteristics of the participants. The study population was categorized into different sub-populations according to their adiposity status (normal, overweight, obese) and their self-reported depression. Multivariate logistic regression analyses were performed to identify independent adiposity status and socio-demographic factors associated with depression. Results The prevalence of self-reported depression was 10.44% (CI 95%: 9.52 - 11.43) with a female predominance and an overweight-obese profile. Extreme obesity (&amp;gt;50Kg/m2) was only present in individuals without depression. Only the overweight status (OR: 1.35 CI95%: 1.03 - 1.78 p = 0.03) was statistically linked with depression along with being female, having a low education level, being unemployed or retired and being a smoker. Conclusions The adiposity driver for the growing depression epidemic appears to be overweight rather than obesity. Stressful social determinants including unemployment, retirement, low education and being female have a role in this growing health concern. This calls for preventive action plans targeting overweight status, depression along with unfavourable sociodemographic characteristics. Key messages Overweight status was found to be linked with depression. Targeted action plans to prevent overweight and depression should be implemented with special attention to population with unfavourable sociodemographic characteristics.

Which body weight status is associated with depression? Results from a European population study