Appetite and weight changes are commonly occurring symptoms of depressive illness. The occurrence of these symptoms may not only be related to depressive mood but may also be related to body weight.

To examine the relationship between symptoms of depression and body weight.

Symptoms of depression were assessed by the Montgomery-Asberg depression rating scale (MADRS) in 1694 patients seeking medical help and fulfilling DSM-IV criteria for a major depressive episode. The level of anxiety was evaluated by Covi’s anxiety scale. Body weight was expressed as body-mass index (BMI, kg/m2) and treated both categorically and continuously.

The total MADRS score was not statistically different across the four BMI categories (underweight: 32.3 ± 0.6, normal weight: 30.9 ± 0.2, grade 1: 30.6 ± 0.3, and 2 overweight: 30.6 ± 0.6, P = 0.053 (NS)). In women with BMI ≤ 18.5 kg/m2 MADRS was significantly higher than that in other BMI categories (underweight: 32.4 ± 0.6, normal weight: 30.6 ± 0.2, grade 1: 30.6 ± 0.4, and 2 overweight: 30.6 ± 0.6: P = 0.036). Increasing BMI was related to a linear decrease in symptoms “Reduced appetite” (P < 0.0001) and “Pessimistic thoughts” (P < 0.003). The presence of melancholic or atypical features was not associated with lower or higher BMI, respectively.

In patients with major depression higher body weight is likely to be associated with less reduction in appetite and less pessimistic thoughts.