Gender and Ethnic Differences in the Association Between Obesity and Depression Among Black Adolescents

Shervin Assari, Cleopatra Howard Caldwell

This study aimed to investigate the association between obesity and major depression disorder (MDD) in a nationally representative sample of Black adolescents in the USA. The study also tested the effects of ethnicity and gender as possible moderators. Data came from the National Survey of American Life (NSAL)-Adolescents, a representative household mental health survey of Black adolescents in the USA. Participants consisted of 1170 Black adolescents (810 African Americans and 360 Caribbean Blacks). Obesity was defined determined by the cutoff points based on the body mass index (BMI) appropriate for age and gender. Twelve-month MDD was measured using the World Mental Health Composite International Diagnostic Interview (CIDI). In the first step, the association between obesity and MDD in the pooled sample, controlling for the main effects of gender and ethnicity. In the next steps, two interactions were tested: (1) obesity and ethnicity and (2) obesity and gender. Although any associations between obesity and MDD in the pooled sample of Blacks were not found, there was a significant interaction between ethnicity and obesity on MDD. Upon testing the associations across intersections of ethnicity and gender, a positive association was found among Caribbean Black females but not Caribbean Black males, African American males, or African American female. The link between BMI and MDD among Blacks depends on ethnicity and gender, and risk of comorbid depression among Black youth with obesity is highest among Caribbean Black females.