Associations Between Extremity Adiposity and Depression, Overestimation of Body Mass Index, and Intention to Lose Weight

Although extremity adiposity is associated with adverse health outcomes, its impact on psychological health in individuals without central obesity remains unclear. We conducted a study to examine this association using data from the United States National Health and Nutrition Examination Survey 2011-2018. We measured extremity adiposity using dual-energy X-ray absorptiometry scans. We assessed depression using the Patient Health Questionnaire-9. We also assessed overestimation of body mass index group and intention to lose weight. We conducted multivariate logistic regression of extremity fat percentages, stratified by biological sex at birth. Our analysis included 4,253 individuals aged 18‒85 years. We found that men with extremity adiposity had an increased risk for depression (arm: risk ratio [RR] = 1.99, 95% confidence interval [CI] [1.11, 3.58], p = .021; leg: RR = 2.17, 95% CI [1.21, 3.89], p < .001); however, women had an increased risk for depression with leg adiposity (RR = 1.89, 95% CI [1.01, 3.51], p = .046). Men with arm adiposity (RR = 18.75, 95% CI [5.07, 69.36], p < .001) were significantly more likely to overestimate their body mass index status compared with women (RR = 5.62, 95% CI [3.18, 9.93], p < .001). Extremity adiposity was associated with increased odds of intention to lose weight in both men and women. Extremity adiposity in individuals without central obesity is associated with an increased risk for depression in men, while both men and women show overestimation in weight perception and a future intention to lose weight.