Depressive symptoms in obese patients study.

The study by Huang et al1 sheds valuable light on how obesity may cause depression. However, depressed people are known to be at higher risk for developing obesity in the first place.2 It is therefore important to know whether any of the participants had a history of prior depression. Other significant risk factors for depression such as concomitant physical illness, medication use, lack of family support and presence of pain should also be investigated. Depressive symptoms have been especially linked to general medical3 and, in particular, to cardiovascular conditions,4 which have a higher prevalence in obese individuals. In addition, the Beck Depression Inventory includes questions about physical symptoms such as fatigue, which may result in the scores being higher, since symptoms of illness may be confused with depression. Finally, insulin resistance was defined as a HOMA-IR (homeostasis model of assessment for insulin resistance) score of >1.64, whereas the most widely adopted HOMA-IR cutoff value is is 2.6.5