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Obesity and depression are major public health problems, posing enormous challenges in the decades to come. The direction of the association between obesity and depression remains unclear, and their co-occurrence in an individual might have negative consequences on work and health outcomes. The aims of this thesis were to examine the direction of association between obesity and depression, and to examine their separate and combined effects on long-term sickness absence, work performance impairment, health-related quality of life and health care utilization and costs. In Chapter 1 we provide the epidemiology of obesity and depression, and the national and global burden that they cause. It also outlines the importance of studying obesity and depression together in relation to work and health outcomes. Moreover, we introduce the conceptual model for the research questions, and described the data sources that we used to answer the research questions. In Chapter 2 we examined the prospective association between obesity and depression and whether depression subtypes have different effects on obesity or vice versa. This prospective study provides suggestive evidence that obesity is associated with the onset of recurrent depression, i.e. having more than one episode of major depression. Recurrent depression tends also to be associated with the subsequent development of obesity among adults in the general population during 2-year follow-up. The heterogeneity of depression should be considered when examining the effect of obesity on depression. In Chapter 3 we explored the separate and joint associations of overweight and distress with long-term sickness absence among Dutch employees. This cross-sectional study showed that overweight and distress had a joint association with long-term sickness absence. This joint association was slightly larger than the sum of the separate associations of overweight and distress on LTSA, but not statistically significant as measured by the synergy index. Addressing distress might reduce the public health burden of LTSA among women with overweight. In Chapter 4 we examined the association of overweight and obesity with work functioning (WF), and whether this association differs between workers with different working-time arrangements (Le. day workers, on call and shift workers). Obesity was associated with poor WF scores, especially a poor WF score for physical demands. …...................................................
Dissertation available at ACIPH Library |
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