Obesity and symptoms of depression among adults in selected countries of the Middle East: a systematic review and meta-analysis.

Although obesity has been widely recognized for its consequences on physical health, its psychological burden in the adult populations in the Middle East remains unclear. This meta-analysis synthesized data from observational studies to investigate the association between obesity and depression among adult populations in Middle Eastern countries. Five bibliographical electronic databases were searched for studies published up to April 2014. Pooled meta-analytic estimates were derived using the random-effect models. Three case-control studies and five cross-sectional studies were identified. Meta-analysis showed significant positive associations between obesity and depression across study designs, with an overall effect of odds ratio 1.27 (95% confidence interval 1.11-1.44). The association between obesity and depression was more marked in women than men although that difference was not statistically significant. Other subgroup analysis showed that none of the potential factors including the assessment for obesity or depression, confounder control and study quality had a modification effect on the studied association. Meta-analysis of eight observational studies from five countries in the Middle East suggests an evidence of a positive association between obesity and depression among adult populations, which appeared to be more marked among women. Future research should examine the causal pathways between obesity and depression.