Depression is one of the most common psychiatric disorders and is related to obesity and underweight.1,2 Our previous study showed that the prevalence of depression was higher in women (7.0%) than in men (3.9%).3 According to body weight status, there was a significant difference in the prevalence of depression (underweight, 16.2%; normal weight, 5.5%; overweight, 4.3%; obese [body mass index, BMI ≥30 kg/m2], 6.9%). Compared to the normal weight group, the underweight group had a higher adjusted odds ratio (OR) for depression (OR, 2.38; 95% confidence interval [CI], 1.45–3.88) adjusted for age, sex, educational level, household income, habitation, marital status, comorbidities, smoking, alcohol, and stress perception.3 Obesewomen had higher adjusted OR for depression (OR, 1.75; 95% CI, 0.79–3.88), while obesemen had lower ORs for depression (OR, 0.62; 95% CI, 0.17–2.27), although it was not statistically significant.3There can be several factors affecting the relationship between obesity and depression, including age, sex, nationality, cultural background, ethnicity, and social status.4 In addition, there was definite sex difference in relationship between body weight and depression. Likewise, other studies reported a positive relationship between obesity and depression in women but not in men.5,6We agree with that women are more exposed to and affected by media.4 For women, menopause can affect mental health, and is associated with depression.7 We performed analysis after adjusting for age, thus menopause condition was adjusted. We analyzed sex difference between BMI and depression in previous study.3Subsequently, we analyzed the relationship between body image perception and depression in the recently published article in the Journal of Obesity & Metabolic Syndrome.8 In multivariate analysis, the risk for depression was high in the underweight group and among participants who perceived themselves as extremely lean or extremely obese.8 Further study is needed to analyze sex difference regarding body image perception and depression.Biased BMI and body image perception are associated with increased incidence of depression.8 In addition, specific weight control methods, such as fasting, skipping meals, and reducing food consumption, rather than exercise, are associated with increased incidence of depression.8 Therefore, healthy methods to establish healthy body image and maintain normal-range BMI should be considered. Society needs to focus its attention and establish systematic support on attempts to achieve healthy body weight.