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Journal of Obesity & Metabolic Syndrome 2019;28(1):61-68
Relationships among Body Mass Index, Body Image, and Depression in Korean Adults: Korea National Health and Nutrition Examination Survey 2014 and 2016
Published online March 30, 2019
© 2019 Korean Society for the Study of Obesity

Gwan Woo Hong1, Soo Min Hong2,*

1Department of Internal Medicine, Dongguk University Ilsan Hospital, Goyang, Korea; 2Department of Internal Medicine, Seoul Paik Hospital, Inje University College of Medicine, Seoul, Korea
*Soo Min Hong,, Department of Internal Medicine, Seoul Paik Hospital, Inje University College of Medicine, 9 Mareunnae-ro, Jung-gu, Seoul 04551, Korea, Tel: +82-2-2270-0001, Fax: +82-2-2270-0579, E-mail:
Received October 13, 2018; Revised November 26, 2018; Accepted January 15, 2019.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.


This study extends the findings of our previous examination of the relationship between obesity and depression in Korean adults. Here, we further investigate the relationships among body image perception, weight control method, and depression based on data from the Korea National Health and Nutrition Examination Survey in 2014 and 2016.


In total, we analyzed 11,782 participants. We classified them into four groups according to body mass index (BMI): underweight (BMI <18.5 kg/m2), normal-to-overweight (BMI 18.5–24.9 kg/m2), obesity stage I (BMI 25.0–29.9 kg/m2), and obesity stage II (BMI >30.0 kg/m2). Current depression was defined as a score of at least 10 on the nine-item Patient Health Questionnaire. We performed chi-square tests and multivariate logistic regression analyses to examine the relationships among BMI, body image perception, method of weight control, and depression.


Depression was diagnosed in 6.5% of the study participants. The underweight group had the highest odds ratio (OR) for depression (OR, 1.94; 95% confidence interval [CI], 1.42–2.65). Further, participants in the extremely lean subgroup within the underweight group had an even higher OR for depression (OR, 3.06; 95% CI, 2.28–4.10). Regarding weight management methods, the rate of depression was higher for fasting and for skipping or reducing a meal than for exercise.


Biased BMI and body image perception are associated with increased incidence of depression. In addition, specific weight control methods, such as fasting, skipping a meal, and reducing food consumption, are also associated with increased incidence of depression.

Keywords : Body mass index, Body image, Depression

June 2019, 28 (2)
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