The association of depression and anxiety with obesity and unhealthy behaviors among community-dwelling US adults.

The aim of this study was to examine the extent to which depression and anxiety are associated with smoking, obesity, physical inactivity and alcohol consumption in the US population using the Patient Health Questionnaire 8 (PHQ-8) and two questions on lifetime diagnosis of anxiety and depression. Data were analyzed in 38 states, the District of Columbia and two territories using the 2006 Behavioral Risk Factor Surveillance System (n=217,379), a large state-based telephone survey. Overall, adults with current depression or a lifetime diagnosis of depression or anxiety were significantly more likely than those without each diagnosis to smoke, to be obese, to be physically inactive, to binge drink and drink heavily. There was a dose-response relationship between depression severity and the prevalence of smoking, obesity and physical inactivity and between history of depression (never depressed, previously depressed, currently depressed) and the prevalence of smoking, obesity, physical inactivity, binge drinking and heavy drinking. Lifetime diagnosis of depression and anxiety had an additive association with smoking prevalence. The associations between depression, anxiety, obesity and unhealthy behaviors among US adults suggest the need for a multidimensional and integrative approach to health care.