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Association between physical multimorbidity, body mass index and mental health/disorders in a representative sample of people with obesity
  1. Ahmed Jérôme Romain1,
  2. Jacques Marleau2,
  3. Aurelie Baillot3,4,5
  1. 1 Ecole de kinésiologie et des sciences de l'activité physique (EKSAP), Faculté de Médecine, Université de Montréal, Montreal, Quebec, Canada
  2. 2 Centre intégré de santé et de services sociaux de l'Outaouais, Gatineau, Quebec, Canada
  3. 3 Sciences infirmières, Université du Québec en Outaouais, Gatineau, Quebec, Canada
  4. 4 Institut du savoir de l’hôpital Montfort-Recherche, Ottawa, Ontario, Canada
  5. 5 Centre de recherche du Centre Intégré de Santé et Services Sociaux de l’Outaouais, Gatineau, Quebec, Canada
  1. Correspondence to Dr Ahmed Jérôme Romain, Ecole de kinésiologie et des sciences de l'activité physique (EKSAP), Faculté de médecine, Université de Montréal, Montreal H3T 1J4, Quebec, Canada; aj.romain{at}


Background Obesity is known to be associated with poor mental health. Studies suggested that multimorbidity might explain the consequences of obesity on mental health. The objective of the present study was to examine to what extent physical multimorbidity and the severity of obesity were associated with mental health and with mental disorders.

Methods Cross-sectional study including a weighted representative sample of individuals in obesity from the province of Quebec included in the 2013–2014 Canadian Community Health Survey (N=1315) and test of the replicability of the association in the three previous cycles (2011–2012, N=1180; 2009–2010, N=1166; 2007–2008, N=1298).

Results Adjusted logistic regressions showed that when obesity classes and physical multimorbidity were considered, the latter was preferentially associated with poor perceived mental health (OR 3.58, 95% CI 2.07 to 6.22), psychological distress (OR 3.71, 95% CI 2.14 to 6.42), major depressive episode (OR 5.16, 95% CI 2.92 to 9.13), mood disorders (OR 2.31, 95% CI 1.41 to 3.78) and anxiety disorders (OR 2.46, 95% CI 1.46 to 4.16). The same associations were confirmed in the previous cycles. Obesity class was only associated with stress (OR 2.05, 95% CI 1.36 to 3.07), but this association was not confirmed in the other cycles. Both physical multimorbidity and severe obesity were associated with mental multimorbidity.

Conclusion Among people with obesity, physical multimorbidity is preferentially associated with poor mental health/disorders. There is an existence of a somatic-mental multimorbidity which should be assessed and prevented in the management of obesity.

  • obesity
  • CCHS
  • multimorbidity
  • mental disorders
  • major depressive episode

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  • Contributors All authors (AJR, JM and AB) have read and approved the final version of the manuscript. Seminal idea: AJR. First draft of the manuscript: AJR. Significant writing: AJR, JM, AB. Statistical plan: AJR, JM, AB. Statistical analyses: JM. Results interpretations: AJR, JM, AB.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval Participants’ approval was assessed by agents from statistics Canada before measurement.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Data may be obtained from a third party and are not publicly available.