Weight change and associated factors in children and adolescents with depression after 1 year treatment at Siriraj hospital

Main Article Content

Pitchanun Nuntatikul
Wanlop Atsariyasing


Objectives: This study aimed to investigate weight changes in children and adolescents with depressive disorder after 1 year of treatment, and to explore the associations between weight gain and associated factors.

Methods: A retrospective chart review was conducted on children and adolescents diagnosed with depressive disorder by psychiatrist at Siriraj Hospital from 2013 to 2019. Initial and post-1-year treatment weights were collected and categorized into 5 groups (very underweight, underweight, average, overweight, and obese) based on standard growth curves. Associated factors, including gender, age, type and duration of medication, comorbidities, and substance use, were recoded. Data were analyzed using mean, median, mode, and logistic regression analyses.

Results: This study included 202 cases, with an average age of 13.8 years. After 1 year of treatment, 141 cases (69.7%) showed no changes in weight, 18 cases (9.0 %) exhibited weight loss, and 43 cases (21.3 %) demonstrated weight gain. Logistic regression analyses revealed that the initial weight groups of very underweight (OR=6.78 (1.25–36.37), p=0.026), underweight (OR=10.61 (3.59–31.34), p<0.001), and overweight (OR=10.97 (3.93–30.58), p<0.001) were significantly associated with weight gain compared to the average weight group. Other studied factors were not associated with weight gain after 1 year of treatment.

Conclusions: The majority of children and adolescents with depressive disorder do not experience weight changes after 1 year of treatment. Factors associated with weight change include the initial weight, with the very underweight, underweight and overweight groups showing significant associations with weight gain.

Article Details

How to Cite
Nuntatikul, P., & Atsariyasing, W. (2024). Weight change and associated factors in children and adolescents with depression after 1 year treatment at Siriraj hospital. Journal of the Psychiatric Association of Thailand, 69(1), 45–54. Retrieved from https://he01.tci-thaijo.org/index.php/JPAT/article/view/267072
Original Articles


Department of Nutrition and Food Safety (NFS). Obesity [Internet]. World Health Organization; [updated 2020, Mar 31; cited 2021, Nov 20]. Available from: https://www.who.int/health-topics/obesity

Department of Health. Overweight and obesity rate in school-aged children [Internet]. Ministry of Health; [updated 2020, Nov 18; cited 2021, Nov 20]. Available from: http://dashboard.anamai.moph.go.th/dashboard/overweightstudent/index?year=2020

Kansra AR, Lakkunarajah S, Jay MS. Childhood and adolescent obesity: a review. Front Pediatr 2020;8:581461.

World Health Organization. Depression [Internet]. [updated 2020, Jan 30; cited 2021, Nov 20]. Available from: https://www.who.int/news-room/fact-sheets/detail/depression

Suicidal Prevention Faculty of Thailand. Suicidal attempts report [Internet]. Department of Mental Health; [updated 2021, Jul 25; cited 2021, Nov 20]. Available from: https://suicide.dmh.go.th/report/suicide/download/view.asp?id=24

Suicidal Prevention Faculty of Thailand. Suicidal attempts by age [Internet]. Department of Mental Health; [updated 2021, Jul 25; cited 2021, Nov 20]. Available from: https://www.dmh.go.th/report/suicide/viewg1.asp?id=28

Cockerill RG, Biggs BK, Oesterle TS, Croarkin PE. Antidepressant use and body mass index change in overweight adolescents: a historical cohort study. Innov Clin Neurosci 2014;11(11-12):14-21.

Mooreville M, Shomaker LB, Reina SA, Hannallah LM, Adelyn Cohen L, Courville AB, et al. Depressive symptoms and observed eating in youth. Appetite 2014;75:141-9.

Solmi M, Kohler CA, Stubbs B, Koyanagi A, Bortolato B, Monaco F, et al. Environmental risk factors and nonpharmacological and nonsurgical interventions for obesity: An umbrella review of meta-analyses of cohort studies and randomized controlled trials. Eur J Clin Invest 2018;48(12):e12982.

Gibson-Smith D, Bot M, Milaneschi Y, Twisk JW, Visser M, Brouwer IA, et al. Major depressive disorder, antidepressant use, and subsequent 2-year weight change patterns in the Netherlands Study of Depression and Anxiety. J Clin Psychiatry 2016;77(2):e144-51.

Lindberg L, Persson M, Danielsson P, Hagman E, Marcus C. Obesity in childhood, socioeconomic status, and completion of 12 or more school years: a prospective cohort study. BMJ Open 2021;11(3):e040432.

Felton J, Cole DA, Tilghman-Osborne C, Maxwell MA. The relation of weight change to depressive symptoms in adolescence. Dev Psychopathol 2010;22(1):205-16.

‌13. Calarge CA, Mills JA, Janz KF, Burns TL, Coryell WH, Zemel BS. Body composition in adolescents during treatment with selective serotonin reuptake inhibitors. Pediatrics 2017;140(1): e20163943.

Rynn MA, Riddle MA, Yeung PP, Kunz NR. Efficacy and safety of extended-release venlafaxine in the treatment of generalized anxiety disorder in children and adolescents: two placebo-controlled trials. Am J Psychiatry 2007;164(2):290-300.

Serretti A, Mandelli L. Antidepressants and body weight: a comprehensive review and meta-analysis. J Clin Psychiatry 2010;71(10):1259–72.

Salvi V, Mencacci C, Barone-Adesi F. H1-histamine receptor affinity predicts weight gain with antidepressants. Eur Neuropsychopharmacol 2016;26(10):1673-7.

‌17. Blumenthal SR, Castro VM, Clements CC, Rosenfield HR, Murphy SN, Fava M, et al. An electronic health records study of long-term weight gain following antidepressant use. JAMA Psychiatry 2014;71(8):889-96.

Pozzi M, Pisano S, Marano G, Carnovale C, Bravaccio C, Rafaniello C, et al. Weight-Change trajectories of pediatric outpatients treated with risperidone or aripiprazole in a naturalistic setting. J Child Adolesc Psychopharmacol 2019;29(2):133-40.

Schoemakers RJ, van Kesteren C, van Rosmalen J, Eussen M, Dieleman HG, Beex-Oosterhuis MM. No differences in weight gain between risperidone and aripiprazole in children and adolescents after 12 months. J Child Adolesc Psychopharmacol 2019;29(3):192-6.

Bradley KL, McGrath PJ, Brannen CL, Bagnell AL. Adolescents' attitudes and opinions about depression treatment. Community Ment Health J 2010;46(3):242-51.

Minor T, Ali MM, Rizzo JA. Body weight and suicidal behavior in adolescent females: the role of self-perceptions. J Ment Health Policy Econ 2016;19(1):21-31.

Rankin J, Matthews L, Cobley S, Han A, Sanders R, Wiltshire HD, et al. Psychological consequences of childhood obesity: psychiatric comorbidity and prevention. Adolesc Health Med Ther 2016;7:125-46.

Roberts RE, Duong HT. Obese youths are not more likely to become depressed, but depressed youths are more likely to become obese. Psychol Med 2013;43(10):2143-51.

Heiskanen TH, Koivumaa-Honkanen HT, Niskanen LK, Lehto SM, Honkalampi KM, Hintikka JJ, et al. Depression and major weight gain: a 6-year prospective follow-up of outpatients. Compr Psychiatry 2013;54(6):599-604.

Mannan, M., Mamun, A., Doi, S., & Clavarino, A. Prospective associations between depression and obesity for adolescent males and females- a systematic review and meta-analysis of longitudinal studies. PLoS One 2016;11(6):e0157240.

Reeves GM. Childhood obesity and depression - connection between these growing problems in growing children. Int J Child Health Dev 2008:103-14.

Hughes K, Bellis MA, Hardcastle KA, Sethi D, Butchart A, Mikton C, et al. The effect of multiple adverse childhood experiences on health: a systematic review and meta-analysis. Lancet Public Health 2017;2(8):e356-66.

Danese A, Tan M. Childhood maltreatment and obesity: systematic review and meta-analysis. Mol Psychiatry 2014;19(5):544-54.

Moradi M, Mozaffari H, Askari M, Azadbakht L. Association between overweight/obesity with depression, anxiety, low self-esteem, and body dissatisfaction in children and adolescents: a systematic review and meta-analysis of observational studies. Crit Rev Food Sci Nutr 2020:1-16.

Mihalopoulos NL, Spigarelli MG. Comanagement of pediatric depression and obesity: a clear need for evidence. Clin Ther 2015;37(9):1933-7.

Libowitz MR, Nurmi EL. The burden of antipsychotic-induced weight gain and metabolic syndrome in children. Front Psychiatry 2021;12:623681.