Depression is associated with increased adiposity in a 4-year follow-up: results from the ELSA-Brasil

•Depressive status (with antidepressant use) is associated with increased adiposity.•There are sex-specific associations between depressive status and adiposity.•SSRIs antidepressant was associated with increased adiposity for both sexes.BACKGROUND: Longitudinal studies focusing on investigating adiposity in relation to depression are scarce. We aimed to assess the association between depression status and trajectory of adiposity parameters in a 4 year-period, and to investigate the role of antidepressants in this association. METHODS: We analyzed baseline and follow-up data from 13 684 participants (35-74 years) of the Brazilian Longitudinal Study of Adult Health. Current depressive episode was assessed through the Clinical Interview Schedule – Revised (CIS-R), and current use of antidepressants was investigated, allowing the classification of participants into four groups: Controls; Untreated depression; Treated depression; and Resistant depression. Pharmacological classes of antidepressants were identified. The outcomes assessed were the relative changes in adiposity: weight, body mass index, waist circumference, waist-to-height ratio, and conicity index. Associations between adiposity and depressive status, as well as class of antidepressants, were investigated by linear regression models. RESULTS: All adiposity parameters were significantly higher in the groups of treated and resistant depression (in current use of antidepressants) among women. For men, there was an increase only in indicators of abdominal adiposity among those with treated depression. Only the selective serotonin reuptake inhibitors were associated with worse adiposity outcomes. LIMITATIONS: The CIS-R only allows the diagnosis of current depression. CONCLUSIONS: Depression is associated with increasing adiposity over time, particularly related to the use of antidepressant medication. It is important to monitor and manage increasing adiposity in clinical settings of depressive patients to prevent metabolic and cardiovascular comorbidities.