People who are heavily in debt are more likely to be heavy themselves, too, according to new research from Germany.

"Overindebted" people - defined as those who would find it impossible to pay off debts in a reasonable time frame — were about twice as likely to be overweight as the general population. They were more than 2.5 times as likely to be obese, Eva Muenster of the University of Mainz and her colleagues found.

European countries, as well as the United States, have seen a sharp rise in the percentage of people who are overindebted, Muenster and her team say. Estimates are that 3 million households - 7.6 percent - of German households fit into the "over-indebted" criteria.

Socioeconomic status is clearly linked to health, the researchers add, but techniques now used to measure it don't take debt into account. To investigate how debt might affect health, they surveyed 949 people who were receiving counseling for debt and insolvency at centers in two German states, comparing them to 8,318 people who participated in a 2003 telephone health survey and were considered to represent a slice of the general population that was not indebted.

The indebted individuals were younger, less educated, and less wealthy, and were also more likely to be depressed, overweight, or obese, the researchers found. About 11 percent of the general population was obese, compared to 25 percent of the indebted group. The indebted individuals were also more likely to smoke every day.

After taking these factors into account, Muenster and her colleagues found that being overindebted was associated with a 1.97-fold greater likelihood of being overweight, and a 2.56-fold greater risk of obesity.

Psychological factors could contribute to the greater risk of being overweight or obese among indebted people, Muenster and her team note, who may eat to cope with stress and depression. Healthy foods may be less affordable for them, the researchers add, while "energy-dense food such as sweets or fatty snacks are often less expensive compared to food with lower energy density such as fruit or vegetables."

The findings don't rule out the possibility that overweight or obese people are more likely to get into debt because they have a tougher time finding a job or make less money than slimmer people, the researchers note.

Muenster and her colleagues conclude by calling for investigators looking at socioeconomic status and health to include indebtedness in their analyses, along with standard measures like income and education.

SOURCE: BMC Public Health, online August 7, 2009.