Body mass index (BMI) in major depressive disorder and its effects on depressive symptomatology and antidepressant response

•Weight gain during study is associated with better therapy outcome.•BMI was mainly associated with neurovegetative and cognitive symptoms of MDD.•Overweight patients showed best response to antidepressant therapy. Obesity is one of the most prevalent somatic comorbidities of Major Depressive Disorder (MDD). We aimed to investigate the relationship between body mass index (BMI) and MDD, the symptomatology of the disorder as well as the outcome of antidepressant treatment. Early medication change (EMC) trial participants with BMI measurement (n = 811) were categorized according to WHO-criteria in normal or low weight (BMI