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Miriam Researchers Explore Link between Obesity, Depression and Weight Loss

5/15/2013
Busch AndrewAndrew Busch, PhD  

Depression and obesity often go hand-in-hand, even though researchers are still unclear exactly how these two conditions are linked. Previous research suggests behavioral weight loss interventions – which combine education, increasing physical activity and reducing caloric intake – can improve symptoms of depression, but little is known about how people with major depressive disorder respond to behavioral weight loss treatment.

Andrew Busch, PhD, of The Miriam Hospital’s Centers for Behavioral and Preventive Medicine, and colleagues at the University of Massachusetts Medical Center, Rush University Medical Center and Boston University, set out to answer some of these questions. Their findings were recently published in the journal Obesity.

  1. How are obesity and depression connected?

    Clinical depression and obesity often co-occur, and each predicts the development of the other. Despite this, those with clinical depression are specifically excluded from the majority of weight loss treatment trials. The research that does exist suggests that those with clinical depression tend to lose significantly less weight when they receive behavioral weight loss treatment.

  2. Your study looked at individual changes in depression during behavioral weight loss treatment. Why did you take that approach?

    Historically, there has been some concern that dieting may worsen existing clinical depression. The data set we used was uniquely suited to investigate this concern as it included a large sample of women diagnosed with both obesity and clinical depression that completed behavioral weight loss treatment. We looked at individual changes in depression across treatment because simply looking at the average group change in depression could potentially mask individual patients who were experiencing a significant worsening of depression.

  3. What did you find and how might these findings impact behavioral weight loss treatment for people with depression?

    Our findings suggest that behavioral weight loss treatment does not worsen depression in women with clinical depression. In fact, the opposite seems to be true. The majority of participants who received only behavioral weight loss treatment experienced a significant reduction in depression symptoms. Thus, those with clinical depression should not be discouraged from starting behavioral weight loss treatment. However, it is also important to note that the clinically depressed women in this study lost significantly less weight than people without depression typically do. So while behavioral weight loss treatment appears to be safe and beneficial for those with clinical depression, it is still less effective in this population.

  4. What are the next steps?

    The data in the current study was limited to women, so studies of mood changes among men in behavioral weight loss treatment are needed. It would also be useful to explore what factors drive depression improvement during behavioral weight loss treatment. Given the high rate of overlap between clinical depression and obesity, there is currently remarkably little research on those suffering from both. One of the most important next steps will be designing techniques to support those with clinical depression during weight loss treatment so that they experience weight loss at a level similar to those without depression.

Citation  

Busch, A. M., Whited, M. C., Appelhans, B. M., Schneider, K. L., Waring, M. E., DeBiasse, M. A., Oleski, J. L., Crawford, S. L., Pagoto, S. L. (2013). Reliable change in depression during behavioral weight loss treatment among women with major depression. Obesity.  

Support  

The Be Active Trial was supported by R01 MH078012 to S. Pagoto. This secondary analysis was supported by K23HL107391 to A. Busch. Partial salary support for M. Waring is provided by 1U01HL105268.