|Andrew 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
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.
How are obesity and
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
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
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.
What are the next
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
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.
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.