Does Depression Reduce the Effectiveness of Behavioral Weight Loss Treatment?

Abstract

Limited evidence suggests that depression is associated with poorer outcomes in behavioral weight loss programs; however, people with major depression are typically excluded from weight loss intervention trials. This study examined the effect of depression on women's participation and weight loss in behavioral treatment. Non–treatment seeking obese women over 40 years of age with major depressive disorder (MDD, n = 65) and without MDD (n = 125) were recruited into a 26-session group intervention. Primary analyses compared participants' mean weight change from baseline to 6 and 12 months; at 6 months, women with MDD lost a mean of 3.8 kg vs 4.3 kg for women without MDD (t = 0.54, p = .59). At 12 months, women with MDD lost 3.0 kg and women without MDD lost 3.6 kg (t = 0.44, p =.66). Women who attended at least 12 treatment sessions lost more weight than women who attended fewer sessions, regardless of depression status (ie, there was no significant interaction between depression and session attendance). Results suggest that depression should not be an exclusion criterion for weight loss intervention programs.

Index Terms:

• behaviorally based weight loss treatment
• depression
• weight loss
• women

Acknowledgements

This project was supported by NIH Research Grant #MH68127 funded by the National Institute of Mental Health and the Office of Behavioral Social Sciences Research. We wish to thank Zoe Bermet for conducting research interviews, and Christine Prenovitz, David Markley, and Amy Mohelnitsky for facilitating the interventions for this project.

Notes

*Using all available interview data, missing data filled in using medical records and last observation carried forward.

†Adjusted for age (40–49, 50–59, 60–64), race/ethnicity (White, African-American, or Other), marital status (married or not married), highest education level (high school or beyond high school), body dissatisfaction (yes/no), and number of sessions completed (< 12, ≥ 12) before assessment.

‡ Adjusted for age (40–49, 50–59, 60–64), race/ethnicity (White, African-American, or Other), marital status (married or not married), highest education level (high school or beyond high school), body dissatisfaction (yes/no), number of sessions completed (< 12, ≥ 12) before assessment, and antidepressant use (yes/no).