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Lower depression scores associated with greater weight loss among rural black women in a behavioral weight loss program

  • Original Research
  • Published:
Translational Behavioral Medicine

Abstract

Depression and stress have been associated with less weight loss among some participants in behavioral weight loss (BWL) programs. The purpose of this study was to (1) measure the levels of depression and stress among a sample of black women living in rural Alabama and Mississippi who were participating in a BWL program and (2) examine the association between these psychosocial variables and weight loss outcomes of participants at 6 months. Overweight and obese black women in a BWL program (n = 409) completed validated surveys to measure depression and stress at baseline and 6 months. Weight and height were also measured at baseline and 6 months. Statistical tests were conducted to examine associations between depression, stress, and weight loss. Mean BMI at baseline was 38.68 kg/m2. Participants achieved a 1.17 kg/m2 reduction in BMI at 6 months. When comparing by baseline depression or stress categories, no significant differences in weight loss outcomes were observed. Analysis of continuous data revealed a significant correlation between baseline depression score and change in BMI. In adjusted models, change in depression score over time was significantly associated with change in weight. No differences in weight loss outcomes at 6 months were observed when comparing participants with and without elevated depressive symptoms or elevated stress at baseline. This suggests that potential participants may not need to be excluded from BWL programs based on pre-specified cut points for these psychological conditions. Greater improvements in depression were associated with better weight loss outcomes suggesting that more emphasis on reducing depression may lead to greater weight losses for black women in BWL programs.

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Acknowledgements

The work described was supported by the following grants: 1U54CA153719 and 1K01CA190559-01. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the National Cancer Institute.

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Authors and Affiliations

  1. School of Medicine, Department of Medicine, Division of Preventive Medicine, University of Alabama at Birmingham, 1720 2nd Avenue South MT 639, Birmingham, AL, 35294-4410, USA

    Tiffany L. Carson PhD, MPH, Bradford E. Jackson PhD, Angela Williams ASBA & Monica L. Baskin PhD

  2. Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL, USA

    Tiffany L. Carson PhD, MPH, Bradford E. Jackson PhD & Monica L. Baskin PhD

  3. Nutrition Obesity Research Center, University of Alabama at Birmingham, Birmingham, AL, USA

    Tiffany L. Carson PhD, MPH & Monica L. Baskin PhD

  4. Minority Health and Health Disparities Research Center, University of Alabama at Birmingham, Birmingham, AL, USA

    Tiffany L. Carson PhD, MPH & Monica L. Baskin PhD

  5. School of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA

    Timiya S. Nolan MSN, ANP-BC, CRNP

Authors
  1. Tiffany L. Carson PhD, MPH
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  2. Bradford E. Jackson PhD
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  3. Timiya S. Nolan MSN, ANP-BC, CRNP
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  4. Angela Williams ASBA
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  5. Monica L. Baskin PhD
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Correspondence to Tiffany L. Carson PhD, MPH.

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Conflict of interest

The authors declare that they have no conflict of interest.

Adherence to ethical standards disclosure

1. The corresponding author, Tiffany Carson, has the approval of all other listed authors for the submission and publication of all versions of the manuscript.

2. All who have made an independent material contribution to the manuscript have been included on the author list.

3. The work submitted in the manuscript is original and has not been published elsewhere and is not presently under consideration of publication by any other journal.

4. The material in the manuscript has been acquired according to modern ethical standards and has been approved by the legally appropriate ethical committee.

5. If any of the statements above ceases to be true, the authors will notify the journal as soon as possible so that the manuscript can be withdrawn.

6. The authors have full control of all primary data and agree to allow the journal to review the data if requested.

7. All procedures and research activities were approved by the Institutional Review Board (IRB) at the University of Alabama at Birmingham. The guiding ethical principles of the IRB—respect for persons, beneficence and justice—are embodied in the “Belmont Report”: Ethical Principles and Guidelines for the Protection of Human Subjects of Research (The National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research, April 18, 1979). All human subjects participated in the informed consent process and indicated their informed consent by signing a written document.

10. No animals were involved in the reported research.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Implications

Practice: Health care professionals who provide behavioral interventions for obesity should be inclusive of individuals with elevated levels of depressive symptoms and/or perceived stress and should include concurrent treatment or strategies to relieve symptoms of depression to achieve greater weight loss among patients.

Policy: Lay community health advisors should be regularly included as a part of the health care system and utilized to effectively deliver health-related information to local communities.

Research: Ongoing research is required to understand health behaviors across diverse populations in order to optimize inclusion/exclusion criteria and intervention components for behavioral interventions.

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Carson, T.L., Jackson, B.E., Nolan, T.S. et al. Lower depression scores associated with greater weight loss among rural black women in a behavioral weight loss program. Behav. Med. Pract. Policy Res. 7, 320–329 (2017). https://doi.org/10.1007/s13142-016-0452-2

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