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Mental health and quality of life during weight loss in females with clinically severe obesity: a randomized clinical trial

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Abstract

The purpose of this investigation was to explore the effects of dietary weight loss intervention, with and without the addition of exercise on health-related quality of life, depressive symptoms, and anxiety. As part of the EMPOWER study for women, sixty premenopausal women (BMI of 40.4 ± 6.7) were randomized to energy restriction only (ER) or to exercise plus energy restriction (EXER) for 12 months. Health-related quality of life was assessed using the SF-36, depressive symptoms were assessed using the Beck Depression Inventory II (BDI), and anxiety symptoms using the Spielberger state and trait anxiety questionnaire. All measures were completed at baseline, 3, 6 and 12 months. At 12 months, there were significant (p < 0.05) group-by-time interactions favouring the EXER group for five of the eight domains and the mental component summary score. At 12 months, a significant group-by-time interaction favouring the EXER group is reported for both state and trait anxiety (p = .005 and p = .001, respectively). At 12 months, there was a significant group-by-time interaction for depressive symptoms favouring EXER (p < 0.05). Within-group changes for BDI scores were improved at all follow-up time points in the EXER group. Exercise training confers an additional benefit to energy restriction in the absence of additional weight loss at 12 months for health-related quality of life, depressive symptoms, and state and trait anxiety scores when compared to energy restriction only. Exercise and an energy-restricted diet improve health-related quality of life and mental health. Exercise may protect mental health without further weight loss for women with severe obesity.

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Funding

Nestlé Health Australia provided VLED products at the cost price in support of the study. John B. Dixon and Gavin W. Lambert were supported by Senior Research Fellowships of the Australian National Health and Medical Research Council. While this study has not received any other external funding, work at the various institutions was supported in part by the Victorian Government’s Operational Infrastructure Support Program.

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Authors and Affiliations

  1. Institute for Physical Activity and Nutrition Research, Deakin University, Geelong, Australia

    Daniel J. van den Hoek, Clint T. Miller, Steve F. Fraser, Steve E. Selig & Gavin W. Lambert

  2. School of Behavioural and Health Sciences, Australian Catholic University, Brisbane, QLD, Australia

    Daniel J. van den Hoek

  3. Human Neurotransmitters and Clinical Obesity Research Laboratory, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia

    Toni Rice, Mariee Grima & Carolina Ika Sari

  4. Clinical Obesity Research Laboratory, Baker Heart and Diabetes Institute, Melbourne, Australia

    John B. Dixon

  5. Iverson Health Innovation Research Institute and School of Health Sciences, Swinburne University of Technology, Melbourne, VIC, Australia

    Gavin W. Lambert & John B. Dixon

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  1. Daniel J. van den Hoek
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Correspondence to Daniel J. van den Hoek.

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Conflicts of interest

John B. Dixon is a board member of Nestlé Health Sciences Australia and has received payment for consultancy from Apollo Endosurgery, Bariatric Advantage, iNova Pharmaceuticals and Novo Nordisk. The laboratories of Professors Dixon and Lambert have recently received research funding from Medtronic. Gavin Lambert has received payment for consultancy from Medtronic. Clint T. Miller, Steve F. Fraser, Steve E. Selig, Toni Rice, Mariee Grima, Daniel J. van den Hoek and Carolina Ika Sari declare no conflicts of interest.

Human and animal rights and Informed Consent

All procedures followed were in accordance with ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000. Informed consent was obtained from all patients for being included in the study.

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van den Hoek, D.J., Miller, C.T., Fraser, S.F. et al. Mental health and quality of life during weight loss in females with clinically severe obesity: a randomized clinical trial. J Behav Med 46, 566–577 (2023). https://doi.org/10.1007/s10865-022-00377-4

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