Current Obesity Reports

, Volume 3, Issue 1, pp 127–136

Depression and Disordered Eating in the Obese Person

Psychological Issues (M Hetherington and V Drapeau, Section Editors)


Three mental health problems commonly associated with obesity are major depression, binge eating disorder (BED), and night eating syndrome (NES). Evidence from both cross-sectional and longitudinal studies support independent relationships between obesity and depression, and between obesity and binge eating. These problems are most prevalent in severely obese individuals (class III obesity; a body mass index (BMI) of >40 kgm2), many of whom seek bariatric surgery, and we briefly review whether the presence of pre-operative depression, BED or NES affects post-operative outcomes. Historically depressed individuals have been screened out of weight loss trials due to concerns of worsening mood with weight loss. Such practices have precluded the development of effective treatments for depressed, obese individuals, leaving large numbers of people without appropriate care. We present recent advances in this area, and attempt to answer whether depressed individuals can lose clinically significant amounts of weight, show improvements in mood, and adhere to the demands of a weight loss intervention.


Obesity Depression Binge eating disorder Night eating syndrome Weight loss Psychological Bariatric surgery Disordered eating 


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. 1.
    Wilson GT, Wilfley DE, Agras WS, Bryson SW. Psychological treatments of binge eating disorder. Arch Gen Psychiatry. 2010;67(1):94.PubMedCentralPubMedCrossRefGoogle Scholar
  2. 2.
    Vocks S, Tuschen-Caffier B, Pietrowsky R, Rustenbach SJ, Kersting A, Herpertz S. Meta-analysis of the effectiveness of psychological and pharmacological treatments for binge eating disorder. Int J Eat Disord. 2010;43(3):205–17.PubMedGoogle Scholar
  3. 3.
    Grilo CM, Masheb RM, Wilson GT, Gueorguieva R, White MA. Cognitive–behavioral therapy, behavioral weight loss, and sequential treatment for obese patients with binge-eating disorder: a randomized controlled trial. J Consult Clin Psychol. 2011;79(5):675–85.PubMedCentralPubMedCrossRefGoogle Scholar
  4. 4.
    Allison KC, Tarves EP. Treatment of night eating syndrome. Psychiatr Clin N Am. 2011;34(4):785–96.CrossRefGoogle Scholar
  5. 5.
    Barth J, Schumacher M, Herrmann-Lingen C. Depression as a risk factor for mortality in patients with coronary heart disease: a meta-analysis. Psychosom Med. 2004;66:802–13.PubMedCrossRefGoogle Scholar
  6. 6.
    O'Connor CM, Abraham WT, Albert NM, Clare R, Gattis Stough W, Gheorghiade M, et al. Predictors of mortality after discharge in patients hospitalized with heart failure: an analysis from the Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients with Heart Failure (OPTIMIZE-HF). Am Heart J. 2008;156:662–73.PubMedCrossRefGoogle Scholar
  7. 7.
    van Melle JP, de Jonge P, Spijkerman TA, Tijssen JG, Ormel J, van Veldhuisen DJ, et al. Prognostic association of depression following myocardial infarction with mortality and cardiovascular events: a meta-analysis. Psychosom Med. 2004;66:814–22.PubMedCrossRefGoogle Scholar
  8. 8.
    Whooley MA, de Jonge P, Vittinghoff E, Otte C, Moos R, Carney RM, et al. Depressive symptoms, health behaviors, and risk of cardiovascular events in patients with coronary heart disease. JAMA. 2008;300:2379–88.PubMedCentralPubMedCrossRefGoogle Scholar
  9. 9.
    Ferketich AK, Schwartzbaum JA, Frid DJ, Moeschberger ML. Depression as an antecedent to heart disease among women and men in the NHANES I study. National Health and Nutrition Examination Survey. Arch Intern Med. 2000;160:1261–8.PubMedCrossRefGoogle Scholar
  10. 10.
    Ford DE, Mead LA, Chang PP, Cooper-Patrick L, Wang NY, Klag MJ. Depression is a risk factor for coronary artery disease in men: the precursors study. Arch Intern Med. 1998;158:1422–6.PubMedCrossRefGoogle Scholar
  11. 11.
    Williams SA, Kasl SV, Heiat A, Abramson JL, Krumholz HM, Vaccarino V. Depression and risk of heart failure among the elderly: a prospective community-based study. Psychosom Med. 2002;64:6–12.PubMedGoogle Scholar
  12. 12.
    Janszky I, Ahlbom A, Hallqvist J, Ahnve S. Hospitalization for depression is associated with an increased risk for myocardial infarction not explained by lifestyle, lipids, coagulation, and inflammation: the SHEEP Study. Biol Psychiatry. 2007;62:25–32.PubMedCrossRefGoogle Scholar
  13. 13.
    Kessler RC, Berglund P, Demler O, Jin R, Koretz D, Merikangas KR, et al. The epidemiology of major depressive disorder: results from the National Comorbidity Survey Replication (NCS-R). JAMA. 2003;289(23):3095–105.PubMedCrossRefGoogle Scholar
  14. 14.••
    de Wit L, Luppino F, van Straten A, Penninx B, Zitman F, Cuijpers P. Depression and obesity: a meta-analysis of community-based studies. Psychiatry Res. 2010;178(2):230–5. This large meta-analysis of more than 17 epidemiological studies confirms an association between obesity and depression. It also showed that only obese women, but not obese men, are at increased risk for depression.PubMedCrossRefGoogle Scholar
  15. 15.
    Onyike CU, Crum RM, Lee HB, Lyketsos CG, Eaton WW. Is obesity associated with major depression? Results from the third National Health and Nutrition Survey. Am J Epidemiol. 2003;58:1136–47.Google Scholar
  16. 16.
    Petry N, Barry D, Pietrzak RH. Overweight and obesity are associated with psychiatric disorders: results from the National Epidemiologic Survery on Alcohol and Related Conditions. Psychosom Res. 2008;70:288–97.Google Scholar
  17. 17.
    American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Arlington: American Psychiatric Publishing; 2013.Google Scholar
  18. 18.••
    Luppino FS, de Wit LM, Bouvy PF, Stijnen T, Cuijpers P, Penninx BW, et al. Overweight, obesity, and depression: a systematic review and meta-analysis of longitudinal studies. Arch Gen Psychiatry. 2010;67(3):220–9. This recent longitudinal meta-analysis showed an increased risk of developing depression in both men and women who are obese at baseline.PubMedCrossRefGoogle Scholar
  19. 19.
    Gariepy G, Wang J, Lesage AD, Schmitz N. The longitudinal association from obesity to depression: results from the 12-year National Population Health Survey. Obesity (Silver Spring). 2010;18(5):1033–8.CrossRefGoogle Scholar
  20. 20.
    Faith MS, Butryn M, Wadden TA, Fabricatore A, Nguyen AM, Heymsfield SB. Evidence for prospective associations among depression and obesity in population-based studies. Obes Rev. 2011;12(5):e438–53.PubMedCrossRefGoogle Scholar
  21. 21.
    Anderson SE, Cohen P, Naumova EN, Jacques PF, Must A. Adolescent obesity and risk for subsequent major depressive disorder and anxiety disorder: prospective evidence. Psychosom Med. 2007;69(8):740–7.PubMedCrossRefGoogle Scholar
  22. 22.
    Herva A, Laitinen J, Miettunen J, Veijola J, Kervonen JT, Laksy K, et al. Obesity and depression: results from the longitudinal Northern Finland 1966 Birth Cohort Study. Int J Obes (Lond). 2006;30(3):520–7.CrossRefGoogle Scholar
  23. 23.
    Kraus T, Haack M, Schuld A, Hinze-Selch D, Pollmacher T. Low leptin levels but normal body mass indices in patients with depression or schizophrenia. Neuroendocrinology. 2001;73(4):243–7.PubMedCrossRefGoogle Scholar
  24. 24.
    Thakore JH, Richards PJ, Reznek RH, Martin A, Dinan TG. Increased intra-abdominal fat deposition in patients with major depressive illness as measured by computed tomography. Biol Psychiatry. 1997;41(11):1140–2.PubMedCrossRefGoogle Scholar
  25. 25.
    Kahl KG, Bester M, Greggersen W, Rudolf S, Dibbelt L, Stoeckelhuber BM, et al. Visceral fat deposition and insulin sensitivity in depressed women with and without comorbid borderline personality disorder. Psychosom Med. 2005;67(3):407–12.PubMedCrossRefGoogle Scholar
  26. 26.
    Hudson JI, Hiripi E, Pope Jr HG, Kessler RC. The prevalence and correlates of eating disorders in the National Comorbidity Survey Replication. Biol Psychiatry. 2007;61(3):348–58.PubMedCentralPubMedCrossRefGoogle Scholar
  27. 27.
    Stunkard AJ. Binge eating disorder and the night eating syndrome. In: Wadden T, Stunkard AJ, editors. Handbook of obesity treatment. New York: The Guildford Press; 2002. p. 107–22.Google Scholar
  28. 28.
    Preti A, Rucci P, Santone G, Picardi A, Miglio R, Bracco R, et al. Patterns of admission to acute psychiatric in-patient facilities: a national survey in Italy. Psychol Med. 2009;39(3):485–96.PubMedCrossRefGoogle Scholar
  29. 29.
    Higgins DM, Dorflinger L, MacGregor KL, Heapy AA, Goulet JL, Ruser C. Binge eating behavior among a national sample of overweight and obese veterans. Obesity (Silver Spring). 2013;21(5):900–3.CrossRefGoogle Scholar
  30. 30.
    Allison KC, Wadden TA, Sarwer DB, Fabricatore AN, Crerand CE, Gibbons LM, et al. Night eating syndrome and binge eating disorder among persons seeking bariatric surgery: prevalence and related features. Obesity. 2006;14:77S–82.PubMedCrossRefGoogle Scholar
  31. 31.
    Hsu LK, Mulliken B, McDonagh B, Krupa DS, Rand W, Fairburn CG, et al. Binge eating disorder in extreme obesity. Int J Obes Relat Metab Disord. 2002;26(10):1398–403.PubMedCrossRefGoogle Scholar
  32. 32.
    de Zwaan M, Mitchell JE, Howell LM, Monson N, Swan-Kremeier L, Crosby RD, et al. Characteristics of morbidly obese patients before gastric bypass surgery. Compr Psychiatry. 2003;44(5):428–34.PubMedCrossRefGoogle Scholar
  33. 33.
    Adami GF, Gandolfo P, Bauer B, Scopinaro N. Binge eating in massively obese patients undergoing bariatric surgery. Int J Eat Disord. 1995;17:45–50.PubMedCrossRefGoogle Scholar
  34. 34.
    Kalarchian MA, Wilson GT, Brolin RE, Bradley L. Binge eating in bariatric surgery patients. Int J Eat Disord. 1998;23(1):89–92.PubMedCrossRefGoogle Scholar
  35. 35.
    Kalarchian MA, Wilson GT, Brolin RE, Bradley L. Assessment of eating disorders in bariatric surgery candidates: self-report questionnaire versus interview. Int J Eat Disord. 2000;28(4):465–9.PubMedCrossRefGoogle Scholar
  36. 36.
    Yanovski SZ, Nelson JE, Dubbert BK, Spitzer RL. Association of binge eating disorder and psychiatric comorbidity in obese subjects. Am J Psychiatry. 1993;150(10):1472–9.PubMedGoogle Scholar
  37. 37.
    Specker S, de Zwaan M, Raymond N, Mitchell J. Psychopathology in subgroups of obese women with and without binge eating disorder. Compr Psychiatry. 1994;35:185–90.PubMedCrossRefGoogle Scholar
  38. 38.
    Mussell MP, Peterson CB, Weller CL, Crosby RD, de Zwaan M, Mitchell JE. Differences in body image and depression among obese women with and without binge eating disorder. Obes Res. 1996;4(5):431–9.PubMedCrossRefGoogle Scholar
  39. 39.
    Telch CF, Stice E. Psychiatric comorbidity in women with binge eating disorder: prevalence rates from a non-treatment-seeking sample. J Consult Clin Psychol. 1998;66(5):768–76.PubMedCrossRefGoogle Scholar
  40. 40.
    Grucza RA, Przybeck TR, Cloninger CR. Prevalence and correlates of binge eating disorder in a community sample. Compr Psychiatry. 2007;48(2):124–31.PubMedCentralPubMedCrossRefGoogle Scholar
  41. 41.
    Carano A, De Berardis D, Campanella D, Serroni N, Ferri F, Di Iorio G, et al. Alexithymia and suicide ideation in a sample of patients with binge eating disorder. J Psychiatr Pract. 2012;18(1):5–11.PubMedCrossRefGoogle Scholar
  42. 42.
    Hawton K, van Heeringen K. Suicide. Lancet. 2009;373:1372–81.PubMedCrossRefGoogle Scholar
  43. 43.
    Kessler RC, Guilherme B, Walters EE. Prevalence of and risk factors for lifetime suicide attempts in the National Comorbidity Survey. Arch Gen Psychiatry. 1999;56(7):617–26.PubMedCrossRefGoogle Scholar
  44. 44.
    Rand CSW, Macgregor MD, Stunkard AJ. The night eating syndrome in the general population and among post-operative obesity surgery patients. Int J Eat Disord. 1997;22:65–9.PubMedCrossRefGoogle Scholar
  45. 45.
    Stunkard AJ, Berkowitz RI, Wadden TA, Tanrikut C, Reiss E, Young L. Binge eating disorder and the night-eating syndrome. Int J Obes Relat Metab Disord. 1996;20(1):1–6.PubMedGoogle Scholar
  46. 46.
    Marshall HM, Allison KC, O’Reardon JP, Birketvedt G, Stunkard AJ. Night eating syndrome among nonobese persons. Int J Eat Disord. 2004;35(2):217–22.PubMedCrossRefGoogle Scholar
  47. 47.
    Calugi S, Dalle Grave R, Marchesini G. Night eating syndrome in class II-III obesity: metabolic and psychopathological features. Int J Obes (Lond). 2009;33:889–904.CrossRefGoogle Scholar
  48. 48.
    Tholin A, Lindroos A, Tynelius P, Akerstedt T, Stunkard AJ, Bulik CM, et al. Prevalence of night eating in obese and non-obese twins. Obesity (Silver Spring). 2009;17(5):1050–5.CrossRefGoogle Scholar
  49. 49.
    Allison KC, Wadden TA, Sarwer DB, Fabricatore AN, Crerand CE, Gibbons LM, et al. Night eating syndrome and binge eating disorder among persons seeking bariatric surgery: prevalence and related features. Surg Obes Relat Dis. 2006;2:153–8.PubMedCrossRefGoogle Scholar
  50. 50.
    Hsu LK, Betancourt S, Sullivan SP. Eating disturbances before and after vertical banded gastroplasty: a pilot study. Int J Eat Disord. 1996;19:23–4.PubMedCrossRefGoogle Scholar
  51. 51.
    Allison KC, Lundgren JD, O’Reardon JP, Geliebter A, Gluck ME, Vinai P, et al. Proposed diagnostic criteria for night eating syndrome. Int J Eat Disord. 2010;43(3):241–7.PubMedGoogle Scholar
  52. 52.
    Birketvedt GS, Florholmen J, Sundsfjord J, Osterud B, Dinges D, Bilker W, et al. Behavioral and neuroendocrine characteristics of the night-eating syndrome. JAMA. 1999;282(7):657–63.PubMedCrossRefGoogle Scholar
  53. 53.
    O’Reardon JP, Ringel BL, Dinges DF, Allison KC, Rogers NL, Martino NS, et al. Circadian eating and sleeping patterns in the night eating syndrome. Obes Res. 2004;12(11):189–96.CrossRefGoogle Scholar
  54. 54.
    Allison KC, Ahima RS, O’Reardon JP, Dinges DF, Sharma V, Cummings DE, et al. Neuroendocrine profiles associated with energy intake, sleep, and stress in the night eating syndrome. J Clin Endocrinol Metab. 2005;90(11):6214–7.PubMedCrossRefGoogle Scholar
  55. 55.
    Allison KC, Grilo CM, Masheb RM, Stunkard AJ. Binge eating disorder and night eating syndrome: a comparative study of disordered eating. J Consult Clin Psychol. 2005;73(6):1107–15.PubMedCrossRefGoogle Scholar
  56. 56.
    Colles SL, Dixon JB, O’Brien PE. Night eating syndrome and nocturnal snacking: association with obesity, binge eating and psychological distress. Int J Obes (Lond). 2007;21(11):1722–30.CrossRefGoogle Scholar
  57. 57.
    Allison KC, Grilo CM, Masheb RM, Stunkard AJ. High self-reported rates of neglect and emotional abuse, by persons with binge eating disorder and night eating syndrome. Behav Res Ther. 2007;45(12):2874–83.PubMedCentralPubMedCrossRefGoogle Scholar
  58. 58.
    Gluck ME, Geliebter A, Satov T. Night eating syndrome is associated with depression, low self-esteem, reduced daytime hunger, and less weight loss in obese outpatients. Obes Res. 2001;9(4):264–7.PubMedCrossRefGoogle Scholar
  59. 59.
    Orhan FO, Ozer UG, Ozer A, Altunoren O, Celik M, Karaaslan MF. Night eating syndrome among patients with depression. Isr J Psychiatry Relat Sci. 2011;48(3):212–7.PubMedGoogle Scholar
  60. 60.
    O’Reardon JP, Allison KC, Martino NS, Lundgren JD, Heo M, Stunkard AJ. A randomized, placebo-controlled trial of sertraline in the treatment of night eating syndrome. Am J Psychiatry. 2006;163(5):893–8.PubMedCrossRefGoogle Scholar
  61. 61.
    Allison KC, Studt SK, Berkowitz RI, Hesson LA, Moore RH, Dubroff JG, et al. An open-label efficacy trial of escitalopram for night eating syndrome. Eat Behav. 2013;14(2):199–203.PubMedCrossRefGoogle Scholar
  62. 62.
    Adams TD, Gress RE, Smith SC, Halverson RC, Simper SC, Rosamond WD, et al. Long-term mortality after gastric bypass surgery. N Engl J Med. 2007;357(8):753–61.PubMedCrossRefGoogle Scholar
  63. 63.••
    Tindle HA, Omalu B, Courcoulas A, Marcus M, Hammers J, Kuller LH. Risk of suicide after long-term follow-up from bariatric surgery. Am J Med. 2010;123(11):1036–42. This paper supports earlier findings by Adams et al. [45] of an increased number of suicides after bariatric surgery. Seventy per cent of the suicides occurred within 3 years of the surgery.PubMedCrossRefGoogle Scholar
  64. 64.
    Karlsson J, Sjostrom L, Sullivan M. Swedish obese subjects (SOS): an intervention study of obesity: two-year follow-up of health-related quality of life (HRQL) and eating behavior after gastric surgery for severe obesity. Int J Obes. 1998;22:113–26.CrossRefGoogle Scholar
  65. 65.
    Sullivan M, Karlsson J, Sjostrom L, Taft C. Why quality of life measures should be used in the treatment of patients with obesity. In: Bjorntrop P, editor. International textbook of obesity. London.: John Wiley and Sons; 2001. p. 485–510.CrossRefGoogle Scholar
  66. 66.
    Dixon JB, Dixon ME, O’Brien PE. Depression in association with severe obesity: changes with weight loss. Arch Intern Med. 2003;163:2058–65.PubMedCrossRefGoogle Scholar
  67. 67.
    Herpertz S, Kielmann R, Wolf AM, Hebebrand J, Senf W. Do psychosocial variables predict weight loss or mental health after obesity surgery? A systematic review. Obes Res. 2004;12:1554–69.PubMedCrossRefGoogle Scholar
  68. 68.
    van Hout GC, Verschure SK, van Heck GL. Psychosocial predictors of success following bariatric surgery. Obes Surg. 2005;15:552–60.PubMedCrossRefGoogle Scholar
  69. 69.
    Clark MM, Balsiger BM, Sletten CD, Dahlman KL, Ames G, Williams DE, et al. Psychosocial factors and 2-year outcome following bariatric surgery for weight loss. Obes Surg. 2003;13:739–45.PubMedCrossRefGoogle Scholar
  70. 70.
    Averbukh Y, Heshka S, El-Shoreya H, Flancbaum L, Geliebter A, Kamel S, et al. Depression score predicts weight loss following Roux-en-Y gastric bypass. Obes Surg. 2003;13:833–6.PubMedCrossRefGoogle Scholar
  71. 71.
    Faulconbridge LF, Wadden TA, Thomas JG, Jones-Coreneille LR, Sarwer DB, Fabricatore AN. Changes in depression and quality of life in obese individuals with binge eating disorder: bariatric surgery versus lifestyle modification. Surg Obes Relat Dis. 2013;9(5):790–6.PubMedCrossRefGoogle Scholar
  72. 72.
    de Zwaan M, Lancaster KL, Mitchell JE, Howell LM, Monson N, Roerig JL, et al. Health-related quality of life in morbidly obese patients: effect of gastric bypass surgery. Obes Surg. 2002;12(6):773–80.PubMedCrossRefGoogle Scholar
  73. 73.
    Pekkarinen T, Koskela K, Huikuri K, Mustajoki P. Long-term results of gastroplasty for morbid obesity: binge-eating as a predictor of poor outcome. Obes Surg. 1994;4:248–55.PubMedCrossRefGoogle Scholar
  74. 74.
    Sallet PC, Sallet JA, Dixon JB, Collis E, Pisani CE, Levy A, et al. Eating behavior as a prognostic factor for weight loss after gastric bypass. Obes Surg. 2007;17(4):445–51.PubMedCrossRefGoogle Scholar
  75. 75.
    Ashton K, Drerup M, Windover A, Heinberg L. Brief, four-session group CBT reduces binge eating behaviors among bariatric surgrey candidates. Surg Obes Relat Dis. 2009;5:257–62.PubMedCrossRefGoogle Scholar
  76. 76.•
    Wadden TA, Faulconbridge LF, Jones-Corneille LR, Sarwer DB, Fabricatore AN, Thomas JG, et al. Binge eating disorder and the outcome of bariatric surgery at one year: a prospective, observational study. Obesity (Silver Spring). 2011;19(6):1220–8. This manuscript showed that patients with pre-operative binge eating disorder achieved comparable weight losses at 6 and 12 months to age- and weight-matched controls without binge-eating. In addition, binge episodes declined sharply after surgery in the BED group, indicating that pre-operative BED is not necessarily a contraindication for surgery.PubMedCentralCrossRefGoogle Scholar
  77. 77.
    Alger-Mayer S, Rosati C, Polimeni JM, Malone M. Preoperative binge eating status and gastric bypass surgery: a long-term outcome study. Obes Surg. 2009;19:139–45.PubMedCrossRefGoogle Scholar
  78. 78.
    Fujioka K, Yan E, Wang HJ, Li Z. Evaluating preoperative weight loss, binge eating disorder, and sexual abuse history on Roux-en-Y gastric bypass outcome. Surg Obes Relat Dis. 2008;4:137–43.PubMedCrossRefGoogle Scholar
  79. 79.
    White MA, Masheb RM, Rothschild BS, Burke-Martindale CH, Grilo CM. The prognostic significance of regular binge eating in extremely obese gastric bypass patients: 12-month postoperative outcomes. J Clin Psychiatry. 2006;67:1928–35.PubMedCrossRefGoogle Scholar
  80. 80.
    White MA, Kalarchian MA, Masheb RM, Marcus MD, Grilo CM. Loss of control over eating predicts outcomes in bariatric surgery patients: a prospective, 24-month follow-up study. J Clin Psychiatry. 2010;71(2):175–84.PubMedCentralPubMedCrossRefGoogle Scholar
  81. 81.
    Burgmer R, Grigutsch K, Zipfel S, Wolf AM, de Zwaan M, Husemann B, et al. The influence of eating behavior and eating pathology on weight loss after gastric restriction operations. Obes Surg. 2005;15(5):684–91.PubMedCrossRefGoogle Scholar
  82. 82.
    Latner JD, Wetzler S, Goodman ER, Glinski J. Gastric bypass in a low-income, inner-city population: eating disturbances and weight loss. Obes Res. 2004;12(6):956–61.PubMedCrossRefGoogle Scholar
  83. 83.
    Powers PS, Perez A, Boyd F, Rosemurgy A. Eathing pathology before and after bariatric surgery: a prospective study. Int J Eat Disord. 1999;25(3):293–300.PubMedCrossRefGoogle Scholar
  84. 84.
    Keys A, Brozek J, Henschel A, Michelson F, Taylor HL. The biology of human starvation. Minneapolis: University of Minnesota Press; 1950.Google Scholar
  85. 85.
    Stunkard AJ. The dieting depression; incidence and clinical characteristics of untoward responses to weight reduction regimens. Am J Med. 1957;23(1):77–86.PubMedCrossRefGoogle Scholar
  86. 86.
    Brinkworth GD, Buckley JD, Noakes M, Clifton PM, Wilson CJ. Long-term effects of a very low-carbohydrate diet and a low-fat diet on mood and cognitive function. Arch Intern Med. 2009;169(20):1873–80.PubMedCrossRefGoogle Scholar
  87. 87.
    Hainer V, Hlavata K, Gojova M, Kunesova M, Wagenknecht M, Kopsky V, et al. Hormonal and psychobehavioral predictors of weight loss in response to a short-term weight reduction program in obese women. Physiol Res. 2008;57 Suppl 1:S17–27.PubMedGoogle Scholar
  88. 88.
    Wadden TA, Foster GD, Letizia KA. One-year behavioral treatment of obesity: comparison of moderate and severe caloric restriction and the effects of weight maintenance therapy. J Consult Clin Psychol. 1994;62(1):165–71.PubMedCrossRefGoogle Scholar
  89. 89.
    Faulconbridge LF, Wadden TA, Berkowitz RI, Sarwer DB, Womble LG, Hesson LA, et al. Changes in symptoms of depression with weight loss: results of a randomized trial. Obesity (Silver Spring). 2009;17(5):1009–16.PubMedCentralCrossRefGoogle Scholar
  90. 90.•
    Faulconbridge LF, Wadden TA, Rubin RR, Wing RR, Walkup MP, Fabricatore AN, et al. One-Year Changes in Symptoms of Depression and Weight in Overweight/Obese Individuals With Type 2 Diabetes in the Look AHEAD Study. Obesity (Silver Spring). 2012;20(4):783–93. This paper showed, in a large sample of obese patients with type 2 diabetes, that those undergoing an intensive lifestyle intervention (who lost ~8% of their initial weight at 1 year) showed significantly lower incidence of depression than those receiving a usual care control intervention.PubMedCentralCrossRefGoogle Scholar
  91. 91.
    Fabricatore AN, Wadden TA, Higginbotham AJ, Faulconbridge LF, Nguyen AM, Heymsfield SB, et al. Intentional weight loss and changes in symptoms of depression: a systematic review and meta-analysis. Int J Obes (Lond). 2011;35(11):1363–76.PubMedCentralCrossRefGoogle Scholar
  92. 92.
    Finer N, James WP, Kopelman PG, Lean ME, Williams G. One-year treatment of obesity: a randomized, double-blind, placebo-controlled, multicentre study of orlistat, a gastrointestinal lipase inhibitor. Int J Obes Relat Metab Disord. 2000;24(3):306–13.PubMedCrossRefGoogle Scholar
  93. 93.
    Tate DF, Wing RR, Winett RA. Using internet technology to deliver a behavioral weight loss program. JAMA. 2001;285(9):1172–7.PubMedCrossRefGoogle Scholar
  94. 94.
    Tsai AG, Wadden TA, Sarwer DB, Berkowitz RI, Womble LG, Hesson LA, et al. Metabolic syndrome and health-related quality of life in obese individuals seeking weight reduction. Obesity (Silver Spring). 2008;16(1):59–63.CrossRefGoogle Scholar
  95. 95.
    Wadden TA, Berkowitz RI, Sarwer DB, Prus-Wisniewski R, Steinberg C. Benefits of lifestyle modification in the pharmacologic treatment of obesity: a randomized trial. Arch Intern Med. 2001;161(2):218–27.PubMedCrossRefGoogle Scholar
  96. 96.
    Pagoto S, Bodenlos JS, Kantor L, Gitkind M, Curtin C, Ma Y. Association of major depression and binge eating disorder with weight loss in a clinical setting. Obesity (Silver Spring). 2007;15(11):2557–9.CrossRefGoogle Scholar
  97. 97.••
    Ludman E, Simon GE, Ichikawa LE, Operskalski BH, Arterburn D, Linde JA, et al. Does depression reduce the effectiveness of behavioral weight loss treatment? Behav Med. 2010;35(4):126–34. This paper was among the first to recruit participants with major depressive disorder diagnosed via structured clinical interview (as opposed to symptoms of depression). They showed that these patients were able to achieve comparable weight losses, and be as adherent to the treatment, as those patients without major depression.PubMedCrossRefGoogle Scholar
  98. 98.
    McGuire MT, Wing RR, Hill JO. The prevalence of weight loss maintenance among American adults. Int J Obes Relat Metab Disord. 1999;23(12):1314–9.PubMedCrossRefGoogle Scholar
  99. 99.
    Linde JA, Jeffery RW, Levy RL, Sherwood NE, Utter J, Pronk NP, et al. Binge eating disorder, weight control self-efficacy, and depression in overweight men and women. Int J Obes Relat Metab Disord. 2004;28(3):418–25.PubMedCrossRefGoogle Scholar
  100. 100.
    Wadden TA, Butryn ML, Wilson C. Lifestyle modification for the management of obesity. Gastroenterology. 2007;132(6):2226–38.PubMedCrossRefGoogle Scholar
  101. 101.
    Marcus MD, Wing RR, Guare J, Blair EH, Jawad A. Lifetime prevalence of major depression and its effect on treatment outcome in obese type II diabetic patients. Diabetes Care. 1992;15(2):253–5.PubMedCrossRefGoogle Scholar
  102. 102.
    Clark MM, Niaura R, King TK, Pera V. Depression, smoking, activity level, and health status: pretreatment predictors of attrition in obesity treatment. Addict Behav. 1996;21(4):509–13.PubMedCrossRefGoogle Scholar
  103. 103.
    Fabricatore AN, Wadden TA, Moore RH, Butryn ML, Heymsfield SB, Nguyen AM. Predictors of attrition and weight loss success: Results from a randomized controlled trial. Behav Res Ther. 2009;47(8):685–91.PubMedCentralPubMedCrossRefGoogle Scholar
  104. 104.
    Somerset SM, Graham L, Markwell K. Depression scores predict adherence in a dietary weight loss intervention trial. Clin Nutr. 2011;30(5):593–8.PubMedCrossRefGoogle Scholar
  105. 105.
    Jeffery RW, Sherwood NE, Brelje K, Pronk NP, Boyle R, Boucher JL, et al. Mail and phone interventions for weight loss in a managed-care setting: weigh-to-be one-year outcomes. Int J Obes Relat Metab Disord. 2003;27(12):1584–92.PubMedCrossRefGoogle Scholar
  106. 106.
    Pagoto S, Bodenlos JS, Schneider KL, Olendzki B, Spates CR, Ma Y. Initial investigation of behavioral activation therapy for co-morbid major depressive disorder and obesity. Psychotherapy (Chic). 2008;45(3):410–5.CrossRefGoogle Scholar
  107. 107.•
    Faulconbridge LF, Wadden TA, Berkowitz RI, Pulcini ME, Treadwell T. Treatment of comorbid obesity and major depressive disorder: a prospective pilot for their combined treatment. J Obes. 2011;2011:1–5. This is one of the first pilot studies to provide a combined treatment targeting depression and weight loss concurrently for obese participants with MDD.CrossRefGoogle Scholar
  108. 108.••
    Linde JA, Simon GE, Ludman EJ, Ichikawa LE, Operskalski BH, Arterburn D, et al. A randomized controlled trial of behavioral weight loss treatment versus combined weight loss/depression treatment among women with comorbid obesity and depression. Ann Behav Med. 2011;41(1):119–30. This is the first published RCT examining weight loss and symptoms of depression in obese women with comorbid MDD. Results are extremely encouraging: patients assigned to either behavioral weight loss combined with depression treatment, or to behavioral weight loss alone, lost comparable amounts of weight.PubMedCentralPubMedCrossRefGoogle Scholar
  109. 109.••
    Pagoto S, Schneider KL, Whited MC, Oleski JL, Merriam P, Appelhans B, et al. Randomized controlled trial of behavioral treatment for comorbid obesity and depression in women: the Be Active Trial. Int J Obes (Lond). 2013. doi:10.1038/ijo.2013.25. This RCT addressed whether treatment of depression prior to behavioral weight loss treatment would result in greater weight losses than behavioral weight loss treatment alone. They found comparable weight losses in each of the treatment groups, but those patients who showed remission of depression lost significantly more than those whose depression did not remit, regardless of treatment group.Google Scholar
  110. 110.
    Hamilton M. A rating scale for depression. J Neurol Neurosurg Psychiatry. 1960;23:56–62.PubMedCrossRefGoogle Scholar
  111. 111.
    Frank E, Prien RF, Jarrett RB, Keller MB, Kupfer DJ, Lavori PW, et al. Conceptualization and rationale for consensus definitions of terms in major depressive disorder. Remission, recovery, relapse, and recurrence. Arch Gen Psychiatry. 1991;48(9):851–5.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  1. 1.Center for Weight and Eating Disorders, Department of PsychiatryUniversity of Pennsylvania Perelman School of MedicinePhiladelphiaUSA

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