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A Randomized Controlled Trial of Behavioral Weight Loss Treatment Versus Combined Weight Loss/Depression Treatment Among Women with Comorbid Obesity and Depression

  • Original Article
  • Published:
Annals of Behavioral Medicine

Abstract

Background

Obesity is associated with clinical depression among women. However, depressed women are often excluded from weight loss trials.

Purpose

This study examined treatment outcomes among women with comorbid obesity and depression.

Methods

Two hundred three (203) women were randomized to behavioral weight loss (n = 102) or behavioral weight loss combined with cognitive-behavioral depression management (n = 101).

Results

Average participant age was 52 years; mean baseline body mass index was 39 kg/m2. Mean Patient Health Questionnaire and Hopkins Symptom Checklist (SCL-20) scores indicated moderate to severe baseline depression. Weight loss and SCL-20 changes did not differ between groups at 6 or 12 months in intent-to-treat analyses (p = 0.26 and 0.55 for weight, p = 0.70 and 0.25 for depressive symptoms).

Conclusions

Depressed obese women lost weight and demonstrated improved mood in both treatment programs. Future weight loss trials are encouraged to enroll depressed women.

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Acknowledgments

This study was funded by National Institutes of Health Grant R01MH068127 (G. E. Simon, PI); ClinicalTrials.gov identifier: NCT00169273, “Epidemiology and Care of Comorbid Obesity and Depression.”

Conflict of Interest Statement

The authors have no conflicts of interest to disclose.

Author information

Authors and Affiliations

  1. Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA

    Jennifer A. Linde Ph.D. & Robert W. Jeffery Ph.D.

  2. Group Health Research Institute, Group Health Cooperative, Seattle, WA, USA

    Gregory E. Simon M.D., M.P.H, Evette J. Ludman Ph.D., Laura E. Ichikawa M.S, Belinda H. Operskalski M.P.H & David Arterburn M.D.

  3. Oregon Research Institute, Eugene, OR, USA

    Paul Rohde Ph.D.

  4. Indiana University School of Medicine, Indianapolis, IN, USA

    Emily A. Finch M.A

Authors
  1. Jennifer A. Linde Ph.D.
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  2. Gregory E. Simon M.D., M.P.H
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  3. Evette J. Ludman Ph.D.
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  4. Laura E. Ichikawa M.S
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  5. Belinda H. Operskalski M.P.H
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  6. David Arterburn M.D.
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  7. Paul Rohde Ph.D.
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  8. Emily A. Finch M.A
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  9. Robert W. Jeffery Ph.D.
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Corresponding author

Correspondence to Jennifer A. Linde Ph.D..

Appendix

Appendix

Session topics: weight loss only and combined weight loss/depression group visits

Session

Weight loss only (90-min sessions)

Combined weight loss/depression (120-min sessions)

1

Orientation: group norms, introduction to self-monitoring, behavior change processes

Orientation: group norms, introduction to self-monitoring, behavior change processes, relation between depression and weight

2

Energy balance and healthy food choices

Energy balance and healthy food choices

3

Diet quality: Fat and cholesterol

Pleasant activities and depression I

4

High fiber, low fat eating

Pleasant activities and depression II

5

Increasing physical activity

Increasing physical activity

6

Lifestyle exercise

Lifestyle exercise, barriers to exercise

7

Barriers to exercise

Relaxation training

8

Eating patterns

Problem solving I

9

Eating in social situations

Problem solving II

10

Eating in restaurants

Eating patterns, eating in social situations, eating in restaurants

11

Re-evaluating diet and exercise goals I

Re-evaluating diet and exercise goals I

12

Re-evaluating diet and exercise goals II

Re-evaluating diet and exercise goals II

13

Stress and eating

Cognitive goals: monitoring thinking

14

Fad diets, weight loss medications, surgery for weight loss

Cognitive techniques: what’s the evidence?

15

Cues for eating and exercise

Cognitive techniques: thought balancing

16

Advanced diet change

Advanced diet change

17

Advanced exercise change

Advanced exercise change

18

Assertion and eating

Social skills and assertiveness I

19

High risk situations

Social skills and assertiveness II

20

Managing slips and lapses

Managing slips and lapses

21

Summing up

Summing up

22

Long-term self-care plan

Long-term self-care plan

23

Monthly check-in: review and reinforcement (diet and exercise; goals and motivation; plans for next month), ad hoc session content determined by group members

Monthly check-in: review and reinforcement (diet, exercise, pleasant activities, and thought balancing; goals and motivation; plans for next month), ad hoc session content determined by group members

24–26

Same as session 23

Same as session 23

  1. For both interventions, sessions 1–16 were held weekly, sessions 17–22 were held biweekly, and sessions 23–26 were held monthly. Topics that are unique to the combined weight loss/depression program are highlighted in bold text

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Linde, J.A., Simon, G.E., Ludman, E.J. 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. 41, 119–130 (2011). https://doi.org/10.1007/s12160-010-9232-2

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  • DOI: https://doi.org/10.1007/s12160-010-9232-2

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