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Weight loss improved depression symptoms in obese people
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A mean weight loss of 8.4% for obese participants in a one-year randomized trial was significantly associated with a reduction in Beck Depression Inventory II scores, according to recent data published in the journal Obesity. Scores fell from a mean 8.1 at baseline to 6.2 at week 52.
“For the majority of people in this study, as they lost weight they showed improvements in their symptoms of depression, which is good news,” Lucy F. Faulconbridge, PhD, research associate at the University of Pennsylvania School of Medicine in the Center for Weight and Eating Disorders, told Endocrine Today. “What was interesting was the significant minority of people, about 13%, who showed a significant worsening of symptoms of depression and we need to know why — what is different about these people and why are they more susceptible to their mood worsening than others?”
Faulconbridge and colleagues selected 194 obese participants (162 women and 32 men) from a one-year randomized weight-loss trial of lifestyle modification and medication therapy.
Participants were randomly assigned to one of four treatment options: lifestyle modification (n=47), sibutramine (Meridia, Abbott) (n=45), a combination of lifestyle modification and sibutramine therapy (n=53) or sibutramine plus brief therapy (n=49). Participants were then asked to complete the Beck Depression Inventory II at baseline, and at weeks six, 10, 18, 26, 40 and 52.
Weight loss and depression symptoms
At one year, participants in the combined lifestyle modification and sibutramine therapy group lost the most amount of weight (12.1±8.8%), followed by those in the lifestyle modification alone group (7.8±8.0%), sibutramine plus brief therapy group (7.7±6.9%) and those in the sibutramine alone group (5.5±6.5%).
Researchers found a significant difference in mean weight loss between the combined therapy group and the sibutramine alone group (P<.01).
Although minimal symptoms of depression were found for all participants at baseline (mean BDI value of 8.1±6.9), mean BDI score for all treatment groups declined at week 52 (6.2±7.7). Scores declined significantly as a function of time (P<.001), but there were no significant differences between treatment groups.
In addition, there were no significant differences between the treatment groups in changes in BDI scores from baseline to weeks six, 10, 18, 26 or 40, but significant reductions were found at all time points for all groups (P<.001).
At week 52, 35.6% of participants across the treatment groups experienced decreases in depression symptoms; however, 13.9% of participants across all treatment groups had discernable increases — ≥5 points on the BDI-II — in depression symptoms. More participants in the sibutramine plus brief therapy group reported increases in depression symptoms compared with the other three groups (22.5%; P<.05)
“We can tentatively conclude that weight loss does not necessarily worsen mood,” Faulconbridge said. “The data show that, for the majority, weight loss that is supervised properly and is undertaken with proper dietary and prescription medications can be safely undertaken by obese people (in that it does not lead to worsening of depression symptoms). However, if we can identify the clinical characteristics of those people that did show worsening symptoms of depression, then we will be better able to develop appropriate interventions to treat these people.” – by Jennifer Southall
Faulconbridge L. Obesity. 2009;175:1009-1016.