Studies Look at Ways to Reduce Depressive Episodes in Obese

For overweight adults with depression, daily multinutrient supplements and individual or group therapy sessions do not reduce major depressive disorder (MDD) episodes over one year, but an integrated intervention appears to be beneficial, according to two studies published in the March 5 issue of the Journal of the American Medical Association.

Mariska Bot, Ph.D., from Vrije Universiteit Amsterdam, and colleagues randomly assigned 1,025 overweight adults with elevated depressive symptoms and no MDD episode in the previous six months to daily multinutrient supplements versus placebo and 21 individual or group therapy sessions versus none. The researchers found that 10 percent of participants developed MDD during follow-up: 9.7, 10.2, 12.5, and 8.6 percent in the placebo without therapy, placebo with therapy, supplement without therapy, and supplement with therapy groups, respectively. MDD onset was not affected by any of the treatment strategies.

Jun Ma, M.D., Ph.D., from the University of Illinois in Chicago, and colleagues enrolled 409 adults with a body mass index (BMI) of 30 kg/m² or greater and nine-item Patient Health Questionnaire scores of ≥10 to either an intervention that integrated behavioral weight loss treatment with problem-solving therapy for depression and antidepressant medications if indicated or usual care. The researchers found that at 12 months, the mean BMI declined from 36.7 to 35.9 among intervention participants and remained unchanged at 36.6 among usual care participants (between-group mean difference, −0.7). The mean 20-item Depression Symptom Checklist scores declined from 1.5 to 1.1 and from 1.5 to 1.4, respectively (between-group mean difference, −0.02).

"A collaborative care intervention integrating behavioral weight loss treatment, problem-solving therapy, and as-needed antidepressant medications significantly improved weight loss and depressive symptoms at 12 months compared with usual care," Ma and colleagues write.

Several authors from the Bot study disclosed financial ties to the pharmaceutical industry; one author receives royalties for a therapy manual and honorarium for running workshops related to cognitive behavioral therapy.

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