Reliable change in depression during behavioral weight loss treatment among women with major depression

UMMS Affiliation

Department of Medicine, Division of Preventive and Behavioral Medicine; Department of Quantitative Health Sciences

Publication Date


Document Type



Behavior and Behavior Mechanisms | Community Health and Preventive Medicine | Epidemiology | Health Services Research | Mental Disorders | Women's Health


OBJECTIVE: Although behavioral weight loss interventions generally have been shown to improve depressive symptoms, little is known as to whether some people with major depressive disorder experience worsening of depression during a weight loss intervention.

DESIGN AND METHODS: Rates and predictors of change in depression symptoms among 148 obese women with major depressive disorder who participated in a trial comparing depression treatment plus behavioral weight loss treatment (Behavioral Activation; BA) to behavioral weight loss treatment alone (Lifestyle Intervention; LI) were examined. a statistically reliable change in depression was calculated as >/=9 points on the beck depression inventory in this sample.

RESULTS: At 6 months, 73% of participants in BA and 54% of participants in LI showed reliable improvement in depression symptoms and 1.5% of participants in BA and 1.3% of participants in LI showed reliable worsening in depression symptoms. Rates of reliable change were similar at 12 months. Participants who experienced reliable improvement in depression lost significantly more weight than those who did not in both conditions. In the LI condition, baseline psychiatric variables and change in physical activity during treatment were also related to reliable improvement in depression.

CONCLUSION: No evidence for an iatrogenic effect of behavioral weight loss treatment on depressive symptoms among obese women with major depressive disorder was detected; rather, behavioral weight loss treatment appears to be associated with significant concurrent improvement in depression. Even greater rates of reliable improvement were observed when depression treatment was added to weight loss treatment.

DOI of Published Version



Busch, A. M., Whited, M. C., Appelhans, B. M., Schneider, K. L., Waring, M. E., DeBiasse, M. A., Oleski, J. L., Crawford, S. L. and Pagoto, S. L. (2013), Reliable change in depression during behavioral weight loss treatment among women with major depression. Obesity, 21: E211–E218. doi: 10.1002/oby.20113. Link to article on publisher's site

Journal/Book/Conference Title

Obesity (Silver Spring, Md.)

PubMed ID


Related Resources

Link to Article in PubMed